{\rtf1{\fonttbl {\f2 Times New Roman Bold;} {\f3 Times New Roman;} {\f4 Arial Bold;} {\f5 Arial;} {\f6 Times New Roman;} {\f7 Times New Roman Italic;} {\f8 Times New Roman;} {\f9 Times New Roman;} {\f10 Times New Roman Italic;} {\f11 Times New Roman;} {\f12 Times New Roman Italic;} {\f13 Times New Roman;} {\f14 Symbol;} {\f15 Times New Roman;} {\f16 Times New Roman;} {\f17 Times New Roman;} {\f18 Times New Roman;} {\f19 Times New Roman;} {\f1000000 Times New Roman;} }{\colortbl; \red0\green0\blue0; \red0\green0\blue0; \red0\green0\blue0; \red0\green0\blue0; \red0\green0\blue0; \red0\green0\blue0; \red255\green0\blue0; \red0\green0\blue255; \red0\green0\blue0; \red0\green0\blue0; \red0\green0\blue0; \red0\green0\blue0; \red0\green0\blue0; \red0\green0\blue255; \red0\green0\blue0; \red0\green0\blue255; \red0\green0\blue0; \red0\green0\blue255; }\viewkind1\viewscale100\margl0\margr0\margt0\margb0\deftab80\dntblnsbdb\expshrt n\paperw12240\paperh18720\pard\sb0\sl-240{\bkmkstart Pg1}{\bkmkend Pg1}\par\pard \ql \li5906\sb0\sl-276\slmult0 \par\pard\ql\li5906\sb0\sl-276\slmult0 \par\pard\ ql\li5906\sb0\sl-276\slmult0 \par\pard\ql\li5906\sb0\sl-276\slmult0 \par\pard\ql \li5906\sb0\sl-276\slmult0 \par\pard\ql\li5906\sb0\sl-276\slmult0 \par\pard\ql\l i5906\sb75\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\f s24 BAB I \par\pard\ql \li5291\sb144\sl-276\slmult0 \up0 \expndtw-4\charscalex10 0 PENDAHULUAN \par\pard\ql \li1984\sb0\sl-276\slmult0 \par\pard\ql\li1984\sb0\sl -276\slmult0 \par\pard\ql\li1984\sb0\sl-276\slmult0 \par\pard\ql\li1984\sb136\sl -276\slmult0\tx2344 \up0 \expndtw-4\charscalex100 A. \tab \up0 \expndtw-3\charsc alex100 Latar Belakang \par\pard\qj \li2344\ri1559\sb11\sl-413\slmult0\fi840 \up 0 \expndtw0\charscalex101 \ul0\nosupersub\cf2\f3\fs24 Agar dapat mempertahanka n kesehatan dan kehidupannya, manusia \line \up0 \expndtw0\charscalex103 mem butuhkan cairan dan elektrolit dalam jumlah dan proporsi yang tepat \li ne \up0 \expndtw-1\charscalex100 diberbagai jaringan tubuh hal ini disebut denga n serangkaian manuver fisika kimia \line \up0 \expndtw0\charscalex100 yang komp leks. Air menempati proporsi yang besar dalam tubuh seseorang \line \up0 \expndtw0\charscalex108 dengan berat badan 70 kg bisa memiliki sekitar 50 liter air dalam tubuhnya. \line \up0 \expndtw0\charscalex102 Faktor-faktor yang mempe ngaruhi keseimbangan cairan dan elektrolit yaitu usia \line \up0 \expndtw-1\char scalex100 fariasi usia berkaitan dengan luas permukaan tubuh, metabolisme yang d

iperlukan \line \up0 \expndtw0\charscalex106 dan berat badan. Temperatur lingkun gan panas yang berlebih mengakibatkan \line \up0 \expndtw0\charscalex100 berkeri ngat, seseorang dapat kehilangan NaCl melalui keringat sebanyak 15 - 30 \line \u p0 \expndtw0\charscalex104 gram/hari. Diet pada saat tubuh kekurangan nutr isi, tubuh akan memecah \line \up0 \expndtw0\charscalex100 cadangan energi, p roses ini akan menimbulkan pergerakan cairan dari intestial ke \line \up0 \expnd tw0\charscalex100 intra seluler. Stress dapat menimbulkan peningkatan metabolism e sel, konsentrasi \line \up0 \expndtw-1\charscalex100 darah dan glikolisin otot . Mekanisme ini dapat menimbulkan referensi sodium dan \line \up0 \expndtw-1\cha rscalex100 air proses ini dapat meningkatkan produksi ADH dan menurunkan produk si urine. \par\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb273\sl-276\slmul t0\fi0\tx2344 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf1\f2\fs24 B.\tab \ up0 \expndtw-1\charscalex100 Tujuan\par\pard\ql \li2344\sb116\sl-276\slmult0 \up 0 \expndtw0\charscalex102 \ul0\nosupersub\cf2\f3\fs24 1.\ul0\nosupersub\cf4\f5\f s24 \ul0\nosupersub\cf2\f3\fs24 Tujuan umum \par\pard\qj \li2704\ri1561\sb26\s l-420\slmult0 \up0 \expndtw0\charscalex100 Mahasiswa dapat asuhan keperawatan pa da pasien sesuai dengan manajemen \up0 \expndtw-3\charscalex100 keperawatan menu rut Helen Varney. \par\pard\ql \li2344\sb99\sl-276\slmult0 \up0 \expndtw0\charsc alex100 2.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Tujuan Khusu s \par\pard\li2704\sb156\sl-276\slmult0\fi0\tx8083 \up0 \expndtw0\charscalex101 Setelah dilakukan asuhan keperawatan pada Ny.\tab \up0 \expndtw0\charscalex 101 \u8221?A\u8221? dengan Hemoroid\par\pard\li2704\sb139\sl-276\slmult0\fi0 \ up0 \expndtw0\charscalex101 diharapkan mahasiswa mampu.\par\pard\ql \li2704\sb13 7\sl-276\slmult0 \up0 \expndtw-1\charscalex100 a.\ul0\nosupersub\cf4\f5\fs24 \u l0\nosupersub\cf2\f3\fs24 Melakukan pengkajian data \par\pard\ql \li2704\sb124\ sl-276\slmult0 \up0 \expndtw-2\charscalex100 b.\ul0\nosupersub\cf4\f5\fs24 \ul0 \nosupersub\cf2\f3\fs24 Mengidentifikasi diagnosa masalah dan kebutuhan \par\pa rd\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c.\ul0\nosupers ub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Merumuskan suatu tindakan yang komp rehensif \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw-2\charscalex100 d.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Melaksanakan suatu tindakan sesuai rencana \par\pard\ql \li2704\sb124\sl-276\slmult0 \up0 \expndtw2\charscalex100 e.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Meng evaluasi pelaksanaan asuhan kebidanan \par\pard\sect\sectd\fs24\paperw12240\pape rh18720\pard\sb0\sl-240{\bkmkstart Pg2}{\bkmkend Pg2}\par\pard\li1984\sb0\sl-276 \slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\p ar\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li 1984\sb0\sl-276\slmult0\par\pard\li1984\sb83\sl-276\slmult0\fi0\tx2344 \up0 \exp ndtw-1\charscalex100 \ul0\nosupersub\cf1\f2\fs24 C.\tab \up0 \expndtw-1\charscal ex100 Manfaat Penulis\par\pard\ql \li2344\sb116\sl-276\slmult0 \up0 \expndtw0\ch arscalex102 \ul0\nosupersub\cf2\f3\fs24 a.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosu persub\cf2\f3\fs24 Bagi klien \par\pard\qj \li2704\ri1561\sb26\sl-420\slmult0 \ up0 \expndtw0\charscalex101 Agar mereka mengetahui bahwa hemoroid merupakan masa lah dalam tubuh \up0 \expndtw-3\charscalex100 karena dapat mempertinggi resiko i nfeksi \par\pard\ql \li2344\sb99\sl-276\slmult0 \up0 \expndtw0\charscalex100 b.\ ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Bagi penulis \par\pard\ qj \li2704\ri1562\sb26\sl-420\slmult0 \up0 \expndtw0\charscalex106 Mendapat peng alaman serta dapat menerapkan teori manajemen menurut \up0 \expndtw-3\charscalex 100 Helen Varney dalam praktik kebidanan \par\pard\ql \li2344\sb119\sl-276\slmul t0 \up0 \expndtw0\charscalex101 c.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\c f2\f3\fs24 Bagi institusi \par\pard\qj \li2704\ri1559\sb6\sl-420\slmult0 \up0 \ expndtw0\charscalex102 Sebagai bahan kepustakan bai yang membutuhkan asuhan kepe rawatan dan \up0 \expndtw-3\charscalex100 perbandingan pada penanganan kasus hem oroid. \par\pard\ql \li1984\sb0\sl-276\slmult0 \par\pard\ql\li1984\sb263\sl-276\ slmult0\tx2344 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs24 D. \tab \up0 \expndtw-3\charscalex100 Cara pengumpulan data \par\pard\ql \li2344\sb124\ sl-276\slmult0 \up0 \expndtw0\charscalex101 \ul0\nosupersub\cf2\f3\fs24 a.\ul0\n osupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Wawancara \par\pard\ql \li27 04\sb144\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Wawancara langsung dengan pasien \par\pard\ql \li2344\sb124\sl-276\slmult0 \up0 \expndtw-1\charscalex100 b

.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Studi dokumentasi \pa r\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Melengkapi data sesuai dengan format yang ada \par\pard\ql \li2344\sb144\sl-276\slmult0 \up 0 \expndtw0\charscalex102 c.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\ fs24 Observasi \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw-3\charsc alex100 Melakukan pengamatan langsung dan pemeriksaan fisik pada pasien \par\par d\sect\sectd\fs24\paperw12240\paperh18720\pard\sb0\sl-240{\bkmkstart Pg3}{\bkmke nd Pg3}\par\pard\ql \li5860\sb0\sl-276\slmult0 \par\pard\ql\li5860\sb0\sl-276\sl mult0 \par\pard\ql\li5860\sb0\sl-276\slmult0 \par\pard\ql\li5860\sb0\sl-276\slmu lt0 \par\pard\ql\li5860\sb0\sl-276\slmult0 \par\pard\ql\li5860\sb0\sl-276\slmult 0 \par\pard\ql\li5860\sb75\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nos upersub\cf1\f2\fs24 BAB II \par\pard\ql \li4996\sb144\sl-276\slmult0 \up0 \expnd tw-4\charscalex100 TINJAUAN PUSTAKA \par\pard\ql \li3801\sb124\sl-276\slmult0 \u p0 \expndtw-4\charscalex100 KEBUTUHAN CAIRAN DAN ELEKTROLIT \par\pard\li1984\sb0 \sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\sl mult0\par\pard\li1984\sb155\sl-276\slmult0\fi0\tx2344 \up0 \expndtw-1\charscalex 100 A.\tab \up0 \expndtw-1\charscalex100 Definisi\par\pard\qj \li2344\ri1559\sb1 1\sl-415\slmult0\fi720 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf2\f3\fs24 Kebutuhan cairan dan elektrolit adalah suatu proses dinamik karena \line \up0 \expndtw0\charscalex100 metabolisme tubuh membutuhkan perubahan yang tetap dalam berespon terhadap \line \up0 \expndtw0\charscalex107 stressor fisiologis dan lingkungan. Cairan dan elektrolit saling berhubungan, \line \up0 \expndtw0\c harscalex100 ketidakseimbangan yang terdiri sendiri jarang terjadi dalam bentuk kelebihan dan \line \up0 \expndtw-3\charscalex100 kekurangan. (Kebutuhan Dasar M anusia, Tarwoto dan Martonah, 2003 : 29) \par\pard\qj \li2344\ri1559\sb0\sl-416\ slmult0\fi719 \up0 \expndtw0\charscalex103 Agar dapat mempertahankan keseh atan dan kehidupan, manusia \up0 \expndtw0\charscalex108 membutuhkan caira n dan elektrolit dalam jumlah dan proporsi yang tepat di \up0 \expndtw0\charscal ex100 berbagai jaringan tubuh hal ini disebut dengan serangkaian manuver fisika kimia \up0 \expndtw-1\charscalex100 yang komplek. Air menempati proporsi yang be sar dalam tubuh seseorang dengan \up0 \expndtw0\charscalex106 berat badan 70 kg bisa memiliki sekitar 50 l air dalam tubuhnya. (Kebutuhan \up0 \expndtw-3\charsc alex100 Dasar Manusia, Wahid Iqbal Mubarok, 2007 : 70) \par\pard\ql \li1984\sb0\ sl-276\slmult0 \par\pard\ql\li1984\sb109\sl-276\slmult0\tx2344 \up0 \expndtw-4\c harscalex100 \ul0\nosupersub\cf1\f2\fs24 B. \tab \up0 \expndtw-3\charscalex100 F aktor-faktor yang mempengaruhi keseimbangan cairan dan elektrolit \par\pard\ql \ li2344\sb124\sl-276\slmult0 \up0 \expndtw0\charscalex105 \ul0\nosupersub\cf2\f3\ fs24 a.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Usia \par\pard\ qj \li2704\ri1559\sb42\sl-400\slmult0 \up0 \expndtw0\charscalex102 Variasi usia berkaitan dengan luas permukaan tubuh, metabolisme yang \up0 \expndtw-3\ charscalex100 diperlukan dan berat badan. \par\pard\ql \li2344\sb123\sl-276\slmu lt0 \up0 \expndtw-1\charscalex100 b.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub \cf2\f3\fs24 Temperatur lingkungan \par\pard\qj \li2704\ri1564\sb26\sl-420\slmu lt0 \up0 \expndtw0\charscalex104 Panas yang berlebih menyebabkan berkeringat, se seorang dapat kehilangan \up0 \expndtw-2\charscalex100 NaCl melalui keringat seb anyak 15 - 30 g/hari \par\pard\ql \li2344\sb99\sl-276\slmult0 \up0 \expndtw0\cha rscalex105 c.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Diet \par \pard\qj \li2704\ri1561\sb26\sl-420\slmult0 \up0 \expndtw0\charscalex104 Pada sa at tubuh kekurangan nutrisi, tubuh akan memecah cadangan energi, \line \up0 \exp ndtw-2\charscalex100 proses ini akan menimbulkan pergerakan cairan dari intersti al ke intraseluler. \par\pard\ql \li2344\sb99\sl-276\slmult0 \up0 \expndtw0\char scalex102 d.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Stress \pa r\pard\qj \li2704\ri1559\sb31\sl-413\slmult0 \up0 \expndtw-1\charscalex100 Stres s dapat menimbulkan peningkatan metabolisme sel, konsentrasi darah dan \up0 \exp ndtw0\charscalex107 glikolisis otot. Mekanisme ini dapat menimbulkan retensi sod ium dan air \up0 \expndtw0\charscalex103 proses ini dapat meningkatkan produksi ADH. (Kebutuhan Dasar Manusia, \up0 \expndtw-3\charscalex100 Wahid Iqbal Mubarok , 2007 : 71) \par\pard\ql \li1984\sb0\sl-276\slmult0 \par\pard\ql\li1984\sb125\s l-276\slmult0\tx2344 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs24 C . \tab \up0 \expndtw-3\charscalex100 Pengaturan Volume Cairan \par\pard\qj \li23

44\ri1560\sb6\sl-420\slmult0\fi719 \up0 \expndtw0\charscalex102 \ul0\nosupersub\ cf2\f3\fs24 Keseimbangan cairan dalam tubuh dihitung dalam keseimbangan antara \ up0 \expndtw-3\charscalex100 jumlah cairan yang masuk dan jumlah cairan yang kel uar. \par\pard\sect\sectd\fs24\paperw12240\paperh18720\pard\sb0\sl-240{\bkmkstar t Pg4}{\bkmkend Pg4}\par\pard\li2344\sb0\sl-276\slmult0\par\pard\li2344\sb0\sl-2 76\slmult0\par\pard\li2344\sb0\sl-276\slmult0\par\pard\li2344\sb0\sl-276\slmult0 \par\pard\li2344\sb0\sl-276\slmult0\par\pard\li2344\sb0\sl-276\slmult0\par\pard\ li2344\sb83\sl-276\slmult0\fi0\tx2704 \up0 \expndtw-1\charscalex100 \ul0\nosuper sub\cf1\f2\fs24 a.\tab \up0 \expndtw-1\charscalex100 Asupan Cairan\par\pard\qj \ li2704\ri1561\sb0\sl-420\slmult0\fi719 \up0 \expndtw-1\charscalex100 \ul0\nosupe rsub\cf2\f3\fs24 Asupan cairan untuk kondisi normal pada orang dewasa adalah \ul 0\nosupersub\cf15\f16\fs24\ul +\ul0\nosupersub\cf2\f3\fs24 2500 \line \up0 \exp ndtw0\charscalex101 cc/hari, asupan cairan dapat berlangsung berupa cairan \up0 \expndtw0\charscalex102 / ditambah dari \par\pard\qj \li2704\ri1561\sb3\ sl-415\slmult0 \up0 \expndtw0\charscalex100 makanan lain. Pengaturan mekanisme k eseimbangan cairan ini menggunakan \line \up0 \expndtw0\charscalex111 mekanisme haus yang berpusat pada hipotalamus. Apabila terjadi \line \up0 \expndtw0 \charscalex102 ketidakseimbangan cairan tubuh dimana asupan kurang/adanya perdar ahan, \line \up0 \expndtw0\charscalex104 maka curah jantung menurun, menyebabkan terjadinya penurunan tekanan \line \up0 \expndtw-3\charscalex100 darah. \par\pa rd\ql \li2344\sb120\sl-276\slmult0\tx2704 \up0 \expndtw-3\charscalex100 \ul0\nos upersub\cf1\f2\fs24 b. \tab \up0 \expndtw-3\charscalex100 Pengeluaran cairan \pa r\pard\qj \li2704\ri1560\sb10\sl-414\slmult0\fi720 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf2\f3\fs24 Pengeluaran cairan sebagai bagian dalam mengimbangi asupan cairan \line \up0 \expndtw0\charscalex100 pada orang dewasa, dalam kondis i normal adalah \ul0\nosupersub\cf15\f16\fs24\ul +\ul0\nosupersub\cf2\f3\fs24 2 300 cc. Jumlah air yang \line \up0 \expndtw0\charscalex103 paling banyak keluar berasal dari ekskresi ginjal (berupa urine), sebanyak \ul0\nosupersub\cf15\f16\f s24\ul + \line \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf2\f3\fs24 1500 cc/ hari pada orang dewasa. Hal ini juga dihubungkan dengan banyaknya \line \up0 \ex pndtw0\charscalex109 asupan air melalui mulut dan pengeluaran air dari ginjal mu dah diukur. \line \up0 \expndtw0\charscalex100 Pengeluaran cairan dapat dilakuka n pula melalui kulit dan saluran pencernaan \line \up0 \expndtw0\charscalex108 ( berupa feses). Pengeluaran cairan dapat dikategorikan pula sebagai \line \up0 \expndtw0\charscalex100 pengeluaran cairan yang tidak dapat diukur, khususn ya pasien luka bakar atau \line \up0 \expndtw-1\charscalex100 luka besar lainnya , jumlah pengeluaran cairan (melalui penguapan) meningkat \line \up0 \expndtw0\c harscalex106 sehingga sulit diukur. Pada kasus seperti ini bila volume urine yang \line \up0 \expndtw-3\charscalex100 dikeluarkan < 500 cc/hari. Diper lukan adanya perhatian khusus. \par\pard\ql \li3424\sb120\sl-276\slmult0 \up0 \e xpndtw-3\charscalex100 Hasil-hasil pengeluaran cairan adalah : \par\pard\ql \li2 704\sb124\sl-276\slmult0 \up0 \expndtw0\charscalex102 1.\ul0\nosupersub\cf4\f5\f s24 \ul0\nosupersub\cf2\f3\fs24 Urine \par\pard\qj \li3064\ri1559\sb30\sl-415\ slmult0 \up0 \expndtw-1\charscalex100 Pembentukan urine terjadi di ginjal dan di keluarkan melalui vesika urinaria \up0 \expndtw0\charscalex105 (kandung kemih). Proses ini merupakan proses pengeluaran tubuh yan \up0 \expndtw0\charscalex103 u tama. Cairan dalam ginjal disaring pada glomerulus dan dalam tubulus \up0 \expnd tw0\charscalex103 ginjal untuk kemudian diserap kembali ke dalam aliran darah hasil \up0 \expndtw-3\charscalex100 ekskresi. Terakhir proses ini adalah urine. \par\pard\qj \li3064\ri1562\sb10\sl-410\slmult0 \up0 \expndtw0\charscalex 107 Jika terjadi penurunan volume dalam sirkulasi darah, reseptor atrium \line \ up0 \expndtw-2\charscalex100 jantung kiri dan kanan mengirim impuls ke otak, kem udian otak kembali ke \line \up0 \expndtw-3\charscalex100 ginjal dan memroduksi ADH sehingga mempengaruhi pengeluaran urine. \par\pard\ql \li2704\sb121\sl-276\s lmult0 \up0 \expndtw0\charscalex101 2.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupers ub\cf2\f3\fs24 Keringat \par\pard\qj \li3064\ri1559\sb6\sl-420\slmult0 \up0 \ex pndtw0\charscalex102 Keringat terbentuk bila tubuh menjadi panas akibat pengaruh suhu yang \line \up0 \expndtw0\charscalex104 panas. Keringat banyak mengandung garam, urea, asam laktat, dan ion \line \up0 \expndtw-3\charscalex100 kalium. \p ar\pard\sect\sectd\fs24\paperw12240\paperh18720\pard\sb0\sl-240{\bkmkstart Pg5}{

\bkmkend Pg5}\par\pard\ql \li2704\sb0\sl-276\slmult0 \par\pard\ql\li2704\sb0\sl276\slmult0 \par\pard\ql\li2704\sb0\sl-276\slmult0 \par\pard\ql\li2704\sb0\sl-27 6\slmult0 \par\pard\ql\li2704\sb0\sl-276\slmult0 \par\pard\ql\li2704\sb0\sl-276\ slmult0 \par\pard\ql\li2704\sb75\sl-276\slmult0 \up0 \expndtw0\charscalex104 \ul 0\nosupersub\cf2\f3\fs24 3.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\f s24 Feses \par\pard\qj \li3064\ri1561\sb6\sl-420\slmult0 \up0 \expndtw0\charsca lex109 Feses yang keluar mengandung air dan sisanya berbentuk padat. \li ne \up0 \expndtw0\charscalex105 Pengeluaran air melalui feses merupakan pengelar an cairan yang paling \line \up0 \expndtw0\charscalex106 sedikit jumlahnya. Ji ka cairan yang keluar melalui feses jumlahnya \par\pard\qj \li3064\ri1561\ sb0\sl-420\slmult0 \up0 \expndtw0\charscalex102 berlebihan, maka dapat mengakiba tkan tubuh menjadi lemas dengan rata\up0 \expndtw-1\charscalex100 rata pengeluar an cairan melalui feses adalah 100 mil/hari. \par\pard\ql \li2344\sb99\sl-276\sl mult0\tx2704 \up0 \expndtw-2\charscalex100 c. \tab \up0 \expndtw-1\charscalex100 Pergerakan cairan tubuh \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw -1\charscalex100 Mekanisme pengeluaran cairan tubuh melalui 3 proses yaitu : \pa r\pard\ql \li2704\ri1559\sb11\sl-413\slmult0\tx3064\tx3064\tx3064 \up0 \expndtw0 \charscalex103 a)\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Difus i adalah proses dimana partikel yang terdapat dalam cairan bergerak \line\tab \u p0 \expndtw0\charscalex100 dari konsentrasi tinggi ke konsentrasi rendah sampai terjadi keseimbangan. \line\tab \up0 \expndtw0\charscalex102 Cairan dan elektrol it didfusikan menembus membran sel, kecepatan difusi \line\tab \up0 \expndtw-1\c harscalex100 dipengaruhi oleh ukuran molekul, konsentrasi larutan dan konsentras i. \par\pard\ql \li2704\ri1559\sb10\sl-410\slmult0\tx3064\tx3064 \up0 \expndtw0\ charscalex105 b)\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Osmosi s adalah bergeraknya pelarut bersih seperti air, melalui membran \line\tab \up0 \expndtw0\charscalex100 semi permiebel dari larutan yang berkonsentrasi lebih re ndah kekonsentrasi \line\tab \up0 \expndtw-1\charscalex100 lebih tinggi yang sif atnya menarik. \par\pard\ql \li2704\ri1562\sb2\sl-420\slmult0\tx3064\tx3064 \up0 \expndtw0\charscalex108 c)\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\f s24 Transport aktif, bahan bergerak dari konsentrasi rendah ke konsentrasi \lin e\tab \up0 \expndtw-1\charscalex100 tinggi karena adanya daya tarik dari tubuh s eperti pompa jantung \line \tab \up0 \expndtw-1\charscalex100 (Kebutuhan Dasar M anusia, Wahid Iqbal Mubarok, 2007 : 72) \par\pard\ql \li1984\sb0\sl-276\slmult0 \par\pard\ql\li1984\sb243\sl-276\slmult0\tx2344 \up0 \expndtw-2\charscalex100 \u l0\nosupersub\cf1\f2\fs24 D. \tab \up0 \expndtw-1\charscalex100 Jenis Cairan \pa r\pard\ql \li2344\sb144\sl-276\slmult0 \up0 \expndtw0\charscalex102 \ul0\nosuper sub\cf2\f3\fs24 1.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Cair an nutrien \par\pard\qj \li2704\ri1559\sb10\sl-415\slmult0 \up0 \expndtw0\charsc alex102 Pasien yang istirahat di tempat tidur memerlukan sebanyak 450 kalori set iap \up0 \expndtw0\charscalex100 harinya, cairan nutrien (zat gizi) melalui intr avena dapat memenuhi kalori ini \up0 \expndtw0\charscalex108 dalam bentuk karb ohidrat, nitrogen dan vitamin yang penting untuk \up0 \expndtw0\charscalex 105 metabolisme, kalori yang terdapat pada cairan nutrien dapat berkisar 200 -\l ine \up0 \expndtw-3\charscalex100 1500 kalori / liter, cairan nutiren terdiri da ri. \par\pard\ql \li2704\ri1559\sb1\sl-420\slmult0\tx3064 \up0 \expndtw0\charsca lex102 a.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Karbohidrat d an air contoh : dextrose (glikosa), levalose (fruktosa) invert \line\tab \up0 \e xpndtw-3\charscalex100 (sugar) (1/2 dextrose dan levulose) \par\pard\ql \li2704\ sb99\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Asam amino, contoh : amigen, aminosol dan travanim \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c.\ul0\ nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Lemak contoh : lipomul dan liposyn \par\pard\ql \li2344\sb144\sl-276\slmult0 \up0 \expndtw-1\charscalex100 2.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Blood volume expende rs \par\pard\qj \li2704\ri1559\sb11\sl-413\slmult0 \up0 \expndtw0\charscalex105 Merupakan bagian dari jenis cairan yang berfungsi meningkatkan volume \up0 \expn dtw0\charscalex100 pembuluh darah setelah kehilangan darah atau plasma. Apabila keadaan darah \up0 \expndtw0\charscalex105 sudah tidak sesuai, misalnya pasien d alam kondisi perdarahan berat, maka \up0 \expndtw-3\charscalex100 pemberian plas

ma akan mempertahankan volume darah. \par\pard\sect\sectd\fs24\paperw12240\paper h18720\pard\sb0\sl-240{\bkmkstart Pg6}{\bkmkend Pg6}\par\pard\li1984\sb0\sl-276\ slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\pa r\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li1 984\sb0\sl-276\slmult0\par\pard\li1984\sb83\sl-276\slmult0\fi0\tx2344 \up0 \expn dtw0\charscalex100 \ul0\nosupersub\cf1\f2\fs24 E.\tab \up0 \expndtw0\charscalex1 00 Pengaturan elektrolit\par\pard\li1984\sb134\sl-276\slmult0\fi360\tx2704 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf2\f3\fs24 1.\tab \up0 \expndtw0\charsc alex100 Natrium (sodium)\par\pard\li1984\sb137\sl-276\slmult0\fi720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Merupakan kation pali ng banyak yang terdapat pada cairan ekstrasel\par\pard\li1984\sb139\sl-276\slmul t0\fi719\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Na\ul0\super\cf5\f6\fs24 +\ul0\nosupersub\cf2\f3\fs24 mempengaruhi keseimbangan air, hantaran impuls saraf dan konsentrasi\par\pard\li1984\sb137\sl-276\slmult0 \fi1080 \up0 \expndtw0\charscalex100 otot\par\pard\li1984\sb139\sl-276\slmult0\f i720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Sodi um diatur oleh intake garam, aldosteron dan pengeluaran urine\par\pard\l i1984\sb137\sl-276\slmult0\fi1080 \up0 \expndtw0\charscalex100 normalnya sekitar 35 - 45 mEg/lt\par\pard\li1984\sb137\sl-276\slmult0\fi360\tx2704 \up0 \expndtw0 \charscalex100 2.\tab \up0 \expndtw0\charscalex100 Kalium (Postassium)\par\pard\ li1984\sb139\sl-276\slmult0\fi720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Merupakan kation utama cairan intrasel\par\pard\li1984\ sb137\sl-276\slmult0\fi720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expnd tw0\charscalex100 Berfungsi sebagai excitability neuromuskuler dan kontraksi oto t\par\pard\li1984\sb139\sl-276\slmult0\fi720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Diperlukan untuk pembentukan glikogen, s intesa protein, pengaturan\par\pard\li1984\sb137\sl-276\slmult0\fi1080 \up0 \e xpndtw0\charscalex100 keseimbangan asam basa, karena ion K\ul0\super\cf5\f6\fs24 +\ul0\nosupersub\cf2\f3\fs24 dapat diubah menjadi ion hidrogen\par\pard\li1984 \sb139\sl-276\slmult0\fi360\tx2704 \up0 \expndtw0\charscalex100 3.\tab \up0 \exp ndtw0\charscalex100 Kalsium\par\pard\li1984\sb137\sl-276\slmult0\fi720 \up0 \exp ndtw0\charscalex100 Berguna untuk integritas kulit dan struktur sel, konduksi ja ntung, pembekuan\par\pard\li1984\sb139\sl-276\slmult0\fi720 \up0 \expndtw0\chars calex100 darah dan pembentukan tulang dan gigi.\par\pard\li1984\sb137\sl-276\slm ult0\fi360\tx2704 \up0 \expndtw0\charscalex100 4.\tab \up0 \expndtw0\charscalex1 00 Magnesium\par\pard\li1984\sb139\sl-276\slmult0\fi720\tx3064 \up0 \expndtw0\ch arscalex100 -\tab \up0 \expndtw0\charscalex100 Merupakan kation terbanyak kedua pada cairan intrasel\par\pard\li1984\sb137\sl-276\slmult0\fi720\tx3064 \up0 \exp ndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Sangat penting untuk akti vitas enzim neurochemia dan muscular excibility\par\pard\li1984\sb139\sl-276\slm ult0\fi1080 \up0 \expndtw0\charscalex100 nilai normalnya sekitar 1,5 - 2,5 mEg / liter\par\pard\li1984\sb137\sl-276\slmult0\fi360\tx2704 \up0 \expndtw0\charscal ex100 5.\tab \up0 \expndtw0\charscalex100 Chlorida\par\pard\li1984\sb139\sl-276\ slmult0\fi720 \up0 \expndtw0\charscalex100 Terdapat pada cairan ekstrasel dan in trasel normalnya sekitar 95 - 105 Eg/liter.\par\pard\li1984\sb137\sl-276\slmult0 \fi360\tx2704 \up0 \expndtw0\charscalex100 6.\tab \up0 \expndtw0\charscalex100 B ikarbonat\par\pard\li1984\sb139\sl-276\slmult0\fi720\tx3064 \up0 \expndtw0\chars calex100 -\tab \up0 \expndtw0\charscalex100 HCO\ul0\sub\cf5\f6\fs24 3\ul0\nosupe rsub\cf2\f3\fs24 adalah bufer kimia utama dalam tubuh dan terdapat pada cairan\ par\pard\li1984\sb137\sl-276\slmult0\fi1080 \up0 \expndtw0\charscalex100 ekstras el dan intrasel\par\pard\li1984\sb139\sl-276\slmult0\fi720\tx3064 \up0 \expndtw0 \charscalex100 -\tab \up0 \expndtw0\charscalex100 Bikarbonat diatur oleh ginjal\ par\pard\li1984\sb137\sl-276\slmult0\fi360\tx2704 \up0 \expndtw0\charscalex100 7 .\tab \up0 \expndtw0\charscalex100 Fosfat\par\pard\li1984\sb139\sl-276\slmult0\f i720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Meru pakan amnion buffer dalam cairan intrasel dan ekstrasel\par\pard\li1984\sb137\sl -276\slmult0\fi720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\char scalex100 Berfungsi untuk meningkatkan kegiatan neuromuskuler\par\pard\li1984\sb 139\sl-276\slmult0\fi720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw 0\charscalex100 Pengaturan oleh hormon parathyroid\par\pard\ql \li2704\sb129\sl-

276\slmult0 \up0 \expndtw-3\charscalex100 (Kebutuhan Dasar Manusia, Wahid Iqbal Mubarok, 2007 : 75) \par\pard\ql \li1984\sb144\sl-276\slmult0\tx2344 \up0 \expnd tw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 F. \tab \up0 \expndtw-3\charscale x100 Masalah Keseimbangan Cairan \par\pard\ql \li2344\sb124\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf2\f3\fs24 a.\ul0\nosupersub\cf4\f5\fs 24 \ul0\nosupersub\cf2\f3\fs24 Hipovolemi atau dehidrasi \par\pard\qj \li2704\ ri1559\sb31\sl-413\slmult0\fi719 \up0 \expndtw0\charscalex103 Kekurangan cairan eksternal terjadi karena penurunan asupan cairan \line \up0 \expndtw0\charscalex 100 dan kelebihan pengeluaran cairan. Tubuh akan merespons kekurangan cairan \li ne \up0 \expndtw0\charscalex102 tubuh dengan mengosongkan cairan vasculer s ebagai kompensasi akibat \line \up0 \expndtw0\charscalex102 penurunan cairan interstial, tubuh akan mengalirkan cairan keluar sel. \par\pard\sect\sect d\fs24\paperw12240\paperh18720\pard\sb0\sl-240{\bkmkstart Pg7}{\bkmkend Pg7}\par \pard\qj \li2704\sb0\sl-400\slmult0 \par\pard\qj\li2704\sb0\sl-400\slmult0 \par\ pard\qj\li2704\sb0\sl-400\slmult0 \par\pard\qj\li2704\sb0\sl-400\slmult0 \par\pa rd\qj\li2704\ri1559\sb29\sl-400\slmult0 \up0 \expndtw0\charscalex105 \ul0\nosupe rsub\cf2\f3\fs24 Pengosongan cairan ini terjadi pada pasien diare dan muntah. Ad a 3 macam \up0 \expndtw-1\charscalex100 kekurangan volume cairan interstial yait u : \par\pard\ql \li2704\sb123\sl-276\slmult0 \up0 \expndtw-7\charscalex100 1.\u l0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Dehidrasi isotonik, terj adi jika tubuh kehilangan sejumlah cairan secara seimbang \par\pard\ql \li2704\r i1561\sb42\sl-400\slmult0\tx3064 \up0 \expndtw0\charscalex106 2.\ul0\nosupersub\ cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Dehidrasi hipertonik, terjadi jika tubuh kehilangan lebih banyak air \line\tab \up0 \expndtw-1\charscalex100 d aripada elektrolit \par\pard\ql \li2704\ri1559\sb4\sl-420\slmult0\tx3064 \up0 \e xpndtw0\charscalex105 3.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Dehidrasi hipotonik, terjadi jika tubuh kehilangan lebih banyak elektrolit \li ne\tab \up0 \expndtw-1\charscalex100 dari pada air \par\pard\ql \li2704\sb119\sl -276\slmult0 \up0 \expndtw-1\charscalex100 Macam-macam dehidrasi berdasarkan der ajatnya : \par\pard\ql \li2704\sb124\sl-276\slmult0 \up0 \expndtw0\charscalex101 1.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Dehidrasi berat den gan ciri-ciri \par\pard\ql \li3064\sb144\sl-276\slmult0 \up0 \expndtw0\charscale x101 a.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Pengeluaran ata u kehilangan cairan sebanyak 4 - 6 liter \par\pard\ql \li3064\sb144\sl-276\slmul t0 \up0 \expndtw0\charscalex101 b.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\c f2\f3\fs24 Serum natrium mencapai 159 - 166 mEg/liter \par\pard\ql \li3064\sb12 4\sl-276\slmult0 \up0 \expndtw0\charscalex104 c.\ul0\nosupersub\cf4\f5\fs24 \ul 0\nosupersub\cf2\f3\fs24 Hipotensi \par\pard\ql \li3064\sb144\sl-276\slmult0 \u p0 \expndtw0\charscalex101 d.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3 \fs24 Turgor kulit gemuk \par\pard\ql \li3064\sb144\sl-276\slmult0 \up0 \expndt w0\charscalex105 e.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Oli guria \par\pard\ql \li3064\sb124\sl-276\slmult0 \up0 \expndtw0\charscalex101 f.\ ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Nadi dan pernapasan men ingkat \par\pard\ql \li3064\sb144\sl-276\slmult0 \up0 \expndtw-2\charscalex100 g .\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Kehilangan cairan men capai > 10% BB \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw-2\charsca lex100 2.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Dehidrasi sed ang, dengan ciri-ciri \par\pard\ql \li3064\sb144\sl-276\slmult0 \up0 \expndtw0\c harscalex100 a.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Kehilan gan cairan 2 - 4 liter atau antara 5 - 10% BB \par\pard\ql \li3064\sb124\sl-276\ slmult0 \up0 \expndtw-1\charscalex100 b.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupe rsub\cf2\f3\fs24 Serum natrium mencapai 152 - 158 mEg/liter \par\pard\ql \li306 4\sb144\sl-276\slmult0 \up0 \expndtw0\charscalex101 c.\ul0\nosupersub\cf4\f5\fs2 4 \ul0\nosupersub\cf2\f3\fs24 Mata cekung \par\pard\ql \li2704\ri1561\sb42\sl400\slmult0\tx3064 \up0 \expndtw0\charscalex100 3.\ul0\nosupersub\cf4\f5\fs24 \ ul0\nosupersub\cf2\f3\fs24 Dehidrasi ringan, dengan ciri-ciri kehilangan cairan mencapai 5% BB atau \line\tab \up0 \expndtw-1\charscalex100 1,5 - 2 liter \par\ pard\ql \li2344\sb123\sl-276\slmult0\tx2704 \up0 \expndtw-4\charscalex100 b. \ta b \up0 \expndtw-3\charscalex100 Hipervolume atau overdehidrasi \par\pard\qj \li2 704\ri1559\sb31\sl-413\slmult0\fi720 \up0 \expndtw0\charscalex105 Terdapat dua m

anifestasi yang ditimbulkan akibat kelebihan cairan \line \up0 \expndtw0\charsca lex103 yaitu hipervolume (peningkatan volume darah dan edema (kelebihan cairan \ line \up0 \expndtw0\charscalex106 pada interstial). Normalnya cairan interstial tidak terikat dengan air, tetapi \line \up0 \expndtw0\charscalex100 elsatsi dan hanya terdapat diantara jaringan, pitting edema merupakan edema \line \up0 \expn dtw0\charscalex104 yang berada pada darah perifer atau akan berbentuk cekung set elah ditekan \line \up0 \expndtw0\charscalex106 pada daerah yang bengkok, hal in i disebabkan oleh perpindahan cairan ke \line \up0 \expndtw0\charscalex105 jarin gan melalui titik tekan. Cairan dalam jaringan yang edema tidak \line \ up0 \expndtw0\charscalex100 digerakkan ke permukaan lain dengan penekanan jari. nonpitting edema tidak \line \up0 \expndtw-1\charscalex100 menunjukkan tanda kel ebihan cairan ekstrasel, tetapi sering karena infeksi dan \line \up0 \expndtw0\c harscalex104 trauma yang menyebabkan membekunay cairan pada permukaan jaringan. \line \up0 \expndtw0\charscalex100 Kelebihan cairan vasculer meningkatkan hidros tatik cairan dan akan menekan \line \up0 \expndtw0\charscalex104 cairan ke permu kaan interstitial. (Kebutuhan Dasar Manusiam Wahid Iqbal \line \up0 \expndtw-3\c harscalex100 Mubaroq, 2007 : 70) \par\pard\sect\sectd\fs24\paperw12240\paperh187 20\pard\sb0\sl-240{\bkmkstart Pg8}{\bkmkend Pg8}\par\pard\ql \li5534\sb0\sl-276\ slmult0 \par\pard\ql\li5534\sb0\sl-276\slmult0 \par\pard\ql\li5534\sb0\sl-276\sl mult0 \par\pard\ql\li5534\sb0\sl-276\slmult0 \par\pard\ql\li5534\sb0\sl-276\slmu lt0 \par\pard\ql\li5534\sb0\sl-276\slmult0 \par\pard\ql\li5534\sb75\sl-276\slmul t0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs24 HEMOROID \par\pard\ li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb8 \sl-276\slmult0\fi0\tx2344 \up0 \expndtw-2\charscalex100 A.\tab \up0 \expndtw-2\ charscalex100 Pengertian\par\pard\qj \li2344\ri1559\sb16\sl-412\slmult0\fi720 \u p0 \expndtw0\charscalex100 \ul0\nosupersub\cf2\f3\fs24 Hemoroid adalah bagian ve na yang berdilatasi dalam kanal anal. Hemoroid \up0 \expndtw0\charscalex108 sang at umum terjadi pada usia 50-an, 50% individu mengalami berbagai tipe \up0 \expn dtw0\charscalex100 hemoroid berdasarkan luasnya vena yang terkena. Kehamilan dik etahui mengalami \up0 \expndtw0\charscalex102 atau memperberat adanya hemoroid. Hemoroid diklasifikasikan menjadi dua tipe, \up0 \expndtw0\charscalex102 yaitu h emoroid internal, yaitu hemoroid yang terjadi diatas sfinter anal sedangkan \up0 \expndtw-1\charscalex100 yang muncul diluar sfingter anal disebut hemoroid ekst ernal. \par\pard\li1984\sb129\sl-276\slmult0\fi359 \up0 \expndtw-1\charscalex100 (Smoltzer,Suzzane C., \ul0\nosupersub\cf6\f7\fs24 Keperawatan Medical Bedah,\ul 0\nosupersub\cf2\f3\fs24 2002 : 55)\par\pard\li1984\sb144\sl-276\slmult0\fi0\tx 2344 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf1\f2\fs24 B.\tab \up0 \expn dtw-1\charscalex100 Manifestasi klinis\par\pard\qj \li2344\ri1559\sb1\sl-416\slm ult0\fi719 \up0 \expndtw0\charscalex104 \ul0\nosupersub\cf2\f3\fs24 Hemoroid men yebabkan rasa gatal dan nyeri, dan sering menyebabkan \up0 \expndtw-2\charscalex 100 perdarahan berwarna merah terang saat defekasi. Hemoroid eksternal dihubungk an \up0 \expndtw0\charscalex100 dengan nyeri hebat akibat inflamasi dan edema ya ng disebabkan oleh trombosisi. \up0 \expndtw-1\charscalex100 Trombosis adalah pe mbekuan darah dalam hemoroid ini dapat menimbulkan nyeri \up0 \expndtw0\charscal ex100 sampai hemoroid ini membesar dan menimbulkan iskemia pada urea tersebut da n \up0 \expndtw0\charscalex100 nekrosis. Hemoroid internal tidak selalu menimbuk an nyeri sampai hemoroid ini \up0 \expndtw-3\charscalex100 membesar dan menimbul kan perdarahan atau prolaps. \par\pard\li1984\sb115\sl-276\slmult0\fi359 \up0 \e xpndtw-1\charscalex100 (Smoltzer,Suzzane C., \ul0\nosupersub\cf6\f7\fs24 Keperaw atan Medical Bedah,\ul0\nosupersub\cf2\f3\fs24 2002 : 56)\par\pard\li1984\sb141 \sl-276\slmult0\fi0\tx2344 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf1\f2\ fs24 C.\tab \up0 \expndtw-1\charscalex100 Penatalaksanaan\par\pard\qj \li2344\ri 1559\sb19\sl-413\slmult0\fi720 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf2 \f3\fs24 Gejala hemoroid dan ketidaknyamanan dapat dihilangkan dengan hygiene \u p0 \expndtw0\charscalex102 personal yang baik dan menghindari mengejan berlebiha n selama devekasi. Diet \up0 \expndtw0\charscalex102 tinggi serat yang mengandun g buah sekam mungkin satu-satunya tindakan yang \up0 \expndtw-1\charscalex100 di perlukan : bila tindakan ini gagal, laksatif yang berfungsi mengobservasi air sa at \up0 \expndtw-1\charscalex100 melewati usus dapat membantu, rendah duduk deng an saleb, dan suposutoria yang \up0 \expndtw0\charscalex112 mengandung anestesi

astrigen dan tirah baring adalah tindakan yang \up0 \expndtw-3\charscale x100 memungkinkan pembesaran berkurang. \par\pard\ql \li3064\sb121\sl-276\slmult 0\tx4451 \up0 \expndtw-3\charscalex100 Terdapat \tab \up0 \expndtw0\charscalex11 0 berbagai tipe tindakan nonoperatif untuk hemoroid. \par\pard\qj \li2344\r i1559\sb6\sl-420\slmult0 \up0 \expndtw0\charscalex105 Fotokoagulasi inframerah, diatermi bipolar, untuk meletakkan mukosa ke otot \up0 \expndtw0\charscalex105 y ang mendasarnya. Injeksi larutan sklerosan juga efektif untuk hemoroid \ up0 \expndtw-3\charscalex100 berukuran kecil dan berdarah, prosedur ini mencegah prolaps. \par\pard\qj \li2344\ri1559\sb0\sl-415\slmult0\fi719 \up0 \expndtw0\ch arscalex102 Tindakan bedah konservatif hemoroid internal adalah prosedur ligasi pita \line \up0 \expndtw0\charscalex107 karet. Hemoroid dilihat melalui anosob d an bagian. Prolaksimal di atas garis \line \up0 \expndtw0\charscalex106 mukokuta n dipegang dengan alat pita karet kecil kemudian diselipkan di atas \line \up0 \ expndtw0\charscalex102 hemoroid. Bagian distal jaringan pada pita karet menjadi nekrotik beberapa hari \line \up0 \expndtw0\charscalex102 dan lepas. Terjadi fri bosis dan mengakibatkan mukosa anal bawah turun dan \par\pard\sect\sectd\fs24\pa perw12240\paperh18720\pard\sb0\sl-240{\bkmkstart Pg9}{\bkmkend Pg9}\par\pard\qj \li2344\sb0\sl-410\slmult0 \par\pard\qj\li2344\sb0\sl-410\slmult0 \par\pard\qj\l i2344\sb0\sl-410\slmult0 \par\pard\qj\li2344\ri1559\sb391\sl-410\slmult0 \up0 \e xpndtw0\charscalex102 \ul0\nosupersub\cf2\f3\fs24 melekat pada otot dasar meskip un tindakan ini memuaskan bagi beberapa pasien, \up0 \expndtw0\charscalex100 nam un pasien lain merasakan tindakan ini menyebabkan nyeri dan mengakibatkan \up0 \ expndtw0\charscalex100 hemoroid sekunder dan infeksi perianal. \par\pard\qj \li2 344\ri1559\sb6\sl-415\slmult0\fi719 \up0 \expndtw0\charscalex105 Hemonodektomi k rioslurgi adalah metode untuk mengangkat hemoroid \up0 \expndtw0\charscalex100 d engan cara membekukan jaringan hemoroid selama waktu tertentu sampai timbul \up0 \expndtw0\charscalex105 nikrosis. Meskipun hal ini relatif kurang menimbulkan n yeri, prosedur ini tidak \up0 \expndtw0\charscalex103 digunakan dengan luas kare na menyebabkan keluarnya rabas yang berbau sangat \up0 \expndtw-1\charscalex100 menyengat dan luka yang ditimbulkan lama sembuhnya. \par\pard\qj \li2344\ri1561\ sb0\sl-420\slmult0\fi719 \up0 \expndtw0\charscalex106 Laser Nd : YAG telah digun akan saat ini dalam mengeksisi hemoroid \up0 \expndtw0\charscalex100 eksternal. Tindakan ini cepat dan kurang menimbulkan nyeri hemoragi dan abses \up0 \expndtw -3\charscalex100 jarang menjadi komplikasi pada periode pasca operatif. \par\par d\qj \li2344\ri1559\sb0\sl-420\slmult0\fi720 \up0 \expndtw-2\charscalex100 Metod e pengobatan hemoroid tidak efektif untuk vena trombosis luas, yang \line \up0 \ expndtw0\charscalex100 harus diatasi dengan bedah, dapat dilakukan untuk mengang kat yang tidak begitu \line \up0 \expndtw-3\charscalex100 luas. \par\pard\qj \li 2344\ri1559\sb0\sl-416\slmult0\fi720 \up0 \expndtw0\charscalex104 Hemoreidektomi atau eksisi bedah, dapat dilakukan untuk mengangkat \up0 \expndtw0\charscalex10 2 semua jaringan sisa yang terlibat dalam proses ini, selama pembedahan, sfingte r \up0 \expndtw0\charscalex100 nektal biasanya didilatasi secara digital dan hem oroid diangkat dengan klem dan \up0 \expndtw0\charscalex100 kater\ul0\nosupersub \cf7\f8\fs24 \ul0\nosupersub\cf2\f3\fs24 atau dengan ligasi dan kemudian dieksi si. Setelah prosedur operatif selesai, \up0 \expndtw0\charscalex102 selang kecil dimasukkan melalui sfingter untuk memungkinkan keluarnya flatus \up0 \expndtw-2 \charscalex100 dan darah, penempatan gelfoan atau kasa oxygen dapat diberikan di atas luka anal. \up0 \expndtw-3\charscalex100 (Keperawatan Medikal Bedah, Brune r dan Suddarth) \par\pard\ql \li1984\sb0\sl-276\slmult0 \par\pard\ql\li1984\sb18 9\sl-276\slmult0\tx2344 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs2 4 D. \tab \up0 \expndtw-3\charscalex100 Jenis-jenis atau Macam-macam Wasir / Hem oroid \par\pard\qj \li2344\ri1559\sb32\sl-412\slmult0\fi719 \up0 \expndtw0\chars calex101 \ul0\nosupersub\cf2\f3\fs24 Wasir atau ambien ada 2 macam, wasir dalam dan wasir luar. Pada wasir \up0 \expndtw0\charscalex100 dalam terdapat pembuluh darah pada anus yang ditutupi oleh selaput lendir yang \up0 \expndtw0\charscalex 105 basah. Jika tidak ditangani bisa terlihat muncul menonjol keluar seperti was ir. \up0 \expndtw0\charscalex108 Sedangkan wasir luar merupakan varises di bawah otot yang umurnya \up0 \expndtw0\charscalex100 berhubungan dengan kuli t. Biasanya wasir ini terlihat tonjolan bengkak kebiruan \up0 \expndtw-3\charsca lex100 pada pinggri anus yang terasa sakit dan gatal. \par\pard\ql \li2344\sb121

\sl-276\slmult0 \up0 \expndtw-3\charscalex100 {\field{\*\fldinst {HYPERLINK "htt p://www.midewife-zietralmart-zone.com/" }}{\fldrslt {\ul0\nosupersub\cf16\f17\fs 24\ul www.midewife-zietralmart-zone.com}}} \par\pard\li1984\sb152\sl-276\slmult0 \fi0\tx2344 \up0 \expndtw0\charscalex105 \ul0\nosupersub\cf1\f2\fs24 E.\tab \up0 \expndtw0\charscalex105 Hal-hal atau faktor pemicu yang menyebabkan terjadinya hemoroid atau\par\pard\li1984\sb136\sl-276\slmult0\fi360 \up0 \expndtw0\charscal ex105 wasir\par\pard\qj \li2344\ri1561\sb6\sl-420\slmult0\fi720 \up0 \expndtw0\c harscalex102 \ul0\nosupersub\cf2\f3\fs24 Wasir dapat diakibatkan oleh hal-ha l sebagai berikut sehingga perlu \up0 \expndtw-3\charscalex100 diwaspadai da n dehidrasi \par\pard\ql \li2344\sb99\sl-276\slmult0 \up0 \expndtw-1\charscalex1 00 1.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Terlalu banyak du duk \par\pard\ql \li2344\sb144\sl-276\slmult0 \up0 \expndtw-1\charscalex100 2.\u l0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Diare menahun \par\pard\ sect\sectd\fs24\paperw12240\paperh18720\pard\sb0\sl-240{\bkmkstart Pg10}{\bkmken d Pg10}\par\pard\ql \li2344\sb0\sl-276\slmult0 \par\pard\ql\li2344\sb0\sl-276\sl mult0 \par\pard\ql\li2344\sb0\sl-276\slmult0 \par\pard\ql\li2344\sb0\sl-276\slmu lt0 \par\pard\ql\li2344\sb0\sl-276\slmult0 \par\pard\ql\li2344\sb0\sl-276\slmult 0 \par\pard\ql\li2344\sb75\sl-276\slmult0 \up0 \expndtw0\charscalex100 \ul0\nosu persub\cf2\f3\fs24 3.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 K ehamilan ibu hamil yang diakibatkan perubahan hormon \par\pard\ql \li2344\sb124\ sl-276\slmult0 \up0 \expndtw0\charscalex101 4.\ul0\nosupersub\cf4\f5\fs24 \ul0\ nosupersub\cf2\f3\fs24 Keturunan penderita wasir \par\pard\ql \li2344\sb144\sl276\slmult0 \up0 \expndtw0\charscalex100 5.\ul0\nosupersub\cf4\f5\fs24 \ul0\nos upersub\cf2\f3\fs24 Hubungan sex yang tidak lazim \par\pard\ql \li2344\sb144\sl -276\slmult0 \up0 \expndtw0\charscalex100 6.\ul0\nosupersub\cf4\f5\fs24 \ul0\no supersub\cf2\f3\fs24 Penyakit yang membuat mengejan penderita \par\pard\ql \li2 344\sb124\sl-276\slmult0 \up0 \expndtw0\charscalex100 7.\ul0\nosupersub\cf4\f5\f s24 \ul0\nosupersub\cf2\f3\fs24 Sembelit / konstipasi, obstipasi menahun \par\ pard\qj \li2344\ri5691\sb26\sl-420\slmult0 \up0 \expndtw0\charscalex100 8.\ul0\n osupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Penekanan kembali aliran dar ah vena \line \up0 \expndtw-1\charscalex100 ({\field{\*\fldinst {HYPERLINK "http ://www.midewife-zietralmart-zone.com/" }}{\fldrslt {\ul0\nosupersub\cf16\f17\fs2 4\ul www.midewife-zietralmart-zone.com}}}\ul0\nosupersub\cf2\f3\fs24 ) \par\pard \ql \li1984\sb0\sl-276\slmult0 \par\pard\ql\li1984\sb263\sl-276\slmult0\tx2344 \ up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 F. \tab \up0 \expndtw-3 \charscalex100 Mengatasi, mengobati dan menyembuhkan wasir / hemoroid \par\pard\ qj \li2344\ri1561\sb6\sl-420\slmult0\fi719 \up0 \expndtw0\charscalex106 \ul0\nos upersub\cf2\f3\fs24 Untuk menghilangkan wasir secara total sebaiknya anda menjal ankan \line \up0 \expndtw-2\charscalex100 beberapa tips menyembuhkan wasir serta melakukan konsultasi dengan dokter \par\pard\ql \li2344\sb99\sl-276\slmult0 \up 0 \expndtw-1\charscalex100 1.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3 \fs24 Jalankan pola hidup sehat \par\pard\ql \li2344\sb144\sl-276\slmult0 \up0 \expndtw-1\charscalex100 2.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\f s24 Olahraga secara teratur \par\pard\ql \li2344\sb144\sl-276\slmult0 \up0 \exp ndtw-1\charscalex100 3.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Makan-makanan berserat \par\pard\ql \li2344\sb124\sl-276\slmult0 \up0 \expndtw2\charscalex100 4.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Hind ari terlalu banyak duduk atau nongkrong di WC / toilet \par\pard\ql \li2344\sb14 4\sl-276\slmult0 \up0 \expndtw-2\charscalex100 5.\ul0\nosupersub\cf4\f5\fs24 \u l0\nosupersub\cf2\f3\fs24 Jangan merokok, minum-minuman keras, narkoba dan lain -lain \par\pard\ql \li2344\sb144\sl-276\slmult0 \up0 \expndtw-1\charscalex100 6. \ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Minum air yang cukup \ par\pard\ql \li2344\sb144\sl-276\slmult0 \up0 \expndtw-2\charscalex100 7.\ul0\no supersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Jangan menahan kencing dan be rak \par\pard\ql \li2344\sb124\sl-276\slmult0 \up0 \expndtw-2\charscalex100 8.\u l0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Jangan suka menggosok an us berlebihan \par\pard\qj \li2344\ri5864\sb26\sl-420\slmult0 \up0 \expndtw-2\ch arscalex100 9.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Minum ob at sesuai anjuran dokter \line \up0 \expndtw-3\charscalex100 ({\field{\*\fldinst {HYPERLINK "http://www.midewife-zietralmart-zone.com/" }}{\fldrslt {\ul0\nosupe

rsub\cf16\f17\fs24\ul www.midewife-zietralmart-zone.com}}}\ul0\nosupersub\cf2\f3 \fs24 ) \par\pard\sect\sectd\fs24\paperw12240\paperh18720\pard\sb0\sl-240{\bkmks tart Pg11}{\bkmkend Pg11}\par\pard\ql \li3640\sb0\sl-276\slmult0 \par\pard\ql\li 3640\sb0\sl-276\slmult0 \par\pard\ql\li3640\sb0\sl-276\slmult0 \par\pard\ql\li36 40\sb0\sl-276\slmult0 \par\pard\ql\li3640\sb0\sl-276\slmult0 \par\pard\ql\li3640 \sb0\sl-276\slmult0 \par\pard\ql\li3640\sb75\sl-276\slmult0 \up0 \expndtw-2\char scalex100 \ul0\nosupersub\cf1\f2\fs24 ASUHAN KEPERAWATAN MENURUT TEORI \par\pard \li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb 8\sl-276\slmult0\fi0\tx2344 \up0 \expndtw-1\charscalex100 A.\tab \up0 \expndtw-1 \charscalex100 Pengkajian Keperawatan\par\pard\li1984\sb134\sl-276\slmult0\fi360 \tx2704 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf2\f3\fs24 1.\tab \up0 \e xpndtw-1\charscalex100 Riwayat Keperawatan\par\pard\qj \li2704\ri1559\sb3\sl-416 \slmult0\fi720 \up0 \expndtw0\charscalex100 Pengkajian keperawatan pada masalah kebutuhan cairan dan elektrolit \up0 \expndtw0\charscalex102 meliputi jumlah asu pan cairan yang dapat diukur mellaui jumlah pemasukan \up0 \expndtw0\charscalex1 00 secara oral, panentreal, atau enteral, jumlah pengeluaran dapat diukur melalu i \up0 \expndtw0\charscalex105 jumlah produksi urine, fases, muntah atau p engeluaran lainnya, status \up0 \expndtw0\charscalex106 kehilanbgan atau keleb ihan cairan, dan perubahan berat badan yang dapat \up0 \expndtw-3\charscalex100 menentukan tingkat dehidrasi. \par\pard\ql \li2344\sb120\sl-276\slmult0\tx2704 \ up0 \expndtw-4\charscalex100 2. \tab \up0 \expndtw-3\charscalex100 Faktor yang b erhubungan \par\pard\ql \li2344\ri1562\sb6\sl-420\slmult0\fi1080\tx2704 \up0 \ex pndtw0\charscalex103 Faktor yang berhubungan melalui faktor-faktor yang mempenga ruhi \line\tab \up0 \expndtw-2\charscalex100 masalah kebutuhan cairan, seperti s akit, diet, lingkungan dan penggunaan obat. \up0 \expndtw-4\charscalex100 3. \u p0 \expndtw-3\charscalex100 Pengkajian fisik \par\pard\qj \li2704\ri1561\sb0\sl420\slmult0\fi720 \up0 \expndtw0\charscalex103 Pengkajian fisik meliputi sistem yang berhubungan dengan masalah \line \up0 \expndtw-1\charscalex100 cairan dan e lektrolit, seperti sistem intergumen (status turgor kulit, dan edema) \line \up0 \expndtw0\charscalex100 sistem kardiovaskuler \up0 \expndtw0\charscalex106 (ada nya distensi vena jugularis), tekanan darah dan \par\pard\ql \li2344\ri1561\sb0\ sl-413\slmult0\fi360\tx2704\tx2704 \up0 \expndtw0\charscalex100 bunyi jantung, s istem penglihatan (kondisi dan cairan mata) sistem neurologi \line\tab \up0 \exp ndtw0\charscalex105 (gangguan sensorik atau motorik, status kesadaran, dan adany a reflek) dan \line\tab \up0 \expndtw-3\charscalex100 sistem gastrointestinal (k eadaan mukosa mulut, lidah, dan bising usus) \line \up0 \expndtw-4\charscalex10 0 4. \up0 \expndtw-3\charscalex100 Pemeriksaan laboratorium atau diagnostik lain nya \par\pard\qj \li2704\ri1560\sb0\sl-420\slmult0\fi719 \up0 \expndtw0\charscal ex105 Pemeriksaan laboratorium dan diagnostik lainnya dapat berupa \line \ up0 \expndtw0\charscalex103 pemeriksaan kadar elektrolit \up0 \expndtw0\charscal ex107 (natrium, kalium, klorida, berat, jenis urine, \par\pard\ql \li2704\sb87\s l-276\slmult0 \up0 \expndtw-3\charscalex100 analisis gas darah dan lain-lain) \p ar\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li 1984\sb8\sl-276\slmult0\fi0\tx2344 \up0 \expndtw0\charscalex100 \ul0\nosupersub\ cf1\f2\fs24 B.\tab \up0 \expndtw0\charscalex100 Diagnosis Keperawatan\par\pard\l i1984\sb135\sl-276\slmult0\fi360 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf 2\f3\fs24 1.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Kekurangan volume cairan berhubungan dengan :\par\pard\li1984\sb137\sl-276\slmult0\fi719\t x3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Pengeluara n urine secara berlebnihan akibat penyakit diabetes mellitus atau\par\pard\li198 4\sb139\sl-276\slmult0\fi1079 \up0 \expndtw0\charscalex100 lainnya\par\pard\li19 84\sb137\sl-276\slmult0\fi720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \ex pndtw0\charscalex100 Peningkatan permeabilitas kapiler dan hilangnya evaporasi p ada pasien\par\pard\li1984\sb139\sl-276\slmult0\fi1080 \up0 \expndtw0\charscalex 100 luka bakar atau meningkatnya kecepatan metabolisme\par\pard\li1984\sb137\sl276\slmult0\fi720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\chars calex100 Pengeluaran cairan secara berlebihan\par\pard\li1984\sb139\sl-276\slmul t0\fi720\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Asupan cairan yang tidak adekuat\par\pard\li1984\sb137\sl-276\slmult0\fi720\tx30 64 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Perdarahan\pa

r\pard\li1984\sb139\sl-276\slmult0\fi360 \up0 \expndtw0\charscalex100 2.\ul0\nos upersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Kelebihan volume cairan berhub ungan dengan :\par\pard\li1984\sb137\sl-276\slmult0\fi720\tx3064 \up0 \expndtw0\ charscalex100 -\tab \up0 \expndtw0\charscalex100 Penurunan mekanisme regulator a kibat kelainan pada ginjal\par\pard\sect\sectd\fs24\paperw12240\paperh18720\pard \sb0\sl-240{\bkmkstart Pg12}{\bkmkend Pg12}\par\pard\li1984\sb0\sl-276\slmult0\p ar\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li 1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\s l-276\slmult0\par\pard\li1984\sb78\sl-276\slmult0\fi719\tx3064 \up0 \expndtw0\ch arscalex100 \ul0\nosupersub\cf2\f3\fs24 -\tab \up0 \expndtw0\charscalex100 Penur unan curah jantung akibat penyakit jantung\par\pard\li1984\sb139\sl-276\slmult0\ fi719\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Gan gguan aliran balik vena akibat penyakit vaskuler periver atau trombus\par\pard\l i1984\sb137\sl-276\slmult0\fi719\tx3064 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Retensi natrium dan air akibat terapi kortikosteroid\par \pard\li1984\sb139\sl-276\slmult0\fi719\tx3064 \up0 \expndtw0\charscalex100 -\ta b \up0 \expndtw0\charscalex100 Tekanan osmetik koloid yang rendah\par\pard\li198 4\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb5\sl-2 76\slmult0\fi0\tx2344 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf1\f2\fs24 C .\tab \up0 \expndtw0\charscalex100 Perencanaan Keperawatan\par\pard\li1984\sb132 \sl-276\slmult0\fi360 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf2\f3\fs24 T ujuan :\par\pard\li1984\sb137\sl-276\slmult0\fi360\tx2704 \up0 \expndtw0\charsca lex100 -\tab \up0 \expndtw0\charscalex100 Mempertahankan volume cairan dalam kea daan seimbang\par\pard\li1984\sb139\sl-276\slmult0\fi359 \up0 \expndtw0\charscal ex100 Rencana tindakan :\par\pard\li1984\sb137\sl-276\slmult0\fi359\tx2704 \up0 \expndtw0\charscalex100 1.\tab \up0 \expndtw0\charscalex100 Monitor jumlah asu pan dan pengeluaran cairan serta perubahan status\par\pard\li1984\sb139\sl -276\slmult0\fi719 \up0 \expndtw0\charscalex100 keseimbangan cairan\par\pard\ql \li2344\sb121\sl-276\slmult0\tx2704 \up0 \expndtw-2\charscalex100 2. \tab \up0 \ expndtw-1\charscalex100 Pertahankan keseimbangan cairan \par\pard\ql \li2704\sb1 44\sl-276\slmult0 \up0 \expndtw-1\charscalex100 Bila kekurangan volume cairan la kukan : \par\pard\ql \li3064\sb144\sl-276\slmult0 \up0 \expndtw-1\charscalex100 Rehidrasi oral atau parenteral sesuai dengan kebutuhan \par\pard\qj \li3064\ri15 59\sb6\sl-420\slmult0 \up0 \expndtw0\charscalex106 Monitor kadar elektrolit dara h seperti uria netrogen darah, urine, serum, \up0 \expndtw-1\charscalex100 osmol aritas, kreatinin, hematrokit dan Hb \par\pard\qj \li3064\ri1559\sb9\sl-410\slmu lt0 \up0 \expndtw0\charscalex107 Hilangkan faktor penyebab kekurangan volume cai ran, seperti muntah \up0 \expndtw0\charscalex107 dengan cara memberikan minum se cara sedikit-sedikit tapi sering atau \up0 \expndtw-1\charscalex100 dengan membe rikan teh \par\pard\ql \li2704\sb121\sl-276\slmult0 \up0 \expndtw-1\charscalex10 0 Bila kelebihan volume cairan, lakukan : \par\pard\ql \li3064\ri1559\sb31\sl-41 3\slmult0\fi0 \up0 \expndtw0\charscalex100 Pengurangan faktor penyebab kelebihan volume cairan dengan cara melihat \line \up0 \expndtw0\charscalex104 kondisi pe nyakit pasien terlebih dahulu. Apabila akibat bendungan aliran \line \up0 \expnd tw0\charscalex110 pembuluh darah, maka anjurkan pasien untuk istirahat dengan po sisi \line \up0 \expndtw0\charscalex108 telentang, posisi kaki ditinggikan, atau tinggikan ekstrimitas yang \line \up0 \expndtw-1\charscalex100 mengalami edema diatas posisi) jantung, kecuali ada kontra indikasi \line \up0 \expndtw0\ charscalex104 Kurangi kontradikis pembuluh darah seperti pada penggunaan kaos la lki \line \up0 \expndtw-1\charscalex100 yang ketat \par\pard\li1984\sb121\sl-276 \slmult0\fi359\tx2704 \up0 \expndtw-1\charscalex100 3.\tab \up0 \expndtw-1\chars calex100 Lakukan mobilisasi melalui pengaturan posisi\par\pard\li1984\sb139\sl-2 76\slmult0\fi359\tx2704 \up0 \expndtw-1\charscalex100 4.\tab \up0 \expndtw-1\cha rscalex100 Anjurkan cara mempertahankan keseimbangan cairan\par\pard\li1984\sb0\ sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb5\sl-276\slm ult0\fi0\tx2344 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf1\f2\fs24 D.\tab \up0 \expndtw-1\charscalex100 Pelaksanaan (Tindakan) Keperawatan\par\pard\ql \l i2344\sb116\sl-276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf2\f3\ fs24 1.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Pemberian caira n melalui infus \par\pard\qj \li2704\ri1559\sb31\sl-413\slmult0 \up0 \expndtw0\c

harscalex104 Pemberian cairan melalui infus merupakan tindakan keperawatan yang \up0 \expndtw0\charscalex100 dilakukan dengan cara memasukkan cairan mela lui intravena dengan bantuan \up0 \expndtw0\charscalex104 infus set, bertujuan m emenuhi kebutuhan cairan dan elektrolit serta sebagai \up0 \expndtw-3\charscalex 100 tindfakan pengobatan dan pemberian makan \par\pard\sect\sectd\fs24\paperw122 40\paperh18720\pard\sb0\sl-240{\bkmkstart Pg13}{\bkmkend Pg13}\par\pard\ql \li27 04\sb0\sl-276\slmult0 \par\pard\ql\li2704\sb0\sl-276\slmult0 \par\pard\ql\li2704 \sb0\sl-276\slmult0 \par\pard\ql\li2704\sb0\sl-276\slmult0 \par\pard\ql\li2704\s b0\sl-276\slmult0 \par\pard\ql\li2704\sb0\sl-276\slmult0 \par\pard\ql\li2704\sb7 5\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf2\f3\fs24 Alat dan bahan \par\pard\ql \li2704\sb124\sl-276\slmult0 \up0 \expndtw0\charscalex101 1)\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 standat infus \par\ pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw0\charscalex102 2)\ul0\nosuper sub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 infus set \par\pard\ql \li2704\sb1 44\sl-276\slmult0 \up0 \expndtw0\charscalex100 3)\ul0\nosupersub\cf4\f5\fs24 \u l0\nosupersub\cf2\f3\fs24 cairan sesuai dengan kebtuhan pasien \par\pard\ql \li 2704\sb124\sl-276\slmult0 \up0 \expndtw-1\charscalex100 4)\ul0\nosupersub\cf4\f5 \fs24 \ul0\nosupersub\cf2\f3\fs24 jarum infus / abocath atau sejenisnya sesuai dengan ukuran \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw0\charscal ex101 5)\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 pengalas \par\ pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw0\charscalex100 6)\ul0\nosuper sub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 pembendung \par\pard\ql \li2704\sb 144\sl-276\slmult0 \up0 \expndtw0\charscalex100 7)\ul0\nosupersub\cf4\f5\fs24 \ ul0\nosupersub\cf2\f3\fs24 kapas alkohol 70% \par\pard\ql \li2704\sb124\sl-276\ slmult0 \up0 \expndtw0\charscalex102 8)\ul0\nosupersub\cf4\f5\fs24 \ul0\nosuper sub\cf2\f3\fs24 plester \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw 0\charscalex101 9)\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 gunt ing \par\pard\ql \li2704\ri3991\sb34\sl-410\slmult0\fi0 \up0 \expndtw-3\charscal ex100 10)\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 kasa steril \l ine \up0 \expndtw-4\charscalex100 11)\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersu b\cf2\f3\fs24 Betadine\ul0\super\cf5\f6\fs24 TM \line \up0 \expndtw-4\charscalex 100 \ul0\nosupersub\cf2\f3\fs24 Prosedur kerja : \par\pard\ql \li2704\sb121\sl-2 76\slmult0 \up0 \expndtw0\charscalex102 1.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosu persub\cf2\f3\fs24 Cuci tangan \par\pard\ql \li2704\sb124\sl-276\slmult0 \up0 \ expndtw0\charscalex100 2.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs2 4 Jelaskan prosedur yang akan dilakukan \par\pard\ql \li2704\ri1559\sb26\sl-420 \slmult0\tx3064 \up0 \expndtw0\charscalex103 3.\ul0\nosupersub\cf4\f5\fs24 \ul0 \nosupersub\cf2\f3\fs24 Hubungkan cairan dan infus set dengan menusukkan ke dal am botol infus \line\tab \up0 \expndtw-1\charscalex100 (cairan) \par\pard\ql \li 2704\ri1563\sb17\sl-400\slmult0\tx3064 \up0 \expndtw0\charscalex103 4.\ul0\nosup ersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 isi cairan ke dalam infus set de ngan menekan bagian ruang tetesan hingga \line\tab \up0 \expndtw-1\charscalex100 selang terisi dan udaranya keluarga \par\pard\ql \li2704\sb123\sl-276\slmult0 \ up0 \expndtw0\charscalex101 5.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f 3\fs24 letakkan pengalas \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndt w0\charscalex100 6.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 lak ukan pembendungan dengan tormiquet \par\pard\ql \li2704\sb124\sl-276\slmult0 \up 0 \expndtw0\charscalex101 7.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\ fs24 gunakan sarung tangan \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expn dtw0\charscalex100 8.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 d esinfeksi daerah yang akan ditusuk \par\pard\ql \li2704\sb144\sl-276\slmult0 \up 0 \expndtw0\charscalex100 9.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\ fs24 lakukan penusukan dengan arah jarum ke atas \par\pard\ql \li2704\ri1559\sb 6\sl-420\slmult0\tx3064 \up0 \expndtw0\charscalex108 10.\ul0\nosupersub\cf4\f5\f s24 \ul0\nosupersub\cf2\f3\fs24 cek apakah sudah mengenai vena (cirinya adalah darah keluar melalui \line\tab \up0 \expndtw-1\charscalex100 jarum infus dan hub ungkan dengan selang infus) \par\pard\ql \li2704\sb119\sl-276\slmult0 \up0 \expn dtw-1\charscalex100 11.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 tarik jarum infus dan hubungkan dengan selang infus \par\pard\ql \li2704\sb144\s l-276\slmult0 \up0 \expndtw-2\charscalex100 12.\ul0\nosupersub\cf4\f5\fs24 \ul0

\nosupersub\cf2\f3\fs24 buka tetesan \par\pard\ql \li2704\sb124\sl-276\slmult0 \ up0 \expndtw-1\charscalex100 13.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf2 \f3\fs24 lakukan desinfeksi dengan betadine\ul0\super\cf5\f6\fs24 TM\ul0\nosuper sub\cf2\f3\fs24 dan tutup dengan kasa steril \par\pard\ql \li2704\sb144\sl-276\ slmult0 \up0 \expndtw-1\charscalex100 14.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosup ersub\cf2\f3\fs24 beri tanggal dan jam pelaksanaan infus pada plester \par\pard\ ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw-2\charscalex100 15.\ul0\nosupersub \cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 cuci tangan \par\pard\ql \li2704\sb124 \sl-276\slmult0 \up0 \expndtw-1\charscalex100 cara menghitung tetesan infus \par \pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw0\charscalex103 1.\ul0\nosupe rsub\cf4\f5\fs24 \ul0\nosupersub\cf2\f3\fs24 Dewasa\par\pard\sect\sectd\sbknon e\cols2\colno1\colw4701\colsr110\colno2\colw7289\colsr160\ql \li3064\sb0\sl-276\ slmult0 \par\pard\ql \li3064\sb32\sl-276\slmult0 \up0 \expndtw-1\charscalex100 T etesan/menit =\par\pard\ql \li3064\sb0\sl-276\slmult0 \par\pard\ql \li3064\sb106 \sl-276\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf10\f11\fs24 Cont oh :\par\pard\column \qj \li20\ri4621\sb112\sl-335\slmult0\tx184 \up0 \expndtw-2 \charscalex100 \ul0\nosupersub\cf9\f10\fs24 jumlah cairan yang masuk \line\tab \ up0 \expndtw-3\charscalex100 lamanya\ul0\nosupersub\cf10\f11\fs24 inf\ul0\nosup ersub\cf9\f10\fs24 us\ul0\nosupersub\cf10\f11\fs24 (\ul0\nosupersub\cf9\f10\fs2 4 jam\ul0\nosupersub\cf10\f11\fs24 )\ul0\nosupersub\cf9\f10\fs24 x\ul0\nosupers ub\cf10\f11\fs24 3 {\shp {\*\shpinst\shpleft4749\shptop15964\shpright7411\shpbottom15964\shpfhdr0\s hpbxpage\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz275\shplid0{\sp{\sn shapeType} {\sv 20}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}{\sp{\sn li neWidth}{\sv 5592}} }}\par\pard\sect\sectd\fs24\paperw12240\paperh18720\pard\sb0\sl-240{\bkmkstart P g14}{\bkmkend Pg14}\par\pard\qj \li3064\sb0\sl-400\slmult0 \par\pard\qj\li3064\s b0\sl-400\slmult0 \par\pard\qj\li3064\sb0\sl-400\slmult0 \par\pard\qj\li3064\sb0 \sl-400\slmult0 \par\pard\qj\li3064\ri1561\sb29\sl-400\slmult0 \up0 \expndtw0\ch arscalex107 \ul0\nosupersub\cf10\f11\fs24 Seorang pasien dewasa memerlukan rehid rasi dengan 500 ml (1 botol) \up0 \expndtw-1\charscalex100 infus dalam satu hari , maka tetesan per menit adalah :\par\pard\sect\sectd\sbknone\cols3\colno1\colw5 395\colsr60\colno2\colw517\colsr40\colno3\colw6098\colsr160\ql \li2704\sb0\sl-27 6\slmult0 \par\pard\ql \li3064\sb19\sl-276\slmult0 \up0 \expndtw-1\charscalex100 Jumlah tetesan/menit =\par\pard\ql \li2704\sb0\sl-276\slmult0 \par\pard\ql \li2 704\sb45\sl-276\slmult0 \up0 \expndtw0\charscalex104 \ul0\nosupersub\cf12\f13\fs 24 2.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Anak\par\pard\c olumn \ql \li75\sb146\sl-276\slmult0 \up0 \expndtw-3\charscalex100 500\par\pard\ ql \li20\sb60\sl-276\slmult0 \up0 \expndtw-3\charscalex100 24 \up0 \expndtw-3\ch arscalex100 \ul0\nosupersub\cf11\f12\fs24 x \up0 \expndtw-5\charscalex100 \ul0\n osupersub\cf12\f13\fs24 3\par\pard\column \ql \li3064\sb0\sl-276\slmult0 \par\pa rd\ql \li20\sb19\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf 13\f14\fs24 \u-4035? \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf12\f13\fs2 4 7 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf11\f12\fs24 tetes \ul0\nosu persub\cf12\f13\fs24 /\ul0\nosupersub\cf11\f12\fs24 menit\par\pard\sect\sectd\sb knone\cols2\colno1\colw4701\colsr110\colno2\colw7289\colsr160\ql \li3064\sb0\sl276\slmult0 \par\pard\ql \li3064\sb22\sl-276\slmult0 \up0 \expndtw-1\charscalex1 00 \ul0\nosupersub\cf12\f13\fs24 Tetesan/menit =\par\pard\ql \li3064\sb0\sl-276\ slmult0 \par\pard\ql \li3064\sb105\sl-276\slmult0 \up0 \expndtw-1\charscalex100 Contoh :\par\pard\column \qj \li20\ri4621\sb101\sl-335\slmult0\tx450 \up0 \expnd tw-2\charscalex100 \ul0\nosupersub\cf11\f12\fs24 jumlah cairan yang masuk \line\ tab \up0 \expndtw-4\charscalex100 lama\ul0\nosupersub\cf12\f13\fs24 inf\ul0\nos upersub\cf11\f12\fs24 us\ul0\nosupersub\cf12\f13\fs24 (\ul0\nosupersub\cf11\f1 2\fs24 jam\ul0\nosupersub\cf12\f13\fs24 ) \par\pard\sect\sectd\sbknone \qj \li3 064\ri1562\sb0\sl-420\slmult0 \up0 \expndtw0\charscalex100 Seorang pasien neonat us memerlukan rehidrasi dengan 250 ml infus dalam \up0 \expndtw-1\charscalex100 waktu 2 jam, maka tetesan per menit adalah :\par\pard\sect\sectd\sbknone\cols3\c olno1\colw5395\colsr60\colno2\colw402\colsr40\colno3\colw6213\colsr160\qj \li234 4\ri0\sb15\sl-595\slmult0\fi719 \up0 \expndtw-1\charscalex100 Jumlah tetesan/men it = \up0 \expndtw-2\charscalex100 2. \up0 \expndtw-1\charscalex100 Transfusi da

rah\par\pard\column \ql \li20\sb130\sl-276\slmult0 \up0 \expndtw-5\charscalex100 250\par\pard\ql \li140\sb60\sl-276\slmult0 \up0 \expndtw-3\charscalex100 2\par\ pard\column \ql \li5887\sb0\sl-276\slmult0 \par\pard\ql \li20\sb2\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf13\f14\fs24 \u-4035? \up0 \exp ndtw-1\charscalex100 \ul0\nosupersub\cf12\f13\fs24 125\ul0\nosupersub\cf11\f12\f s24 tetes mikro\ul0\nosupersub\cf12\f13\fs24 /\ul0\nosupersub\cf11\f12\fs24 men it \par\pard\sect\sectd\sbknone \qj \li2704\ri1559\sb11\sl-413\slmult0 \up0 \exp ndtw-1\charscalex100 \ul0\nosupersub\cf12\f13\fs24 Transfusi darah merupakan tin dakan keperawatran yang dilakukan pada pasien \up0 \expndtw0\charscalex100 yang membutuhkan darah dengan cara memasukkan darah melalui vena \up0 \expndt w0\charscalex103 dengan menggunakan alat transfusi sel. Tujuannya adalah untuk m emenuhi \up0 \expndtw-3\charscalex100 kebutuhan darah dan memperbaiki perfusi ja ringan. \par\pard\ql \li2704\sb121\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Alat dan bahan \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw0\charscal ex100 1.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Standar infu s \par\pard\ql \li2704\sb124\sl-276\slmult0 \up0 \expndtw0\charscalex100 2.\ul0\ nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Transfusi set \par\pard\q l \li2704\sb144\sl-276\slmult0 \up0 \expndtw0\charscalex100 3.\ul0\nosupersub\cf 4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 NaCl 0,9% \par\pard\ql \li2704\sb144\s l-276\slmult0 \up0 \expndtw-2\charscalex100 4.\ul0\nosupersub\cf4\f5\fs24 \ul0\ nosupersub\cf12\f13\fs24 Darah sesuai dengan kebutuhan pasien \par\pard\ql \li2 704\sb144\sl-276\slmult0 \up0 \expndtw-2\charscalex100 5.\ul0\nosupersub\cf4\f5\ fs24 \ul0\nosupersub\cf12\f13\fs24 Jarum infus /abocath atau sejenisnya sesuai dengan ukuran \par\pard\ql \li2704\sb124\sl-276\slmult0 \up0 \expndtw0\charscal ex101 6.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Pengalas \pa r\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw0\charscalex100 7.\ul0\nosup ersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Pembendung \par\pard\ql \li270 4\sb144\sl-276\slmult0 \up0 \expndtw0\charscalex102 8.\ul0\nosupersub\cf4\f5\fs2 4 \ul0\nosupersub\cf12\f13\fs24 Kapas \par\pard\ql \li2704\sb124\sl-276\slmult 0 \up0 \expndtw0\charscalex100 9.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf 12\f13\fs24 Alkohol 70% \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw -4\charscalex100 10.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 P lester \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw-4\charscalex100 1 1.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Kasa steril \par\pa rd\ql \li2704\sb124\sl-276\slmult0 \up0 \expndtw-4\charscalex100 12.\ul0\nosuper sub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 betadine \par\pard\ql \li2704\ri3 907\sb26\sl-420\slmult0 \up0 \expndtw-4\charscalex100 13.\ul0\nosupersub\cf4\f5\ fs24 \ul0\nosupersub\cf12\f13\fs24 sarung tangan \line \up0 \expndtw-4\charscal ex100 Prosedur kerja \par\pard\ql \li2704\sb119\sl-276\slmult0 \up0 \expndtw0\ch arscalex100 1.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Cuci t angan \par\pard\ql \li2704\sb124\sl-276\slmult0 \up0 \expndtw-2\charscalex100 2. \ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Jelaskan prosedur ya ng akan dilakukan \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw-1\char scalex100 3.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Hubungka n cairan NaCl 0,9% dan transfusi set dengan cara menusukkan {\shp {\*\shpinst\shpleft5438\shptop3132\shpright5939\shpbottom3132\shpfhdr0\shp bxpage\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz27\shplid0{\sp{\sn shapeType}{\s v 20}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}{\sp{\sn lineW idth}{\sv 5592}} }} {\shp {\*\shpinst\shpleft4749\shptop4303\shpright7411\shpbottom4303\shpfhdr0\shp bxpage\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz126\shplid1{\sp{\sn shapeType}{\ sv 20}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}{\sp{\sn line Width}{\sv 5592}} }} {\shp {\*\shpinst\shpleft5438\shptop6364\shpright5824\shpbottom6364\shpfhdr0\shp bxpage\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz171\shplid2{\sp{\sn shapeType}{\ sv 20}}{\sp{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}}{\sp{\sn line Width}{\sv 5592}} }}\par\pard\sect\sectd\fs24\paperw12240\paperh18720\pard\sb0\sl-240{\bkmkstart P

g15}{\bkmkend Pg15}\par\pard\ql \li2704\sb0\sl-410\slmult0 \par\pard\ql\li2704\s b0\sl-410\slmult0 \par\pard\ql\li2704\sb0\sl-410\slmult0 \par\pard\ql\li2704\ri1 562\sb391\sl-410\slmult0\tx3064\tx3064 \up0 \expndtw0\charscalex103 \ul0\nosuper sub\cf12\f13\fs24 4.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Isi cairan NaCl 0,9% ke dalam transfusi set dengan menekan bagian ruang \line\ta b \up0 \expndtw0\charscalex105 tetesan hingga ruangan tetesan terisi sebagian da n buka penutup hingga \line\tab \up0 \expndtw-1\charscalex100 selang terisi dan udaranya keluar \par\pard\ql \li2704\sb121\sl-276\slmult0 \up0 \expndtw0\charsca lex101 5.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Letakkan pe ngalas \par\pard\ql \li2704\sb124\sl-276\slmult0 \up0 \expndtw0\charscalex100 6. \ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Lakukan pembendung d engan tourniquet \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw0\charsc alex101 7.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Gunakan sa rung tangan \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw0\charscalex1 00 8.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Desinfeksi daer ah yang akan ditusuk \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw0\ch arscalex100 9.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Lakuka n penusukan dengan arah jarum ke atas \par\pard\ql \li2704\ri1560\sb6\sl-420\slm ult0\tx3064 \up0 \expndtw0\charscalex107 10.\ul0\nosupersub\cf4\f5\fs24 \ul0\no supersub\cf12\f13\fs24 Cek apakah sudah mengenal vena (cirinya adalah darah kelu ar melalui \line\tab \up0 \expndtw-1\charscalex100 jarum infus / abocath) \par\p ard\ql \li2704\sb119\sl-276\slmult0 \up0 \expndtw0\charscalex100 11.\ul0\nosuper sub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Tarik jarum infus dan hubungkan s elang infus dengan selang transfusi \par\pard\ql \li2704\sb124\sl-276\slmult0 \u p0 \expndtw-2\charscalex100 12.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12 \f13\fs24 Buka tetesan \par\pard\ql \li2704\sb144\sl-276\slmult0 \up0 \expndtw-1 \charscalex100 13.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Lak ukan desinfeksi dengan betadine dan tutup dengan kasa steril \par\pard\ql \li270 4\sb144\sl-276\slmult0 \up0 \expndtw-1\charscalex100 14.\ul0\nosupersub\cf4\f5\f s24 \ul0\nosupersub\cf12\f13\fs24 Beri tanggal dan jam pelaksanaan infus pada p lester \par\pard\ql \li2704\ri1562\sb6\sl-420\slmult0\tx3064 \up0 \expndtw0\char scalex102 15.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Setelah nacl 0,9% masuk, kurang lebih 15 menit, ganti dengan darah yang \line\tab \up0 \ expndtw-1\charscalex100 sudah disiapkan \par\pard\ql \li2704\ri1559\sb0\sl-420\s lmult0\tx3064 \up0 \expndtw0\charscalex106 16.\ul0\nosupersub\cf4\f5\fs24 \ul0\ nosupersub\cf12\f13\fs24 Sebelum dimasukkan terlebih dahulu cek warna darah, ide ntitas pasien, \line\tab \up0 \expndtw-1\charscalex100 jenis golongan darah dan tanggal kadaluwarsa \par\pard\ql \li2704\sb99\sl-276\slmult0 \up0 \expndtw-1\cha rscalex100 17.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Lakukan observasi tanda-tanda vital selama pemakaian transfusi \par\pard\ql \li2704\sb1 44\sl-276\slmult0 \up0 \expndtw-2\charscalex100 18.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Cuci tangan \par\pard\ql \li1984\sb0\sl-276\slmult 0 \par\pard\ql\li1984\sb0\sl-276\slmult0 \par\pard\ql\li1984\sb12\sl-276\slmult0 \tx2344 \up0 \expndtw-4\charscalex100 \ul0\nosupersub\cf1\f2\fs24 E. \tab \up0 \ expndtw-3\charscalex100 Evaluasi Keperawatan \par\pard\qj \li2344\ri1559\sb9\sl416\slmult0\fi720 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf12\f13\fs24 Eva luasi terhadap gangguan kebutuhan cairan dan elektrolit secara umum \line \up0 \ expndtw0\charscalex100 dapat dinilai dan adanya kemampuan dalam mempertaha nkan keseimbangan \line \up0 \expndtw-1\charscalex100 cairan dan elektrolit den gan ditunjukkan oleh adanya keseimbangan antara jumlah \line \up0 \expndtw0\char scalex103 asupan dan pengeluaran, nilai elektrolit dalam batas normal, berat bad an sesuai \line \up0 \expndtw0\charscalex106 dengan tinggi badan atau tidak ada penurunan, turgor kulit baik, tidak terjadi, \line \up0 \expndtw-2\charscalex100 edema, dan lain-lain. (Kebutuhan Dasar Manusia, A. Azis Alimul H, 2006 : 31) \p ar\pard\sect\sectd\fs24\paperw12240\paperh18720\pard\sb0\sl-240{\bkmkstart Pg16} {\bkmkend Pg16}\par\pard\ql \li5812\sb0\sl-276\slmult0 \par\pard\ql\li5812\sb0\s l-276\slmult0 \par\pard\ql\li5812\sb0\sl-276\slmult0 \par\pard\ql\li5812\sb0\sl276\slmult0 \par\pard\ql\li5812\sb0\sl-276\slmult0 \par\pard\ql\li5812\sb0\sl-27 6\slmult0 \par\pard\ql\li5812\sb75\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf1\f2\fs24 BAB III \par\pard\ql \li5171\sb144\sl-276\slmult0 \u

p0 \expndtw-2\charscalex100 TINJAUAN KASUS \par\pard\li1984\sb0\sl-276\slmult0\p ar\pard\li1984\sb0\sl-276\slmult0\par\pard\li1984\sb0\sl-276\slmult0\par\pard\li 1984\sb140\sl-276\slmult0\fi0\tx2584 \up0 \expndtw-1\charscalex100 I.\tab \up0 \ expndtw-1\charscalex100 PENGKAJIAN\par\pard\li1984\sb139\sl-276\slmult0\fi599\tx 2944 \up0 \expndtw-1\charscalex100 A.\tab \up0 \expndtw-1\charscalex100 Data Sub yektif\par\pard\li1984\sb132\sl-276\slmult0\fi960\tx3304 \up0 \expndtw-1\charsca lex100 \ul0\nosupersub\cf12\f13\fs24 1.\tab \up0 \expndtw-1\charscalex100 Identi tas Klien\par\pard\li1984\sb137\sl-276\slmult0\fi1320\tx5584 \up0 \expndtw-1\cha rscalex100 Nama\tab \up0 \expndtw-1\charscalex100 : Ny. \u8220?A\u8221?\par\pard \li1984\sb139\sl-276\slmult0\fi1320\tx5584 \up0 \expndtw-1\charscalex100 Umur\ta b \up0 \expndtw-1\charscalex100 : 51 tahun\par\pard\li1984\sb137\sl-276\slmult0\ fi1320\tx5584 \up0 \expndtw-1\charscalex100 Pendidikan\tab \up0 \expndtw-1\chars calex100 : SD\par\pard\li1984\sb139\sl-276\slmult0\fi1320\tx5584 \up0 \expndtw-1 \charscalex100 Status\tab \up0 \expndtw-1\charscalex100 : menikah\par\pard\li198 4\sb137\sl-276\slmult0\fi1320\tx5584 \up0 \expndtw-1\charscalex100 Agama\tab \up 0 \expndtw-1\charscalex100 : Islam\par\pard\li1984\sb139\sl-276\slmult0\fi1320\t x5584 \up0 \expndtw-1\charscalex100 Suku / bangsa\tab \up0 \expndtw-1\charscalex 100 : Jawa / Indonesia\par\pard\li1984\sb137\sl-276\slmult0\fi1320\tx5584 \up0 \ expndtw-1\charscalex100 Alamat\tab \up0 \expndtw-1\charscalex100 : Penaggalan Mo joagung Jombang\par\pard\li1984\sb139\sl-276\slmult0\fi1320\tx5584\tx7744 \up0 \ expndtw-1\charscalex100 MRS\tab \up0 \expndtw-1\charscalex100 : 10 Juli 2009\tab \up0 \expndtw-1\charscalex100 Jam : 16.00\par\pard\li1984\sb137\sl-276\slmult0\ fi1320\tx5584 \up0 \expndtw-1\charscalex100 No. MRS\tab \up0 \expndtw-1\charscal ex100 : 235939\par\pard\li1984\sb139\sl-276\slmult0\fi1320\tx5584\tx7744 \up0 \e xpndtw-1\charscalex100 Tanggal Pengkajian\tab \up0 \expndtw-1\charscalex100 : 17 Juli 2009\tab \up0 \expndtw-1\charscalex100 Jam : 11.00 WIB\par\pard\li1984\sb1 37\sl-276\slmult0\fi1320 \up0 \expndtw-1\charscalex100 Penanggung Jawab (suami) : Tn. \u8221?K\u8221?\par\pard\li1984\sb139\sl-276\slmult0\fi1320\tx5584 \up0 \e xpndtw-1\charscalex100 Alamat\tab \up0 \expndtw-1\charscalex100 : Penanggalan, M ojoagung Jombang\par\pard\li1984\sb137\sl-276\slmult0\fi960\tx3304 \up0 \expndtw -1\charscalex100 2.\tab \up0 \expndtw-1\charscalex100 Keluhan Utama\par\pard\li1 984\sb139\sl-276\slmult0\fi1320 \up0 \expndtw-1\charscalex100 Pasien mengatakan tidak nafsu makan disertai mual muntah.\par\pard\li1984\sb137\sl-276\slmult0\fi9 60\tx3304 \up0 \expndtw-1\charscalex100 3.\tab \up0 \expndtw-1\charscalex100 Riw ayat Kesehatan\par\pard\ql \li3304\sb128\sl-276\slmult0 \up0 \expndtw-1\charscal ex100 a.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Riwayat Kese hatan sekarang \par\pard\ql \li3664\sb144\sl-276\slmult0\tx10031 \up0 \expndtw0\ charscalex110 Pasien mengatakan nyeri pada perut dan nyeri pada anus \tab \up0 \ expndtw-4\charscalex100 pada \par\pard\ql \li3664\sb124\sl-276\slmult0\tx4519\tx 5390 \up0 \expndtw-3\charscalex100 tanggal \tab \up0 \expndtw0\charscalex109 10 Juli \tab \up0 \expndtw0\charscalex108 2009 Jam 14.00 WIB, saat BAB dan kemudian \par\pard\qj \li3664\ri1559\sb26\sl-420\slmult0 \up0 \expndtw0\charscalex100 di bawa ke puskesmad Mojoagung pada tanggal 10 Juli 2009 karena \up0 \expndtw0\char scalex101 pasien mual dan muntah pasien dirujuk ke Bapelkes RSD Jombang \up0 \ex pndtw-3\charscalex100 pada tanggal 10 Juli 2009, jam 16.00 WIB \par\pard\ql \li3 304\sb99\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b.\ul0\nosupersub\cf4\f5\f s24 \ul0\nosupersub\cf12\f13\fs24 Riwayat Kesehatan Yang Lalu \par\pard\qj \li 3664\ri1559\sb26\sl-420\slmult0 \up0 \expndtw0\charscalex102 Pasien mengatakan tidak pernah menderita penyakit menahun, \line \up0 \expndtw-3\charscalex10 0 menurun dan menular seperti TBC, DM, HIV, jantung dan lain-lain. \par\pard\ql \li3304\sb99\sl-276\slmult0 \up0 \expndtw-1\charscalex100 c.\ul0\nosupersub\cf4\ f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Riwayat kesehatan keluarga \par\pard\qj \li3664\ri1559\sb34\sl-410\slmult0 \up0 \expndtw0\charscalex105 Pasien mengataka n dalam keluarganya tidak ada yang menderita \up0 \expndtw0\charscalex103 penyak it menahun, menurun dan menular seperti TBC, DM, HIV, \up0 \expndtw-3\charscalex 100 jantung, hipertensi dan lain-lain. \par\pard\sect\sectd\fs24\paperw12240\pap erh18720\pard\sb0\sl-240{\bkmkstart Pg17}{\bkmkend Pg17}\par\pard\ql \li2944\sb0 \sl-276\slmult0 \par\pard\ql\li2944\sb0\sl-276\slmult0 \par\pard\ql\li2944\sb0\s l-276\slmult0 \par\pard\ql\li2944\sb0\sl-276\slmult0 \par\pard\ql\li2944\sb0\sl276\slmult0 \par\pard\ql\li2944\sb0\sl-276\slmult0 \par\pard\ql\li2944\sb75\sl-2

76\slmult0 \up0 \expndtw0\charscalex101 \ul0\nosupersub\cf12\f13\fs24 4.\ul0\nos upersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Pola fungsi kesehatan \par\p ard\ql \li3304\sb124\sl-276\slmult0 \up0 \expndtw0\charscalex100 a.\ul0\nosupers ub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Pasien mengatakan tidak pernah me rokok \par\pard\ql \li3304\sb144\sl-276\slmult0 \up0 \expndtw0\charscalex100 b.\ ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\f13\fs24 Pasien mengatakan tid ak pernah minum alkohol \par\pard\ql \li3304\ri1563\sb42\sl-400\slmult0\tx3664 \ up0 \expndtw0\charscalex104 c.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosupersub\cf12\ f13\fs24 Pasien mengatakan bahwa pasien tidak pernah menggunakan obat-\line\tab \up0 \expndtw-1\charscalex100 obatan terlarang \par\pard\ql \li2944\sb123\sl-27 6\slmult0 \up0 \expndtw0\charscalex102 5.\ul0\nosupersub\cf4\f5\fs24 \ul0\nosup ersub\cf12\f13\fs24 Pola Aktivitas\par\pard\sect\sectd\sbknone\cols3\colno1\col w5753\colsr160\colno2\colw2284\colsr160\colno3\colw3753\colsr160\ql \li1984\sb0\ sl-276\slmult0 \par\pard\ql \li1984\sb19\sl-276\slmult0\tx3606 \up0 \expndtw-2\c harscalex100 No\tab \up0 \expndtw-1\charscalex100 Aktivitas\par\pard\ql \li2073\ sb158\sl-276\slmult0\tx2495 \up0 \expndtw-3\charscalex100 1\tab \up0 \expndtw-1\ charscalex100 Mandi\par\pard\ql \li2073\sb10\sl-276\slmult0\tx2495 \up0 \expndtw -3\charscalex100 2\tab \up0 \expndtw-1\charscalex100 Berpakaian/dandan\par\pard\ ql \li2073\sb12\sl-276\slmult0\tx2495 \up0 \expndtw-3\charscalex100 3\tab \up0 \ expndtw-1\charscalex100 Mobilisasi di tempat tidur\par\pard\ql \li2073\sb9\sl-27 6\slmult0\tx2495 \up0 \expndtw-3\charscalex100 4\tab \up0 \expndtw-1\charscalex1 00 Pindah\par\pard\ql \li2073\sb10\sl-276\slmult0\tx2495 \up0 \expndtw-3\charsca lex100 5\tab \up0 \expndtw-1\charscalex100 Ambulasi\par\pard\ql \li2073\sb10\sl276\slmult0\tx2495 \up0 \expndtw-3\charscalex100 6\tab \up0 \expndtw-1\charscale x100 Naik tangga\par\pard\ql \li2073\sb9\sl-276\slmult0\tx2495 \up0 \expndtw-3\c harscalex100 7\tab \up0 \expndtw-1\charscalex100 Belanja\par\pard\ql \li2073\sb1 0\sl-276\slmult0\tx2495 \up0 \expndtw-3\charscalex100 8\tab \up0 \expndtw-1\char scalex100 Memasak\par\pard\qj \li2011\ri854\sb5\sl-285\slmult0\fi62\tx2495\tx248 8 \up0 \expndtw-3\charscalex100 9\tab \up0 \expndtw-1\charscalex100 Merapikan te mpat tidur \line \up0 \expndtw-2\charscalex100 10 \tab \up0 \expndtw-1\charscale x100 Skala ADL\par\pard\column \ql \li560\sb158\sl-276\slmult0 \up0 \expndtw-1\c harscalex100 Saat sehat\par\pard\ql \li20\sb10\sl-276\slmult0\tx510\tx997\tx1484 \tx1971 \up0 \expndtw-3\charscalex100 0\tab \up0 \expndtw-3\charscalex100 1\tab \up0 \expndtw-3\charscalex100 2\tab \up0 \expndtw-3\charscalex100 3\tab \up0 \ex pndtw-3\charscalex100 4\par\pard\ql \li6436\sb0\sl-276\slmult0 \par\pard\ql \li6 436\sb0\sl-276\slmult0 \par\pard\ql \li6436\sb0\sl-276\slmult0 \par\pard\ql \li6 436\sb0\sl-276\slmult0 \par\pard\ql \li6436\sb0\sl-276\slmult0 \par\pard\ql \li6 436\sb0\sl-276\slmult0 \par\pard\ql \li6436\sb0\sl-276\slmult0 \par\pard\ql \li6 436\sb0\sl-276\slmult0 \par\pard\ql \li6436\sb0\sl-276\slmult0 \par\pard\ql \li5 43\sb100\sl-276\slmult0 \up0 \expndtw-1\charscalex100 Jumlah : 0\par\pard\column \ql \li579\sb158\sl-276\slmult0 \up0 \expndtw-1\charscalex100 Saat sakit\par\pa rd\ql \li20\sb10\sl-276\slmult0\tx512\tx997\tx1484\tx1971 \up0 \expndtw-3\charsc alex100 0\tab \up0 \expndtw-3\charscalex100 1\tab \up0 \expndtw-3\charscalex100 2\tab \up0 \expndtw-3\charscalex100 3\tab \up0 \expndtw-3\charscalex100 4\par\pa rd\ql \li8870\sb0\sl-276\slmult0 \par\pard\ql \li8870\sb0\sl-276\slmult0 \par\pa rd\ql \li8870\sb0\sl-276\slmult0 \par\pard\ql \li8870\sb0\sl-276\slmult0 \par\pa rd\ql \li8870\sb0\sl-276\slmult0 \par\pard\ql \li8870\sb0\sl-276\slmult0 \par\pa rd\ql \li8870\sb0\sl-276\slmult0 \par\pard\ql \li8870\sb0\sl-276\slmult0 \par\pa rd\ql \li8870\sb0\sl-276\slmult0 \par\pard\ql \li543\sb100\sl-276\slmult0 \up0 \ expndtw-1\charscalex100 Jumlah : 3 \par\pard\sect\sectd\sbknone \li2944\sb0\sl-2 76\slmult0\par\pard\li2944\sb152\sl-276\slmult0\fi360 \up0 \expndtw0\charscalex1 01 Keterangan :\par\pard\sect\sectd\sbknone \li2944\sb136\sl-276\slmult0\fi360\t x4144 \up0 \expndtw0\charscalex101 0\tab \up0 \expndtw0\charscalex101 : mandiri\ par\pard\sect\sectd\sbknone \li2944\sb140\sl-276\slmult0\fi360\tx4144 \up0 \expn dtw0\charscalex101 1\tab \up0 \expndtw0\charscalex101 : dibantu sebagian\par\par d\sect\sectd\sbknone \li2944\sb136\sl-276\slmult0\fi360\tx4144 \up0 \expndtw0\ch arscalex101 2\tab \up0 \expndtw0\charscalex101 : perlu bantuan orang lain\par\pa rd\sect\sectd\sbknone \li2944\sb137\sl-276\slmult0\fi360\tx4144 \up0 \expndtw0\c harscalex101 3\tab \up0 \expndtw0\charscalex101 : perlu bantuan orang lain dan a lat\par\pard\sect\sectd\sbknone \li2944\sb139\sl-276\slmult0\fi360\tx4144 \up0 \

expndtw0\charscalex101 4\tab \up0 \expndtw0\charscalex101 : tergantung / tidak m ampu\par\pard\sect\sectd\sbknone \li2944\sb137\sl-276\slmult0\fi0\tx3304 \up0 \e xpndtw0\charscalex101 6.\tab \up0 \expndtw0\charscalex101 Pola Istirahat dan Tid ur\par\pard\sect\sectd\sbknone \li2944\sb139\sl-276\slmult0\fi360\tx5104\tx6304 \up0 \expndtw0\charscalex101 Saat sehat\tab \up0 \expndtw0\charscalex101 : maka n\tab \up0 \expndtw0\charscalex101 : \ul0\nosupersub\cf17\f18\fs24\ul +\ul0\nosu persub\cf12\f13\fs24 3x/hari, menu nasi, lauk, porsi sedang\par\pard\sect\sectd \sbknone \li2944\sb137\sl-276\slmult0\fi2399\tx6304 \up0 \expndtw0\charscalex101 malam\tab \up0 \expndtw0\charscalex101 : \ul0\nosupersub\cf17\f18\fs24\ul +\ul0 \nosupersub\cf12\f13\fs24 7 jam dengan kualitas tidur nyenyak\par\pard\sect\sec td\sbknone \li2944\sb139\sl-276\slmult0\fi360\tx5104 \up0 \expndtw0\charscalex10 1 Saat sakit\tab \up0 \expndtw0\charscalex101 : tidak tentu kadang tidak bi sa tidur karena\par\pard\sect\sectd\sbknone \li2944\sb137\sl-276\slmult0\fi239 9 \up0 \expndtw0\charscalex101 merasakan nyeri pada anus\par\pard\sect\sectd\sbk none \li2944\sb139\sl-276\slmult0\fi0\tx3304 \up0 \expndtw0\charscalex101 7.\tab \up0 \expndtw0\charscalex101 Pola Nutrisi\par\pard\sect\sectd\sbknone \li2944\s b137\sl-276\slmult0\fi360\tx5104\tx6304 \up0 \expndtw0\charscalex101 Saat sehat\ tab \up0 \expndtw0\charscalex101 : makan\tab \up0 \expndtw0\charscalex101 : 3x/ hari, menu nasi, lauk, porsi sedang\par\pard\sect\sectd\sbknone \li2944\sb139\sl -276\slmult0\fi2399\tx6304 \up0 \expndtw0\charscalex101 minum\tab \up0 \expndtw0 \charscalex101 : 3-4 gelas/hari (air putih, teh)\par\pard\sect\sectd\sbknone \li 2944\sb137\sl-276\slmult0\fi360\tx5104\tx6304\tx6506 \up0 \expndtw0\charscalex10 1 Saat sakit\tab \up0 \expndtw0\charscalex101 : makan\tab \up0 \expndtw0\charsc alex101 :\tab \up0 \expndtw0\charscalex101 3x/hari, menu nasi, lauk, sayur, pors i\par\pard\sect\sectd\sbknone \li2944\sb139\sl-276\slmult0\fi2399 \up0 \expndtw0 \charscalex101 sedang\par\pard\sect\sectd\sbknone \li2944\sb137\sl-276\slmult0\f i2399\tx6304 \up0 \expndtw0\charscalex101 minum\tab \up0 \expndtw0\charscalex101 : 6-7 gelas/hari (air putih)\par\pard\sect\sectd\sbknone \li2944\sb139\sl-276\s lmult0\fi0\tx3304 \up0 \expndtw0\charscalex101 8.\tab \up0 \expndtw0\charscalex1 01 Pola eliminasi\par\pard\sect\sectd\sbknone \li2944\sb137\sl-276\slmult0\fi360 \tx5104\tx6304 \up0 \expndtw0\charscalex101 Saat sehat\tab \up0 \expndtw0\charsc alex101 : BAK\tab \up0 \expndtw0\charscalex101 : 3-4x/hari, warna kuning jernih \par\pard\sect\sectd\sbknone \li2944\sb139\sl-276\slmult0\fi2399\tx6304 \up0 \ex pndtw0\charscalex101 BAB\tab \up0 \expndtw0\charscalex101 : 1x/hari, warna kunin g, bau khas, keras\par\pard\sect\sectd\sbknone \li2944\sb137\sl-276\slmult0\fi36 0\tx5104\tx6304 \up0 \expndtw0\charscalex101 Saat sakit\tab \up0 \expndtw0\chars calex101 : BAK\tab \up0 \expndtw0\charscalex101 : 2-3x/hari, warna kuning jerni h {\shp {\*\shpinst\shpleft1871\shptop4468\shpright1882\shpbottom4478\shpfhdr0\shp bxpage\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz60\shplid0 {\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{ \sn geoRight}{\sv 11}}{\sp{\sn geoBottom}{\sv 10}} {\sp{\sn pVerticies}{\sv 8;5;(1,10);(10,10);(10,1);(1,1);(1,10)}} {\sp{\sn pSegmentInfo}{\sv 2;11;16384;45824;1;45824;1;45824;1;45824;1;45824;3276 8}} {\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}{\s p{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}{\s p{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}} }} {\shp {\*\shpinst\shpleft1871\shptop4468\shpright1882\shpbottom4478\shpfhdr0\shp bxpage\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz62\shplid1 {\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{ \sn geoRight}{\sv 11}}{\sp{\sn geoBottom}{\sv 10}} {\sp{\sn pVerticies}{\sv 8;5;(1,10);(10,10);(10,1);(1,1);(1,10)}} {\sp{\sn pSegmentInfo}{\sv 2;11;16384;45824;1;45824;1;45824;1;45824;1;45824;3276 8}} {\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}{\s p{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}{\s

p{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}} }} {\shp {\*\shpinst\shpleft1881\shptop4468\shpright2388\shpbottom4488\shpfhdr0\shp bxpage\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz64\shplid2 {\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{ \sn geoRight}{\sv 507}}{\sp{\sn geoBottom}{\sv 20}} {\sp{\sn pVerticies}{\sv 8;5;(0,20);(507,20);(507,0);(0,0);(0,20)}} {\sp{\sn pSegmentInfo}{\sv 2;11;16384;45824;1;45824;1;45824;1;45824;1;45824;3276 8}} {\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}{\s p{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}{\s p{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}} }} {\shp {\*\shpinst\shpleft2387\shptop4468\shpright2398\shpbottom4478\shpfhdr0\shp bxpage\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz66\shplid3 {\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{ \sn geoRight}{\sv 11}}{\sp{\sn geoBottom}{\sv 10}} {\sp{\sn pVerticies}{\sv 8;5;(1,10);(10,10);(10,1);(1,1);(1,10)}} {\sp{\sn pSegmentInfo}{\sv 2;11;16384;45824;1;45824;1;45824;1;45824;1;45824;3276 8}} {\sp{\sn fFillOK}{\sv 1}}{\sp{\sn fFilled}{\sv 1}}{\sp{\sn fillColor}{\sv 0}}{\s p{\sn fLine}{\sv 0}}{\sp{\sn lineType}{\sv 0}}{\sp{\sn fArrowheadsOK}{\sv 1}}{\s p{\sn fBehindDocument}{\sv 1}}{\sp{\sn lineColor}{\sv 0}} }} {\shp {\*\shpinst\shpleft2397\shptop4468\shpright5726\shpbottom4488\shpfhdr0\shp bxpage\shpbypage\shpwr3\shpwrk0\shpfblwtxt1\shpz68\shplid4 {\sp{\sn shapeType}{\sv 0}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{ \sn geoRight}{\sv 3329}}{\sp{\sn geoBottom}{\sv 20}} {\sp{\sn pVerticies}{\sv 8;5;(0,20);(3329,20);(3329,