Tutorial Terapi Cairan.docx

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Terapi Cairan Perioperatif Pada Pasien SC G2P1A0 Hamil Aterm Dengan Riwayat SC Dengan Hipokalemia Kiki atma !i"aya #20100$101%1& '(r)aiti Andiyani #20100$101*+&

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Terapi Cairan Perioperatif Pada

Pasien SC G2P1A0 Hamil AtermDengan Riwayat SC Dengan

Hipokalemia

Kiki atma !i"aya #20100$101%1&

'(r)aiti Andiyani #20100$101*+&

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,dentitas

• 'ama - 'y.

• /sia - $ ta(n

 Alamat - Pak(nen3 4K• 5RS- 067017201+

• Tgl 8p - 067017201+

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 AnamnesisPasien peremp(an $ ta(n G2P1A0 keamilan $% mingg(

datang ke poli (nt(k kontrol r(tin keamilan. Pasien memp(nyairiwayat SC 9 ta(n yang lal(. Pasien s(da merasakan keneng7

keneng. Kel(ar airan dari "alan lair #7&3 gerak "anin #:&3 p(sing #7&3

m(al #7&3 m(nta#7&. Pasien mengatakan )adannya sering terasa

kak(.

• RPD- riwayat SC #:& 9 ta(n yang lal(3 riwayat HT #7&3 D5 #7&3 alergidan asma #7&

• RPK- riwayat HT #7&3 D5 #7&3 alergi dan asma #7&

• Riwayat 8)stetri - G2P1A03 anak pertama SC 9 ta(n yang

lal(#dengan P;<&3 ))-2*00 gr 

• Riwayat Haid - terat(r3 menare (sia 1$ ta(n3 sikl(s 2% ari3 lama

aid =+ ari

• Riwayat A'C - R(tin di dokter 

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Pemeriksaan isik K/- )aik3 ompos mentis

>ital sign - TD 1$0?100 mmHg. ' %% kpm3 R 1% kpm3 S

$+39 C3 << + kg3 T<- 1 m

Kepala dan leer- CA #7?7&3 S, #7?7&3 m(kosa m(l(t )asa3

lnn tidak tera)a3 mallampati 1

Toraks-

Par(- inspeksi simetris kanan kiri3 palpasi ketinggalan

gerak #7?7&3 perk(si sonor #:?:&3 a(sk(ltasi @esik(ler #:?:&

ant(ng- it(s ordis tak tampak3 S17S2 reg(ler 

 A)domen- inspeksi mem)(nit3 mem)("(r3 striaegra@idar(m #7&3 a(sk(ltasi )ising (s(s #:& normal3 palpasi

epar lien tidak tera)a3 nyeri tekan #7&3 perk(si pekak

)erali #7&

;kstremitas- akral angat3 CRT B2 detik3 edema #7&

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Cont....Stat(s 8)stetri

Tera)a "anin t(nggal3 meman"ang3 Pres)o3 P(ka3 T/ 2+ m3 H,S #:&

 "arang3 selap(t ket()an (t(3 D #:& lendir dara #7&

Pemeriksaan Pen(n"ang

• Pemeriksaan Dara

o

Hemoglo)in- 11.9 #12719&o e(kosit- 10.+ #6710r)&

o Hematokrit- $ #$+72&

o Trom)osit- 2$ #10760&

o PPT- 123+ #1271%&

o  APTT 2932 #20760&

o H)sag- #7&

o ;lektrolit - kali(m 23 #$373$&

Protein /rine :

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aporan AnestesiDiagnosa pra)eda - G2A1P0 amil aterm dengan P;R dan

Hipokalemia dengan riwayat SC ai P;<Diagnosa pasa)eda - G2A1P0 amil aterm dengan P;R dan

Hipokalemia dengan riwayat SC ai P;<

Diagnosa anestesi - ASA ,, proSC

enis tindakan operasi -SC

enis anestesi - Spinal Anestesi• Premedikasi - 7

• Sedasi - 7

• ,nd(ksi - <(pi@aain Spinal 20 mg

• 8)at78)atan - Analgetik - Ketorola $0mg

  Antiemetik - 8ndansetron 6mg

• Terapi airan preoperatif -loading R $0 tpm

 

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Jam Tekanan darah

(mmHg)

15.10 160?%0

15.15 120/73

15.20 11*?92

15.25 121?9

1. Induksi (bupivacaine 20 mg)

2. Ondansetron 4 mg

3. Ketorolac 30 mg

Tekanan darah dan nadi selama operasi:

8ksitosin :5etergin

S(da terpasang ,@D R $0 tpm

Infus RL di gani dengan !a"#$

%g &

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Jam Tekanan darah

(mmHg)

15.30 100?+0

15.35 *?2

15.40 100?+0

15.45 10?+1

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Jam Tekanan darah

(mmHg)

15.50 10?+0

15.55 100?+0

16.00 111?*

16.05 100?++

16.10 11$?+0

16.15 111?+

16.20 10*?+*

8perasi selesai

Perkiraan perdaraan d(rante operasi se)anyak = 600

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PEMBAHASA

N

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