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MORNING REPORT

Jumat, 23 Januari 2016

Dokter jaga : dr. Rusmunandar, Sp.Jp-FIHA

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Fera Mulidar1407101030186

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Jumlah pasien yang dikonsulkan dari IGD ke bagian Kardiologi

Kamis 14 Januari 2016

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No Identitas Pasien Diagnosa ital sign !erapi DPJP

1

Nama " drs# $%J#Kelamin " &aki'laki(sia " )* tahun+$ " 1'0*',4'*2

+-. !D" 200/120N" )" 20

'%mlodipin tab110 mg-alsartan 1,0 mg

-P/ obser3asi

DPJP " dr#usmunandar5p#JP

2 Nama" Ny#J#Kelamin " Perempuan(sia " 60 tahun+$ " 0'60'*'1

+-. 78N-% III'Ie8 +%D 9D$ tipe 2 9%KI stage IIpre renal9-ipertensi stgI

!D " 14)/,4N" *, " 2,5P:2 " );

-&asi 2 ampul ekstraselan

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2/7/16 3Management of Hypertensive urgency

3 ama ! "n# $s%#&elamin ! la'i(la'i

)sia ! 67 ta*un+M ! 1(07(76(,0

+HF fc-H$ ...(.

ec dd !1 HH2 +$

" !100/60 ! 76

!24

-'sigen 2(4/menit

-. 5*aro 7,0 mg-Furosemide 2amp/8 %am-"anapres 1 8 mg-5imvastatin 120mg-.5 31 talet

-"riedon M 11

-P/ >+-:

DPJP " dr%?hari Gani

5pPD KK

4

ama !y# F9#&elamin !perempuan

)sia ! 28 ta*un+M ! 1(07(76(,7

+HF fc-H$ . ecdd/ 1# HH

2# +$:os#ferisec dd/1# emamtipoid2# Malaria

3# .5&

" ! 104/62! 140 !32

-'sigen 4(6l/menit-rip furosemide 2

cc/%am-igo'sin 2 0;,mg-$spilet 180 mg-+

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&$5)5

Pasien bernama Ny# 5 usia 4* tahun datang dengan keluhan nyeri kepala kepala yangdirasakan se

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!horaks "Inspeksi " simetris saat statis dan dinamis

Palpasi " stem 7remitus kananFkiri

Perkusi " sonor dikedua lapang paru

%uskultasi " esikuler A9/9B rhonki A'/'B @hee?ing A'/'B

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JantungInspeksi " I8tus 8ordis tidak terlihat

Palpasi " i8tus 8ordis teraba di I+5 mid8la3i8ularis sinistra

Perkusi "

Catas atas " I+5 III mid8la3i8ularis sinistra

Catas kanan " I+5 parasternal dekstra

Catas kiri " I+5 mid8la3i8ularis sinistra 1

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%bdomen

Inspeksi " simetris distensi A'B

Palpasi " organomegali A'B G/-/& tidak membesar

Perkusi " timpanishifting dullnessA'B undulasi A'B

%uskultasi" Peristaltik A4 dalam 1 menitB

>kstremitas"

>kstremitas superior " sianosisA'/'B edemaA'/'B pu8atA'/'B akral dingin A'/'B +! H2

>kstremitas in7erior " sianosisA'/'B edemaA'/'B pu8atA'/'B akral dingin A'/'B +! H2

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A&=

2/7/16 11Management of Hypertensive urgency

.rama sinus; ritme reguler dengan H 67/menit; a'sisnormal; < @ave normal; H ?(; H ?(; 5" elevasi ?(; 5"depresi ?(;

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.A".F.&$5. M$5$$H1# $pa'a* diagnosa pada 'asus diatas 2# Iagaimana patogenesis penya'it pada pasien

terseut3# $pa pemeri'saan penun%ang yang diutu*'an

untu' memantu menega'an diagnosa diatas4# Iagaimana tatala'sana 'asus diatas

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$$.5$ M$5$$H1#

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.$=5$

2/7/16 14Management of Hypertensive urgency

HIPERTENSI R!ENSI

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"$"$$&5$$ &.5.5H.

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%lgorithm 7or !reatment o7 -ypertension

Not at !oa" #"ood Pressure $%&'()*( mmHg+

$%&()( mmHg or t/ose 01t/ d1a2etes or 3/ron13 k1dne4 d1sease+

In1t1a" Drug 5/o13es

Drug$s+ or t/e 3ompe""1ng

1nd13at1ons

:ther antihypertensi3e drugs

Adiureti8s %+>I %C CC ++CB

as needed#

61t/ 5ompe""1ng

Ind13at1ons

71est4"e 8od113at1ons

Stage 9 H4pertens1on

A5CP 160 or DCP 100 mm-gB

2'drug 8ombination 7or most Ausually

thia?ide'type diureti8 and

%+>I or %C or CC or ++CB

Stage & H4pertens1on

A5CP 1401) or DCP 0 mm-gB

!hia?ide'type diureti8s 7or most#

$ay 8onsider %+>I %C CC ++C

or 8ombination#

61t/out 5ompe""1ng

Ind13at1ons

Not at !oa"

#"ood Pressure

:ptimi?e dosages or add additional drugs

until goal blood pressure is a8hie3ed#

+onsider 8onsultation @ith hypertension spe8ialist#

P 12" 5 21 t1 D1 5" A t1/ t 1 A t

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Calcium

antagonists

Calcium

antagonists

AT1-receptors

blockers

AT1-receptors

blockers-blockers-blockers

-blockers-blockers

DiureticsDiuretics

ACE inhibitorsACE inhibitorsThe most rational combinationsThe most rational combinations

Classes of antihypertensive

agents proven to be beneficial

in controlled interventional trial

Classes of antihypertensive

agents proven to be beneficial

in controlled interventional trial

Poss12"e 5om21nat1on o D1eren3e 5"asses o Ant1/4pertens1e Agents

9(( European So31et4 o H4pertens1on-European So31et4 o 5ard1o"og4

!u1de"1nes or management o arter1a" /4pertens1on

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"$"$$&5$$

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A$.= I9A+".A

1# $pa'a* peredaan*ipertensi urgensi denganemergensi

2# $pa sa%a oat yangdiguna'an pada *ipertensidisertai dengan 'eadaan'*usus

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H$5. IA$9$ M$..

1# Hipertensi urgensi

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Mana%emen 'risis*ipertensi

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5."A5.5

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TERI8A;ASIH

2/7/16 2,Management of Hypertensive urgency