TUGAS AKHIR

PROSES ASUHAN GIZI TERSTANDAR PADA PASIEN CHRONIC KIDNEY DISEASE (CKD) DENGAN

HEMODIALISIS DI RSUD PANEMBAHAN SENOPATI BANTUL

Diajukan sebagai salah satu syarat untuk memperoleh gelar Ahli Madya Gizi

NUSAIBAH INAS NAFISAH P07131116005

PRODI D-III GIZI

JURUSAN GIZI POLITEKNIK KESEHATAN KEMENTERIAN KESEHATAN

YOGYAKARTA TAHUN 2019

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DAFTAR ISI

Halaman

HALAMAN JUDUL ....................................................................................... i HALAMAN PERSETUJUAN PEMBIMBING .............................................. ii HALAMAN PENGESAHAN ......................................................................... iii HALAMAN PERNYATAAN ORISINALITAS ................................................ iv HALAMAN PERNYATAAN PERSETUJUAN PUBLIKASI TUGAS AKHIR KEPENTINGAN AKADEMIS ............................................................... v KATA PENGANTAR .................................................................................... vi DAFTAR ISI ................................................................................................... vii DAFTAR TABEL ........................................................................................... ix DAFTAR LAMPIRAN .................................................................................. x DAFTAR GAMBAR ....................................................................................... xi ABSTRACT ..................................................................................................... xii ABSTRAK ....................................................................................................... xiii BAB I PENDAHULUAN

A. Latar Belakang ..................................................................................... 1 B. Rumusan Masalah ................................................................................ 3 C. Tujuan Penelitian ................................................................................. 3 D. Ruang Lingkup ..................................................................................... 4 E. Manfaat Penelitian ............................................................................... 4 F. Keaslian Penelitian ............................................................................... 5

BAB II TINJAUAN PUSTAKA

A. Telaah Pustaka ..................................................................................... 11 B. Landasan Teori ..................................................................................... 29 C. Pertanyaan Penelitian ........................................................................... 31

BAB III METODE PENELITIAN

A. Jenis Dan Desain Studi Kasus ............................................................. 32 B. Subyek Studi Kasus ............................................................................ 32 C. Fokus Studi ......................................................................................... 32 D. Definisi Operasional Fokus Studi ....................................................... 33 E. Metode Pengumpulan Data dan Instrumen Studi Kasus ..................... 37 F. Tempat dan Waktu Studi Kasus .......................................................... 38 G. Analisis Data dan Penyajian Data ....................................................... 38 H. Etika Studi Kasus ................................................................................ 38

BAB IV METODE PENELITIAN

A. Hasil .................................................................................................... 39 B. Pembahasan ......................................................................................... 59

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BAB V KESIMPULAN DAN SARAN

A. Kesimpulan ......................................................................................... 62 B. Saran ................................................................................................... 65

DAFTAR PUSTAKA ...................................................................................... 66

Lampiran

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DAFTAR TABEL

Halaman

Tabel 1. Bahan Makanan yang Dianjurkan dan Tidak Dianjurkan ................. 16

Tabel 2. Koreksi BB pada Pasien dengan Oedema ......................................... 18

Tabel 3. Kategori IMT menurut Kemenkes RI ............................................... 19

Tabel 4. Data Biokimia pada Pasien Gagal Ginjal Kronik ............................. 21

Tabel 5. Data Klinik-Fisik pada Pasien Gagal Ginjal Kronik ......................... 21

Tabel 6. Contoh Tabel Monitoring dan Evaluasi ............................................ 36

Tabel 7. Data Identitas Responden .................................................................. 42

Tabel 8. Data Biokimia Responden ................................................................. 44

Tabel 9. Data Klinis Responden ...................................................................... 45

Tabel 10. Data Kebiasaan Makan Responden ................................................. 46

Tabel 11. Perbandingan Asupan Responden dengan Standar Diet Rumah Sakit ................................................................................................................. 48

Tabel 12. Obat dan Infus Pasien ...................................................................... 49

Tabel 13 Perbandingan Kebutuhan Gizi Standar Diet RS dengan Rekomendasi .................................................................................................... 55

Tabel 14. Data Biokimia .................................................................................. 55

Tabel 15. Data Klinis/Fisik Responden ........................................................... 56

Tabel 16. Data Asupan Zat Gizi ke 1 .............................................................. 57

Tabel 17. Data Asupan Zat Gizi ke 2 ............................................................... 57

Tabel 18. Skrining NRS 2002 .......................................................................... 74

Tabel 19. Recall 24 Jam Pasien ....................................................................... 75

Tabel 20. Perbandingan Standar Diet Rumah Sakit dan Perhitungan.............. 76

Tabel 21. Tabel Data Biokimia ........................................................................ 77

Tabel 22. Tabel Perencanaan Menu ke-1 ......................................................... 78

Tabel 23. Tabel Asupan Zat Gizi Menu ke-1................................................... 80

Tabel 24. Tabel Perencanaan Menu ke-2 ......................................................... 82

Tabel 25. Tabel Asupan Zat Gizi Menu ke-2................................................... 84

Tabel 26. Tabel Perencanaan Monitoring dan Evaluasi .................................. 86

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DAFTAR LAMPIRAN

Halaman

Lampiran 1 Penjelasan Sebelum Penelitian .................................................... 70

Lampiran 2 Lembar Persetujuan Responden .................................................. 72

Lampiran 3 Skrining NRS 2002 ..................................................................... 74

Lampiran 4 Recall 24 Jam Pasien ................................................................... 75

Lampiran 5 Perbandingan Diet Rumah Sakit dan Perhitungan Kebutuhan .... 76

Lampiran 6 Data Biokimia .............................................................................. 77

Lampiran 7 Perencanaan Menu ke-1 .............................................................. 78

Lampiran 8 Intervensi Asupan Menu ke-1 ...................................................... 80

Lampiran 9 Perencanaan Menu ke-2 ............................................................. 82

Lampiran 10 Intervensi Asupan Menu ke-2 ................................................... 84

Lampiran 11 Perencanaan Monitoring dan Evaluasi ....................................... 86

Lampiran 12 Leaflet Diet Gagal Ginjal Kronik dengan Hemodialisis ............ 87

Lampiran 13 Leaflet Bahan Makanan Penukar................................................ 88

Lampiran 14 Foto Menu .................................................................................. 89

Lampiran 15 Susunan Acara Konseling........................................................... 91

Lampiran 16 SOP Konseling Gizi pada Pasien dan Keluarga Pasien ............. 95

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DAFTAR GAMBAR

Halaman

Gambar 1. Analisis Asupan Zat Gizi Selama Pelayanan ................................. 62

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