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Skenario E Blok 23 Tahun 2014

A male newborn was referred to MOH.Hoesin Hospital by a midwife who helped his

mother,Mr sUtami delivery with chief complaint of grunting. Mother s history wastaken from

the midwife. She said that Mr sUtami s pregnancy was full term. The baby was born 3 hours agowith apgar score 5 for 1 st minute and 8 for 5 th minute, birth body weight was 3 kg. The mother

had premature rupture of membrane 2 days ago and had bad smell liquor. From the physical

examination the baby was hypoactive and tachypnea, no sucking reflex, and there was chest

indrawing.

KlarifikasiIstilah

1.Grunting:Suarasepertidengkuranpadaakhirekspirasi

2.Premature rupture ofmembrane: Suatukondisipadakehamilandidefinisikansebagaipecahnya

membrane kantungketubandanchorionlebihdarisatu jam sebelumawalpersalinan.

3.Bad smelly liquor: baucairanketuban(amnion) yang tidakenak .

4.Hypoactive: Penurunan abnormal suatuaktivitas

5.APGAR score: Penilaiantentangkeadaanbayidalamangkaberdasarkandenyutjantung,

usahabernafas, tonus otot, reflex iritabilitasdanwarna

6.Tachypnea: Pernafasan yang sangatcepat

7.Sucking reflex: Gerakanmenghisappadamulutbayi yang di

timbulkandenganmenyentuhbibirataukulitdidekatmulutbayi

8.ChestIndrawing: retraksidinding dada

9.Full term : Periodegestasicukupbulan (37-42 minggu)

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Identifikasimaslah

1. A male newborn was referred to Moh.Hoesin Hospital by a midwife who helped his

mother,Mr sUtami delivery with chief complaint of grunting.

2. Mothers history was taken from the midwife. She said that MrsUtami;s pregnancy was full

term. The baby was born 3 hours ago with APGAR score 5 for 1 st minute and 8 for 5 th minute,

birth body weight was 3 kg.

4. The mother had premature rupture of membrane 2 days ago and had bad smell liquor.

5. From the physical examination the baby was hypoactive and tachypnea, no sucking reflex,

and there was chest indrawing

Analisismasalah

1. A male newborn was referred to MOH.Hoesin Hospital by a midwife who helped his

mother,MrsUtami delivery with chief complaint of grunting.

1.1 Etiologidanmekanisme grunting?1

1.2 Hubunganjeniskelamin (laki-laki) dengankasus ini?2

2. Mothers history was taken from the midwife. She said that MrsUtami;s pregnancy wasfull term.The baby was born 3 hours ago with APGAR score 5 for 1 st minute and 8 for 5 th

minute, birth body weight was 3 kg.

2.1BagaimanaklasifikasiAPGAR score?3

2.2Apamakna (score 5 for 1 st minute and 8 for 5 th minute)?4

2.3 Apamaknaberatbadanbayi 3 kg? 5

3. The mother had premature rupture of membrane 2 days ago and had bad smell liquor.

3.1Apamaknaklinispecahketuban 2 hari yang laludengankelahiranbayi 3 jam yang lalu?6

3.2Apadimaksudkandenganbautidakenakcairanketubanpada kasus?7

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3.3 Faktorresikoketubanpecah dini?8

3.4 Etiologidanmekanismeketubanpecah dini?9

4. From the physical examination the baby was hypoactive and tachypnoe, no sucking

reflex, and there was chest indrawing.

4.1Interpretasidanmekanisme abnormal daripemeriksaan fisik?10

4.2 Cara pemeriksaan sucking reflex?11

5.Diagnosis Banding12

6.Bagaimanacara mendiagnosis13

7.Diagnosis Kerja14

8.Pemeriksaan Penunjang15

9.Epidemiologi16

10. Faktor Resiko17

11. Patogenesis18

12. Penatalaksanaan19

13.Komplikasi20

14.Pencegahan21

15. Prognosis22

16. StandarKompetensiDokterIndonesia 23

Hipotesis

Bayilaki-lakicukupbulanlahir (spontan) 3 jam yang laludibawake RSU

Moh.Hoesindidugamenderitagangguanpernafasan (ARDS)etcausa bronchopneumonia dan sepsis

neonatorum.

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Learning issue

1.Acute Respiratory Distress Syndrome

2.Neonatal Sepsis

3. Bronchopneumonia

NAMA

Mutiara 12 1 7 19 23 Li 1Renal 11 23 8 20 22 Li 2Suci 10 22 9 21 1 Li3Putra 9 21 10 22 20 Li1Yuda 8 20 11 23 19 Li2Putri 7 19 12 18 21 Li3Juli 6 18 1 13 17 Li1

Rify 5 17 2 14 16 Li2Jane 4 16 3 15 15 Li3KS 3 15 4 16 14 Li1Aiman 2 14 5 17 13 Li2Siva 1 13 6 18 12 Li3