tag:blogger.com,1999:blog-73708319082441691162024-02-20T04:55:56.419-08:00laparatomiaskep2http://www.blogger.com/profile/14871269833435613937noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-7370831908244169116.post-10024663858474712522012-02-01T06:02:00.000-08:002012-02-01T06:02:49.734-08:00askep laparatomi<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">BAB 1<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">PENDAHULUAN<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l25 level2 lfo33; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.1<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Latar Belakang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Organ-organ pada saluran pencernaan, saluran limfatik, saluran urogenital dan saluran reproduksi merupakan organ tubuh yang berada di ruang abdomen. Semua organ tersebut dapat ditemukan dengan menggunakan teknik operasi laparotomi. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Laparotomi berasal dari dua kata terpisah, yaitu laparo dan tomi. Laparo sendiri berati perut atau abdomen sedangkan tomi berarti penyayatan. Sehingga laparotomi dapat didefenisikan sebagai penyayatan pada dinding abdomen atau peritoneal. Istilah lain untuk laparotomi adalah celiotomi.( Fossum, 2002) <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Keuntungan penggunaan teknik laparotomi medianus adalah tempat penyayatan mudah ditemukan karena adanya garis putih (linea alba) sebagai penanda, sedikit terjadi perdarahan dan di daerah tersebut sedikit mengandung syaraf. Adapun kerugian yang dapat terjadi dalam penggunaan metode ini adalah mudah terjadi hernia jika proses penjahitan atau penangan post operasi kurang baik dan persembuhan yang relatif lama. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Oleh karena itu, dalam praktikum kali ini digunakan teknik operasi laparotomi medianus cental dengan pertimbangan yang telah dijelaskan di atas. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tujuan laparotomi adalah untuk menemukan dan mengetahui keadaan organ visceral yang ada di dalam ruang abdominal secara langsung serta untuk menegakkan diagnosa. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l25 level2 lfo33; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.2<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Rumusan Masalah<o:p></o:p></span></div><ol start="1" type="1"><li class="MsoNormal" style="color: #7030a0; line-height: 150%; mso-list: l20 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Apa pengertian dari laparatomi?<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; mso-list: l20 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Apa saja jenis-jenis dari laparatomi?<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; mso-list: l20 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Apa indikasi diadakannya laparatomi?<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; mso-list: l20 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Bagaimana asuhan keperawatan pada klien laparatomi?<o:p></o:p></span></li>
</ol><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l25 level2 lfo33; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.3<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tujuan Penulisan<o:p></o:p></span></div><ol start="1" type="1"><li class="MsoNormal" style="color: #7030a0; line-height: 150%; mso-list: l6 level1 lfo36; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Mengetahui apa pengertian dari laparatomi<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; mso-list: l6 level1 lfo36; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Mengetahui apa saja jenis-jenis dari laparatomi<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; mso-list: l6 level1 lfo36; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Mengetahui apa indikasi diadakannya laparatomi<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; mso-list: l6 level1 lfo36; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; letter-spacing: -.1pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Mengetahui bagaimana asuhan keperawatan pada klien laparatomi<o:p></o:p></span></li>
</ol><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;"><br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">BAB 2<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">PEMBAHASAN<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">2.1 Pengertian <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Laparatomi yaitu insisi pembedahan melalui pinggang (kurang begitu tepat), tapi lebih umum pembedahan perut (Harjono. M, 1996). Pembedahan yang dilakukan pada usus akibat terjadinya perlekatan usus dan biasanya terjadi pada usus halus. (Arif Mansjoer, 2000). Ramali Ahmad (2000) mengatakan bahwa laparatomy yaitu pembedahan perut, membuka selaput perut dengan operasi. Sedangkan menurut Sanusi (1999), laparatomi adalah insisi pembedahan melalui dinding perut atau abdomen.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l12 level2 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-bidi-font-weight: bold; mso-fareast-font-family: Harrington;">2.2<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">Jenis Laparotomi <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l12 level3 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.5in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-bidi-font-weight: bold; mso-fareast-font-family: Harrington;">2.2.1<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">Menurut Tekhnik Pembedahan<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; mso-add-space: auto; mso-list: l10 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Insisi pada garis tengah abdomen (mid-line incision)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l28 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Paparan bidang pembedahan yang baik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l28 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Dapat diperluas ke cephalad ( ke arah “kranial” ) <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l28 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Penyembuhan dan kosmetik tidak sebaik insisi tranversal<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l28 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Dipilih cara ini bila insisi tranversal diperkirakan tidak dapat memberikan paparan bidang pembedahan yang memadai<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l28 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Dipilih pada kasus gawat-darurat<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><a href="http://lh3.ggpht.com/_ezSsIEHCzdA/Sz3pHuPjTfI/AAAAAAAABFI/LIDthRmCjUA/s1600-h/clip_image002%5B4%5D%5B4%5D.jpg"><span style="color: #7030a0; mso-fareast-font-family: "Times New Roman"; 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id="Picture_x0020_5" o:spid="_x0000_i1026" type="#_x0000_t75" alt="Untitled-1"
style='width:210.75pt;height:163.5pt;visibility:visible' o:button="t"> <v:imagedata src="file:///C:\DOCUME~1\INGGA\LOCALS~1\Temp\msohtmlclip1\01\clip_image003.jpg"
o:title="Untitled-1"/> </v:shape><![endif]--><!--[if !vml]--><img alt="Untitled-1" border="0" height="218" src="file:///C:/DOCUME~1/INGGA/LOCALS~1/Temp/msohtmlclip1/01/clip_image004.jpg" v:shapes="Picture_x0020_5" width="281" /><!--[endif]--></span></b></a></span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Sering digunakan pada pembedahan obstetri dan ginekologi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Keuntungan</span></b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l4 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in left 63.0pt; text-align: justify; text-indent: 0in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Jarang terjadi herniasi pasca bedah<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l4 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in left 63.0pt; text-align: justify; text-indent: 0in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kosmetik lebih baik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l4 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in left 63.0pt; text-align: justify; text-indent: 0in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kenyamanan pasca bedah bagi pasien lebih baik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kerugian</span></b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l0 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in left 63.0pt; text-align: justify; text-indent: 0in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Daerah pemaparan (lapangan operasi) lebih terbatas<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l0 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in left 63.0pt; text-align: justify; text-indent: 0in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tehnik relatif lebih sulit<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-list: l0 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in left 63.0pt; text-align: justify; text-indent: 0in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Perdarahan akibat pemisahan fascia dari lemak lebih banyak <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 4; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Jenis insisi tranversal :<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l11 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Insisi <b>PFANNENSTIEL :</b><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l27 level2 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 63.0pt; text-align: justify; text-indent: -9.0pt;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kekuatan pasca bedah : BAIK<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l27 level2 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 63.0pt; text-align: justify; text-indent: -9.0pt;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b.</span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Paparan bidang bedah : KURANG<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l11 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Insisi <b>MAYLARD :</b><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 63.0pt; mso-list: l19 level2 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 63.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Paparan bidang bedah lebih baik dibanding PFANNENSTIEL oleh karena dilakukan pemotongan pada m.rectus abdominalis dan disisihkan ke arah kranial dan kaudal<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 63.0pt; mso-list: l19 level2 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 63.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Dapat digunakan untuk melakukan diseksi Lnn. Pelvik dan Lnn.Paraaortal <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 63.0pt; mso-list: l19 level2 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 63.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Dibanding insisi MIDLINE : <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 1.25in; mso-list: l3 level3 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.25in 1.5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;">§<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Nyeri pasca bedah kurang. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 1.25in; mso-list: l3 level3 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.25in 1.5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;">§<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Penyembuhan lebih kuat dan pelekatan minimal namun <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 1.25in; mso-list: l3 level3 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.25in 1.5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;">§<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Ekstensi ke bagian kranial sangat terbatas sehingga akses pada organ abdomen bagian atas sangat kurang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-list: l11 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Insisi <b>CHERNEY :</b><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 63.0pt; mso-list: l30 level2 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 63.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Perbedaan dengan insisi MAYLARD : pemotongan m.rectus dilakukan pada origo di simfisis pubis.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 63.0pt; mso-list: l30 level2 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 63.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Penyembuhan bedah dengan kekuatan yang baik dan paparan bidang pembedahan terbatas.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 63.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l11 level1 lfo16; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Paramedian</span></b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">, yaitu sedikit ke tepi dari garis tengah (</span><span style="color: #7030a0; font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: Harrington; mso-char-type: symbol; mso-hansi-font-family: Harrington; mso-symbol-font-family: Symbol;">±</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"> 2,5 cm), panjang (12,5 cm).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l11 level1 lfo16; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Transverse upper abdomen incision</span></b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">, yaitu insisi di bagian atas, misalnya pembedahan colesistotomy dan splenektomy.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-pagination: none; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-list: l12 level3 lfo17; mso-pagination: none; tab-stops: 45.0pt; text-align: justify; text-indent: -.5in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.2.2<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Jenis Laparatomi Menurut Indikasi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo18; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Adrenalektomi: pengangkatan salah satu atau kedua kelenjar adrenalin<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo18; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Apendiktomi: operasi pengangkatan apendiks<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo18; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Gasterektomi: pengangkatan sepertiga distal lambung (duodenum/jejunum, mengangkat sel-sel penghasil gastrin dalam bagian sel parietal)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo18; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Histerektomi: pengangkatan bagian uterus<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo18; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Kolektomi: seksisi bagian kolon atau seluruh kolon<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo18; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Nefrektomi: operasi pengangkatan ginjal<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo18; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pankreatomi: pengangkatan pancreas<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo18; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Seksiosesaria: pengangkatan janin dengan membuka dinding ovarium melalui abdomen.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo18; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Siksetomi: operasi pengangkatan kandung kemih<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo18; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">10.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Selfigo oofarektomi: pengangkatan salah satu atau kedua tuba valopi dan ovarium<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l12 level2 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.3<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Indikasi Bedah Laparatomi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: 27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tindakan laparatomi bisa ditegakkan atas indikasi pada klien dengan apendiksitis, pangkreatitis, hernia, kista ovarium, kangker serviks, kangker ovarium, kangker tuba falopi, kangker hati, kangker lambung, kangker kolon, kangker kandung kemih, kehamilan ektopik, mioma uteri, peritonitis, trauma abdomen, pendarahan abdomen, massa abdomen, dll.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: 27.0pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l12 level2 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.4<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Manifestasi Klinik Tindakan Laparatomi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; mso-list: l30 level3 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Nyeri tekan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; mso-list: l30 level3 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Perubahan tekanan darah, nadi dan pernafasan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; mso-list: l30 level3 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kelemahan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; mso-list: l30 level3 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Gangguan integumuen dan jaringan subkutan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; mso-list: l30 level3 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> Konstipasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; mso-list: l30 level3 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Mual dan muntah, anoreksia<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l12 level2 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.5<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Topografi anatomi abdomen<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: 27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Ada dua macam cara pembagian topografi abdomen yang umum dipakai untuk menentukan lokalisasi kelainan, yaitu:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.0pt; margin-right: 0in; margin-top: 0in; mso-list: l14 level1 lfo21; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pembagian atas empat kuadran, dengan membuat garis vertikal dan horizontal melalui umbilicus, sehingga terdapat daerah kuadran kanan atas, kiri atas, kanan bawah, dan kiri bawah.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.0pt; margin-right: 0in; margin-top: 0in; mso-list: l14 level1 lfo21; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pembagian atas sembilan daerah, dengan membuat dua garis horizontal dan dua garis vertikal. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-list: l24 level2 lfo22; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Garis horizontal pertama dibuat melalui tepi bawah tulang rawan iga kesepuluh dan yang kedua dibuat melalui titik spina iliaka anterior superior (SIAS). <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-list: l24 level2 lfo22; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span lang="SV" style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Garis vertikal dibuat masing-masing melalui titik pertengahan antara SIAS dan mid-line abdomen.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-list: l24 level2 lfo22; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span lang="SV" style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Terbentuklah daerah hipokondrium kanan, epigastrium, hipokondrium kiri, lumbal kanan, umbilical, lumbal kanan, iliaka kanan, hipogastrium/ suprapubik, dan iliaka kiri.<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><!--[if gte vml 1]><v:shape
id="_x0000_i1027" type="#_x0000_t75" style='width:197.25pt;height:172.5pt'> <v:imagedata src="file:///C:\DOCUME~1\INGGA\LOCALS~1\Temp\msohtmlclip1\01\clip_image005.jpg"
o:title="Regiones Abdominales"/> </v:shape><![endif]--><!--[if !vml]--><img border="0" height="230" src="file:///C:/DOCUME~1/INGGA/LOCALS~1/Temp/msohtmlclip1/01/clip_image006.jpg" v:shapes="_x0000_i1027" width="263" /><!--[endif]--><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pada keadaan normal, di daerah umbilical pada orang yang agak kurus dapat terlihat dan teraba pulsasi arteri iliaka. Beberapa organ dalam keadaan normal dapat teraba di daerah tertentu, misalnya kolon sigmoid teraba agak kaku di daerah kuadaran kiri bawah, kolon asendens dan saecum teraba lebih lunak di kuadran kanan bawah. </span><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Ginjal yang merupakan organ retroperitoneal dalam keadaan normal tidak teraba. </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Kandung kemih pada retensio urine dan uterus gravid teraba di daerah suprapubik.<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><!--[if gte vml 1]><v:shape
id="_x0000_i1028" type="#_x0000_t75" style='width:224.25pt;height:187.5pt'> <v:imagedata src="file:///C:\DOCUME~1\INGGA\LOCALS~1\Temp\msohtmlclip1\01\clip_image007.jpg"
o:title="ch93f1"/> </v:shape><![endif]--><!--[if !vml]--><img border="0" height="250" src="file:///C:/DOCUME~1/INGGA/LOCALS~1/Temp/msohtmlclip1/01/clip_image008.jpg" v:shapes="_x0000_i1028" width="299" /><!--[endif]--><o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l12 level2 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.6<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Komplikasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l3 level4 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Gangguan perfusi jaringan sehubungan dengan tromboplebitis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Tromboplebitis postoperasi biasanya timbul 7 - 14 hari setelah operasi. Bahaya besar tromboplebitis timbul bila darah tersebut lepas dari dinding pembuluh darah vena dan ikut aliran darah sebagai emboli ke paru-paru, hati, dan otak. Pencegahan tromboplebitis yaitu latihan kaki post operasi, ambulatif dini.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Infeksi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Infeksi luka sering muncul pada 36 - 46 jam setelah operasi. Organisme yang paling sering menimbulkan infeksi adalah stapilokokus aurens, organisme; gram positif. Stapilokokus mengakibatkan pernanahan. Untuk menghindari infeksi luka yang paling penting adalah perawatan luka dengan memperhatikan aseptik dan antiseptik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Kerusakan integritas kulit sehubungan dengan dehisensi luka atau eviserasi.<br />
Dehisensi luka merupakan terbukanya tepi-tepi luka. Eviserasi luka adalah keluarnya organ-organ dalam melalui insisi. Faktor penyebab dehisensi atau eviserasi adalah infeksi luka, kesalahan menutup waktu pembedahan, ketegangan yang berat pada dinding abdomen sebagai akibat dari batuk dan muntah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Ventilasi paru tidak adekuat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Gangguan kardiovaskuler : hipertensi, aritmia jantung<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Gangguan keseimbangan cairan dan elektrolit<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Gangguan rasa nyaman dan kecelakaan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l12 level2 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.7<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Proses Penyembuhan Luka<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l27 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Fase inflamasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Fase ini berlangsung selama dua sampai lima hari, proses yang terjadi didalamnya, yaitu :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Homestasis <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l19 level2 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Vasokontriksi, vasokontriksi pembuluh darah sehingga menghentikan perdarahan dan menurunkan masuknya mikroorganisme.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l19 level2 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Platelet aggregation</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l19 level2 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tromboplastin yang menggumpal.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Inflamasi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l14 level2 lfo21; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Vasodilatasi, vasodilatasi pembuluh darah dapat menghantarkan nutrisi dan fagosit terhadap luka saat timbul tanda-tanda peradangan.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l14 level2 lfo21; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Fagositosis, pada saat terjadi peradangan atau infeksi sel fagosit memakan atau menghancurkan bakteri, benda asing.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l27 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Fase proliferase</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Fase ini berlangsung selama lima hari sampai tiga minggu, proses yang terjadi didalamnya, yaitu :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Granulasi</span></b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">, pembentukan fibrobals dari kolagen, mengisi luka dan menghasilkan kapiler baru.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Epitelisasi</span></b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">, sel ini menyebar kesegala penjuru untuk menutup luka sekitar tiga cm sehingga luka dapat tertutup.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 40.5pt; mso-add-space: auto; mso-list: l27 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Fase remodeling atau maturasi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Fase ini berlangsung selama tiga minggu sampai dua tahun, proses penyerapan kembali jaringan yang berlebih dan membentuk jaringan baru yang tipis dan lemas, kekuatannya hanta 80 persen dari jaringan yang asli.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><br />
Upaya untuk mempercepat penyembuhan luka:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l3 level4 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Meningkatkan intake makanan tinggi protein dan vitamin C.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l3 level4 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Menghindari obat-obat anti radang seperti steroid.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l3 level4 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pencegahan infeksi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l3 level4 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pengembalian Fungsi fisik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pengembalian fungsi fisik dilakukan segera setelah operasi dengan latihan napas dan batuk efektif, latihan mobilisasi dini.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l3 level4 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Mempertahankan konsep diri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pada gangguan konsep diri : Body image bisa terjadi pada pasien post laparatomy karena adanya perubahan sehubungan dengan pembedahan. Intervensi perawatan terutama ditujukan pada pemberian support psikologis, ajak klien dan kerabat dekatnya berdiskusi tentang perubahan-perubahan yang terjadi dan bagaimana perasaan pasien setelah operasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
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</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">BAB 3<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">ASUHAN KEPERAWATAN<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-list: l16 level2 lfo20; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.1<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pengkajian<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.0pt; margin-right: 0in; margin-top: 0in; mso-list: l14 level3 lfo21; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Anamnesis<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Gangguan yang mengenai abdomen dan sistem gastrointestinalbisa menimbulkan gejala yang sangat beragam:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l35 level1 lfo19; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Nyeri abdomen<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l35 level1 lfo19; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Muntah<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l35 level1 lfo19; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Hematenesis (muntah darah)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l35 level1 lfo19; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Sulit menelan (disfagia)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l35 level1 lfo19; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">e.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Ganguan cerna atau dispepsia<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l35 level1 lfo19; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">f.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Diare<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l35 level1 lfo19; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">g.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Perubahan kebiasaan buang air besar<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l35 level1 lfo19; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">h.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Bengkak atau benjolan pada perut<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l35 level1 lfo19; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">i.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Penurunan berat badan atau gejala akibat malabsorpsi<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l35 level1 lfo19; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">j.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Melena (tinja hitam seperti ter akibat darah dari saluran cerna bagian atas) atau darah per ektum.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Penting untuk menilai adakah penyakit lokal dan adakah efek sismetik seperti penurunan berat badan atau malabsorpsi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Riwayat Penyakit Dahulu<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Apakah pernah mengalami penyakit saluran cerna sebelumnya? <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Apakah pernah dilakukan operasi pada daerah perut sebelumnya?<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Tentukan riwayat konsumsi alkohol dan kebiasaan merokok pasien.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Riwayat konsumsi alkohol yang rinci sangat penting.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Obat apa yang pernah dikonsumsi oleh pasien?<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pernahkah pasien mendapat terapi untuk penyakit saluran cerna, termasuk terapi yang mungkin merupakan penyebab gejala?<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Riwayat Keluarga<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Adakah kondisi turunan yang mempengaruhi sistem gastrointestinal?<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.0pt; margin-right: 0in; margin-top: 0in; mso-list: l14 level3 lfo21; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pemeriksaan Fisik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 27.0pt;"><span lang="FI" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">Urutan teknik pemeriksaan pada abdomen ialah inspeksi, auskultasi, palpasi, dan perkusi. Auskultasi dilakukan sebelum kita melakukan palpasi dan perkusi dengan tujuan <i><u>agar hasil pemeriksaan auskultasi lebih akurat karena kita belum melakukan manipulasi terhadap abdomen</u></i>.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.0pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 27.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: 9.0pt; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">INSPEKSI<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 9.0pt; text-align: justify; text-indent: 27.0pt;"><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Dilakukan pada pasien dengan posisi tidur terlentang dan diamati dengan seksama dinding abdomen. </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Yang perlu diperhatikan adalah:<o:p></o:p></span></div><ol start="1" style="margin-top: 0in;" type="a"><li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l31 level1 lfo23; tab-stops: list .5in; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Keadaan kulit; warnanya (ikterus, pucat, coklat, kehitaman), elastisitasnya (menurun pada orang tua dan dehidrasi), kering (dehidrasi), lembab (asites), dan adanya bekas-bekas garukan (penyakit ginjal kronik, ikterus obstruktif), jaringan parut (tentukan lokasinya), striae (gravidarum/ cushing syndrome), pelebaran pembuluh darah vena (obstruksi vena kava inferior & kolateral pada hipertensi portal).<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l31 level1 lfo23; tab-stops: list .5in; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Besar dan bentuk abdomen; rata, menonjol, atau scaphoid (cekung).<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l31 level1 lfo23; tab-stops: list .5in; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Simetrisitas; perhatikan adanya benjolan local (hernia, hepatomegali, splenomegali, kista ovarii, hidronefrosis).<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l31 level1 lfo23; tab-stops: list .5in; text-align: justify;"><span lang="SV" style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Gerakan dinding abdomen pada peritonitis terbatas.<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l31 level1 lfo23; tab-stops: list .5in; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pembesaran organ atau tumor, dilihat lokasinya dapat diperkirakan organ apa atau tumor apa.<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l31 level1 lfo23; tab-stops: list .5in; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Peristaltik; gerakan peristaltik usus meningkat pada obstruksi ileus, tampak pada dinding abdomen dan bentuk usus juga tampak (<i>darm-contour</i>).<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l31 level1 lfo23; tab-stops: list .5in; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pulsasi; pembesaran ventrikel kanan dan aneurisma aorta sering memberikan gambaran pulsasi di daerah epigastrium dan umbilical.<o:p></o:p></span></li>
</ol><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Perhatikan juga gerakan pasien:<o:p></o:p></span></div><ol start="1" style="margin-top: 0in;" type="a"><li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l33 level1 lfo24; tab-stops: list .5in; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pasien sering merubah posisi </span><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: Harrington; mso-char-type: symbol; mso-hansi-font-family: Harrington; mso-symbol-font-family: Wingdings;">à</span><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;"> adanya obstruksi usus.<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l33 level1 lfo24; tab-stops: list .5in; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pasien sering menghindari gerakan </span><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: Harrington; mso-char-type: symbol; mso-hansi-font-family: Harrington; mso-symbol-font-family: Wingdings;">à</span><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;"> iritasi peritoneum generalisata.<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l33 level1 lfo24; tab-stops: list .5in; text-align: justify;"><span lang="SV" style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Pasien sering melipat lutut ke atas agar tegangan abdomen berkurang/ relaksasi </span><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: Harrington; mso-char-type: symbol; mso-hansi-font-family: Harrington; mso-symbol-font-family: Wingdings;">à</span><span lang="SV" style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;"> peritonitis.<o:p></o:p></span></li>
<li class="MsoNormal" style="color: #7030a0; line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l33 level1 lfo24; tab-stops: list .5in; text-align: justify;"><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pasien melipat lutut sampai ke dada, berayun-ayun maju mundur pada saat nyeri </span><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: Harrington; mso-char-type: symbol; mso-hansi-font-family: Harrington; mso-symbol-font-family: Wingdings;">à</span><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%;"> pankreatitis parah.<o:p></o:p></span></li>
</ol><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: 9.0pt; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">AUSKULTASI<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 9.0pt; text-align: justify; text-indent: 27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Kegunaan auskultasi ialah untuk mendengarkan suara peristaltic usus dan bising pembuluh darah. Dilakukan selama 2-3 menit.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l14 level2 lfo21; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Mendengarkan suara peristaltic usus.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Diafragma stetoskop diletakkan pada dinding abdomen, lalu dipindahkan ke seluruh bagian abdomen. Suara peristaltic usus terjadi akibat adanya gerakan cairan dan udara dalam usus. Frekuensi normal berkisar 5-34 kali/ menit.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Bila terdapat obstruksi usus, peristaltic meningkat disertai rasa sakit (borborigmi). Bila obstruksi makin berat, abdomen tampak membesar dan tegang, peristaltic lebih tinggi seperti dentingan keeping uang logam (metallic-sound).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Bila terjadi peritonitis, peristaltic usus akan melemah, frekuensinya lambat, bahkan sampai hilang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l14 level2 lfo21; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Mendengarkan suara pembuluh darah.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Bising dapat terdengar pada fase sistolik dan diastolic, atau kedua fase. Misalnya pada aneurisma aorta, terdengar bising sistolik (<i>systolic bruit</i>). </span><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Pada hipertensi portal, terdengar adanya bising vena (<i>venous hum</i>) di daerah epigastrium. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 9.0pt; text-align: justify;"><b><span lang="FI" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">PALPASI<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;"><span lang="FI" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">Beberapa pedoman untuk melakukan palpasi, ialah:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo25; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Pasien diusahakan tenang dan santai dalam posisi berbaring terlentang. </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Sebaiknya pemeriksaan dilakukan tidak buru-buru.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo25; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Palpasi dilakukan dengan menggunakan palmar jari dan telapak tangan. Sedangkan untuk menentukan batas tepi organ, digunakan ujung jari. Diusahakan agar tidak melakukan penekanan yang mendadak, agar tidak timbul tahanan pada dinding abdomen.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo25; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="IT" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IT;">Palpasi dimulai dari daerah superficial, lalu ke bagian dalam. Bila ada daerah yang dikeluhkan nyeri, sebaiknya bagian ini diperiksa paling akhir.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo25; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="IT" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: IT;">Bila dinding abdomen tegang, untuk mempermudah palpasi maka pasien diminta untuk menekuk lututnya. Bedakan spasme volunteer & spasme sejati; dengan menekan daerah muskulus rectus, minta pasien menarik napas dalam, jika muskulus rectus relaksasi, maka itu adalah spasme volunteer. </span><span lang="FI" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">Namun jika otot kaku tegang selama siklus pernapasan, itu adalah spasme sejati.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo25; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">e.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="FI" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: FI;">Palpasi bimanual; palpasi dilakukan dengan kedua telapak tangan, dimana tangan kiri berada di bagian pinggang kanan atau kiri pasien sedangkan tangan kanan di bagian depan dinding abdomen.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo25; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">f.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Pemeriksaan ballottement; cara palpasi organ abdomen dimana terdapat asites.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: .25in;"><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Caranya dengan melakukan tekanan yang mendadak pada dinding abdomen & dengan cepat tangan ditarik kembali. Cairan asites akan berpindah untuk sementara, sehingga organ atau massa tumor yang membesar dalam rongga abdomen dapat teraba saat memantul.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: .25in;"><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Teknik ballottement juga dipakai untuk memeriksa ginjal, dimana gerakan penekanan pada organ oleh satu tangan akan dirasakan pantulannya pada tangan lainnya.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo25; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">g.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Setiap ada perabaan massa, dicari ukuran/ besarnya, bentuknya, lokasinya, konsistensinya, tepinya, permukaannya, fiksasi/ mobilitasnya, nyeri spontan/ tekan, dan warna kulit di atasnya. </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Sebaiknya digambarkan skematisnya.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 9.0pt; text-align: justify; text-indent: 27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Palpasi hati; dilakukan dengan satu tangan atau bimanual pada kuadran kanan atas. Dilakukan palpasi dari bawah ke atas pada garis pertengahan antara mid-line & SIAS. Bila perlu pasien diminta untuk menarik napas dalam, sehingga hati dapat teraba. Pembesaran hati dinyatakan dengan berapa sentimeter di bawah lengkung costa dan berapa sentimeter di bawah prosesus xiphoideus. Sebaiknya digambar.<o:p></o:p></span></div><div style="line-height: 150%; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington;">Anatomic Location of Organs by Quadrant</span></b><span style="color: #7030a0; font-family: Harrington;"><o:p></o:p></span></div><div align="center"> <table border="1" cellpadding="0" class="MsoNormalTable" style="border-bottom-style: outset; border-bottom-width: 1.5pt; border-color: initial; border-left-style: outset; border-left-width: 1.5pt; border-right-style: outset; border-right-width: 1.5pt; border-top-style: outset; border-top-width: 1.5pt; margin-left: 27pt; width: 552px;"><tbody>
<tr> <td style="background: white; padding: .75pt .75pt .75pt .75pt; width: 200.95pt;" width="268"> <div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><strong><span lang="SV" style="color: #7030a0; font-family: Harrington; mso-ansi-language: SV;">RIGHT UPPER QUADRANT (RUQ )</span></strong><span lang="SV" style="color: #7030a0; font-family: Harrington; mso-ansi-language: SV;"><o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span lang="SV" style="color: #7030a0; font-family: Harrington; mso-ansi-language: SV;">Liver<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span lang="SV" style="color: #7030a0; font-family: Harrington; mso-ansi-language: SV;">Gallbladder<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Duodenum<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Head of pancreas<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Right kidney and adrenal<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Hepatic flexure of colon<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Part of ascending and transverse colon<o:p></o:p></span></div></td> <td style="background: white; padding: .75pt .75pt .75pt .75pt; width: 208.55pt;" width="278"> <div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><strong><span style="color: #7030a0; font-family: Harrington;">LEFT UPPER QUADRANT (LUQ)</span></strong><span style="color: #7030a0; font-family: Harrington;"><o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Stomach<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Spleen<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Left lobe of liver<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Body of pancreas<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Left kidney and adrenal<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Splenic flexure of colon<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Part of transverse and descending colon<o:p></o:p></span></div></td> </tr>
<tr> <td style="background: white; padding: .75pt .75pt .75pt .75pt; width: 200.95pt;" width="268"> <div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><strong><span style="color: #7030a0; font-family: Harrington;">RIGHT LOWER QUADRANT (RLQ)</span></strong><span style="color: #7030a0; font-family: Harrington;"><o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Cecum<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Appendix<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Right ovary and tube<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Right ureter<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Right spermatic cord<o:p></o:p></span></div></td> <td style="background: white; padding: .75pt .75pt .75pt .75pt; width: 208.55pt;" width="278"> <div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><strong><span style="color: #7030a0; font-family: Harrington;">LEFT LOWER QUADRANT (LLQ)</span></strong><span style="color: #7030a0; font-family: Harrington;"><o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Part of descending colon<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Sigmoid colon<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Left ovary and tube<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Left ureter<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Left spermatic cord<o:p></o:p></span></div></td> </tr>
</tbody></table></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div align="center"> <table border="1" cellpadding="0" class="MsoNormalTable" style="border-bottom-style: outset; border-bottom-width: 1.5pt; border-color: initial; border-left-style: outset; border-left-width: 1.5pt; border-right-style: outset; border-right-width: 1.5pt; border-top-style: outset; border-top-width: 1.5pt; margin-left: 17.85pt; width: 553px;"><tbody>
<tr style="height: 67.95pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0; mso-yfti-lastrow: yes;"> <td style="background: white; height: 67.95pt; padding: .75pt .75pt .75pt .75pt; width: 412.05pt;" width="549"> <div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><strong><span style="color: #7030a0; font-family: Harrington;">MIDLINE</span></strong><b><span style="color: #7030a0; font-family: Harrington;"><o:p></o:p></span></b></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Aorta<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Uterus (if enlarged)<o:p></o:p></span></div><div align="center" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; text-align: center;"><span style="color: #7030a0; font-family: Harrington;">Bladder (if distended)<o:p></o:p></span></div></td> </tr>
</tbody></table></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: 9.0pt; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">PERKUSI<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 9.0pt; text-align: justify; text-indent: 27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Perkusi berguna <i><u>untuk mendapatkan orientasi keadaan abdomen secara keseluruhan, menentukan besarnya hati, limpa, ada tidaknya asites, adanya massa padat atau massa berisi cairan (kista), adanya udara yang meningkat dalam lambung dan usus, serta adanya udara bebas dalam rongga abdomen</u></i>. Suara perkusi abdomen yang normal adalah<b> timpani</b> (organ berongga yang berisi udara), kecuali di daerah hati (redup; organ yang padat).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level4 lfo25; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Orientasi abdomen secara umum.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify; text-indent: 27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Dilakukan perkusi ringan pada seluruh dinding abdomen secara sistematis untuk mengetahui distribusi daerah timpani dan daerah redup (dullness). Pada perforasi usus, pekak hati akan menghilang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level4 lfo25; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Cairan bebas dalam rongga abdomen<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify; text-indent: 27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Adanya cairan bebas dalam rongga abdomen (asites) akan menimbulkan suara perkusi timpani di bagian atas dan dullness dibagian samping atau suara dullness dominant. Karena cairan itu bebas dalam rongga abdomen, maka bila pasien dimiringkan akan terjadi perpindahan cairan ke sisi terendah. Cara pemeriksaan asites:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level4 lfo25; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Pemeriksaan gelombang cairan (<i>undulating fluid wave</i>).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify; text-indent: 27.0pt;"><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Teknik ini dipakai bila cairan asites cukup banyak. Prinsipnya adalah ketukan pada satu sisi dinding abdomen akan menimbulkan gelombang cairan yang akan diteruskan ke sisi yang lain.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify; text-indent: 27.0pt;"><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Pasien tidur terlentang, pemeriksa meletakkan telapak tangan kiri pada satu sisi abdomen dan tangan kanan melakukan ketukan berulang-ulang pada dinding abdomen sisi yang lain. </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Tangan kiri kan merasakan adanya tekanan gelombang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level4 lfo25; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Pemeriksaan pekak alih (<i>shifting dullness</i>).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; text-align: justify; text-indent: 27.0pt;"><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Prinsipnya cairan bebas akan berpindah ke bagian abdomen terendah. Pasien tidur terlentang, lakukan perkusi dan tandai peralihan suara timpani ke redup pada kedua sisi. Lalu pasien diminta tidur miring pada satu sisi, lakukan perkusi lagi, tandai tempat peralihan suara timpani ke redup maka akan tampak adanya peralihan suara redup.<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><!--[if gte vml 1]><v:shape
id="_x0000_i1029" type="#_x0000_t75" style='width:195.75pt;height:216.75pt'> <v:imagedata src="file:///C:\DOCUME~1\INGGA\LOCALS~1\Temp\msohtmlclip1\01\clip_image009.jpg"
o:title="ch35f8"/> </v:shape><![endif]--><!--[if !vml]--><img border="0" height="289" src="file:///C:/DOCUME~1/INGGA/LOCALS~1/Temp/msohtmlclip1/01/clip_image010.jpg" v:shapes="_x0000_i1029" width="261" /><!--[endif]--><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l16 level2 lfo20; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.2<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Dignosa Keperawatan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level3 lfo34; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Ansietas berhubungan dengan prosedur pembedahan, prosedur preoperative.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level3 lfo34; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kurang pengetahuan berhubungan dengan kurang informasi, tidak mengenal sumber informasi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level3 lfo34; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Nyeri berhubungan dengan insisi, distensi abdomen, immobilisasi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level3 lfo34; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kekurangan volume cairan berhubungan dengan kehilangan darah, kehilangan air dengan abnormal.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level3 lfo34; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kerusakan integritas kulit berhubungan dengan insisi pembedahan, perubahan sensasi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level3 lfo34; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Risiko infeksi berhubungan dengan adanya tempat masuknya mikroorganisme sekunder akibat pembedahan</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l16 level2 lfo20; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.3<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Intervensi Keperawatan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level5 lfo34; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Ansietas berhubungan dengan prosedur pembedahan, prosedur preoperative.<b><br />
Kriteria hasil :</b></span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l23 level1 lfo26; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pasien akan menunjukan kemampuan focus pada pengetahuan baru dan skil</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l23 level1 lfo26; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Identifikasi gejala sebagai indicator kecemasan sendiri</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l23 level1 lfo26; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tidak menunjukan prilaku agresiv</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l23 level1 lfo26; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Berkomunikasi dan penanganan perasaan negative dengan tepat</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l23 level1 lfo26; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Rileks dan nyaman dalam beraktivitas</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; tab-stops: 27.0pt; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Intervensi Rasional<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l7 level1 lfo27; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Monitor pasien tanda dan gejala insietas saat pengkajian keperawatan</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Pengkajian seksama kondisi pasien dengan ansietas memungkinkan perawat membuat priorotas perawatan</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l7 level1 lfo27; tab-stops: 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Fokuskan diskusi pada stressor yang mempengaruhi kondisi pasien</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Focus diskusi memfasilitasi kemampuan pasien untuk menyatakan ketakutan dan perasaan yang dirasakan dan membengun hubungan terapeutik.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l7 level1 lfo27; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Diskusikan persepsi pasien akan prosedur pembedahan, ketakutan yang berhubungan dengan operasi</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Diskusi akan persepsi dan ketakutan membuat pasien mengekspresikan diri sendiri dan mengeksplore pengetahuannya.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l7 level1 lfo27; tab-stops: 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Berikan informasi prosedur sebelum operasi, penyakit pasien, dan persiapan operasi</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/:</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"> </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tindakan untuk menambah pengetahuan dan reduksi ansietas.<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--></span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level5 lfo34; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kurang pengetahuan berhubungan dengan kurang informasi, tidak mengenal sumber informasi.<b><o:p></o:p></b></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kriteria hasil :<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Mengungkapkan pemahaman tentang proses penyakit dan pengobatan.<b><o:p></o:p></b></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Intervensi Rasional</span></b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l23 level2 lfo26; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">Tinjau ulang prosedur dan harapan pasca operasi<b><o:p></o:p></b></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">R/: Memberikan dasar pengetahuan dimana pasien dapat membuat pilihan berdasarkan informasi.<b><o:p></o:p></b></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l23 level2 lfo26; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">Diskusikan pentingnya masukan cairan adekuat, kebutuhan diet<b><o:p></o:p></b></span></div><div class="MsoNormal" style="margin-left: 9.0pt; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">R/: Meningkatkan penyembuhan dan normalisasi usus.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l23 level2 lfo26; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">Demostrasikan perawatan luka atau belutan yang tepat.<b><o:p></o:p></b></span></div><div class="MsoNormal" style="margin-left: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">R/: Meningaktkan penyembuhan, menurunkan resiko infeksi, memberikan kesempatan untuk mengobservasi luka</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l23 level2 lfo26; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">Tinjau ulang perawatan selang gastrotomi bila pasien dipulangkan dengan alat ini.<b><o:p></o:p></b></span></div><div class="MsoNormal" style="margin-left: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">R/: Meningkatkan kemandirian, meningkatkan kemampuan perawatan diri.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l23 level2 lfo26; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">Identifikasikan tanda-tand ayang memerlukan evaluasi medis, demam menetap, bengkak, eritema, artau terbukanya tepi luka, perubahan karakteristik drainage. <o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">R/:</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">Pengenalan dini komplikasi dan intervensi segera dapat mencegah progresi situasi serius, mengancam hidup.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l23 level1 lfo26; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">f.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">Anjurkan peningkatan aktivitas bertahap sesuai tolernsi dan keseimbangan dengan periode istirahat yang adekuat<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><br />
R/:</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">Mncegah kelelahan, merangsang sirkulasi dan normalisasi fungsi organ, meningkatkan penyembuhan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level5 lfo34; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Nyeri berhubungan dengan insisi, distensi abdomen, immobilisasi.<br />
<b>Kriteria hasil :</b></span><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l23 level2 lfo26; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Melaporkan nyeri hilang </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l23 level2 lfo26; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tampak rileks, mempu beristirahat dengan tepat</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l23 level2 lfo26; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pasien akan menunjukan teknik relaksasi individu yang efektif dalam mencapai kenyamanan</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l23 level2 lfo26; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Mempertahankan level nyeri pada skala nyeri yang dapat ditoleransi (skala 0-10)</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l23 level2 lfo26; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Mengakui faktor penyebab sehingga dapat menggunakan pengukuran untuk mencegah nyeri akibat</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; tab-stops: 27.0pt; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Intervensi Rasional<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l34 level1 lfo28; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kaji skala nyeri atau ketidaknyamanan dengan skala 0 – 10.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Analisa secara seksama karekteristik nyeri membatu diffirensial diagnosis nyeri. Standarisasi skala nyeri menunjang keakuratan</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l34 level1 lfo28; tab-stops: 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Ajarkan teknik manajemen nyeri : nafas dalam, guide imagery, relaksasi, visualisasi dan aktivitas terapeutik.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Manajemen pengalihan fokus perhatian nyeri. Pendidikan pada pasien untuk mengurangi nyeri, setiap orang memiliki perbedaan derajat nyeri yang dirasakan</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l34 level1 lfo28; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kaji secara komprehensif kondisi nyeri termasuk lokasi, karakteristik, onset, durasi, frekuensi, kuantitas atau kualitas nyeri, dan faktor presipitasi/pencetus.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Laporan pasien merupakan indikator terpercaya mengenai eksistensi dan intensitas nyeri pada pasien dewasa. Baru atau peningkatan nyeri memerlukan medikal evaluasi segera.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l34 level1 lfo28; tab-stops: 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Observasi secara verbal atau nonverbal ketidaknyamanan.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Respon verbal dapat menjadi indikasi adanya dan derajat nyeri yang dirasakan. Respon non verbal menampilkan kondisi nyeri.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l34 level1 lfo28; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Instruksikan pasien untuk melaporkan nyeri bila sangat hebat.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Partisipasi langsung dalam penanganan dan deteksi dini untuk pengelolaan nyeri secara segera setelah dilaporkan.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l34 level1 lfo28; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">f.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Informasikan pasien prosedur yang dapat meningkatkan nyeri dan tawarkan koping adaptif.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Tindakan persiapan kondisi pasien sebelum prosedur dan membantu mpasien menetapkan koping sehubungan dengan kebutuhan penanganan stres akibat nyeri.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l34 level1 lfo28; tab-stops: 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">g.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pantau tanda-tanda vital</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Respon outonomik meliputi pada tekanan darah, nadi dan pernafasan, yang berhubungan dengan keluhan / penghilang nyeri. Abnormalitas tanda vital terus menerus memerlukan evaluasi lanjut.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l34 level1 lfo28; tab-stops: 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">h.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kaji insisi bedah, perhatikan edema, perubahan kontur luka (pembentukan hematoma), atau inflamasi, mengeringkan tepi luka.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Perdarahan pada jaringan, bengkak, inflamasi local atau terjadinya infeksi dapat menyebabkan peningkatan nyeri insisi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l34 level1 lfo28; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">i.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Berikan analgesic, narkotika, sesuai indikasi. <br />
R/: Menurunkan laju metabolic dan iritasi usus karena oksin sirkulasi/local, yang membantu menghilangkan nyeri dan meningkatkan penyembuhan. mengontrol atau mengurangi nyeri untuk meningkatkan istirahat dan meningkatkan kerja sama dengan aturan terapeutik. </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level5 lfo34; tab-stops: 27.0pt list 2.5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kekurangan volume cairan berhubungan dengan kehilangan darah, kehilangan air dengan abnormal.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kriteria hasil :<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l9 level1 lfo29; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Menunjukan level elektrolit, BUN, hematokrit dan serum osmolalitas dalam keadaan normal.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l9 level1 lfo29; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Urine output dalam batas normal </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l9 level1 lfo29; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Hasil hemodinamika dalam batas normal</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; tab-stops: 27.0pt; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Intervensi Rasional<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l15 level2 lfo30; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Monitor dan perbaiki intake output, antara setiap jam dan perbandingkan. Ukur dan dokumentasikan output urine setiap 1-4 jam.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Terapi diuretik, hipertermia, pembatasan intake cairan dapat menimbulkan kekurangan cairan. Pengukuran tiap jam dan perbandingannya dapt mendeteksi kekurangan.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l15 level2 lfo30; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Monitor hasil laboratorium sesuai indikasi (osmolalitas urine <200mOsm/kg, osmolalitas serum >300 mOsm/kg, serum sodium >145 mEq/L, peningkatan level BUN dan hematokrit)</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Hasil laboratorium menambah keadaan objektif dari ketidakseimbangan. Penurunan osmolalitas urine berhubungan dengan diuresis, peningkatan serum osmolalitas, serum sodium dan hematokrit menunjukan hemokonsentrasi</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l15 level2 lfo30; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Monitor ECG dan tekanan hemodinamika secara periodic. Perhatikan adanya gelombang U, QT memanjang, depresi segmen ST, gelombang T memendek dan tekanan hemodinamika kardiak output rendah</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Pemantauan secara periodic menunjang peringatan secepatnya apabila terjadi kondisi yang fatal. Tanda ECG menunjukan penurunan responsibilitas stimulus sel kardiak, menghasilkan hipokalemia sekunder akibat pengeluaran potassium.Sedangkan penurunan tekanan menunjukan hipovolemia dan penurunan kardiak output menunjukan preload insuffisiensi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l15 level2 lfo30; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Berikan terapi sesuai indikasi, biasanya cairan isotonic dengan penambahan potassium klorida jika serum potassium rendah. Pantau akses IV , antisipasi peningkatan pemberian cairan jika hipertermia atau adanya infeksi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Cairan isotonic adalah pengganti cairan untuk kehilangan cairan tubuh. Produk darah, koloid, atau albmin, dapat digunakan untuk peningkatan MAP. Monitor digunakan untuk mencegah overload volume cairan. Cairan dengan potassium harus dipantau dengan seksama karena pottasium mengiritasi vena dan infus potassium yang cepat dapat menyebabkan hiperkalemia. Hipertermia dan infeksi terjadi akibat kehilangan cairan karena peningkatan metabolic, peningkatan keringat dan ekskresi cairan melalui pernafasan.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l15 level2 lfo30; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pantau tanda-tanda vital dengan sering, perhatikan peningkatan nadi dan perubahan tekanan darah.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Tanda-tanda haemoragik usus dan/atau pembentukan hematoma, yang dapat menyebabkan syok hipovalemik.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l15 level2 lfo30; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">f.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Palpasi nadi perifer, evaluasi pengisian kapiler, turgor kulit dan status membrane mukosa.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Memberikan informasi tentang volume sirkulasi umum dan tingkat hidrasi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l15 level2 lfo30; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">g.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Perhatikan adanya edema</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Edema dapat terjadi karena perpindahan cairan berkenaan dengan penurunan kadar albumin serum/protein.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l15 level2 lfo30; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">h.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Observasi, catat kualitas kateter drainage / ngt</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Haluaran cairan berlebihan dapat menyebabkan ketidakseimbangan elektrolit dan alkalosis metabolic dengan kehilangan lanjut kalium oleh ginjal yang berupaya untuk mengkompensasi</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l15 level2 lfo30; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">i.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pantau suhu </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Demam rendah umum terjadi selam 24 -48 jam pertama dan dapat menambah kehilangan cairan</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l15 level2 lfo30; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">j.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pertahankan patensi penghisapan NGT.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Meningkatkan dekompresi usus untuk menurunkan distensi atau kekuatan pada garis jahitan dan menurunkan mual atau muntah , yang dapat menyrtai anastesi, manipulasi usus, atau kondisi yang sebelumnya ada, missal kanker.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level5 lfo34; tab-stops: 27.0pt list 2.5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kerusakan integritas kulit berhubungan dengan insisi pembedahan, perubahan sensasi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kriteria hasil :<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l9 level2 lfo29; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pasien akan menunjukan perwatan optimal kulit dan luka secara rutin</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l9 level2 lfo29; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Menunjukan intgritas kulit dan membrane mukosa adekuat ( temperature jaringan, elastisitas, hidrasi, pigmentasi, dan warna)</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l9 level2 lfo29; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Mencapai pemulihan luka tepat waktu tanpa ada komplikasi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; tab-stops: 27.0pt; text-align: justify;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Intervensi Rasional<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l18 level1 lfo31; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Monitor karakteristik luka meliputi lokasi, ada/tidaknya dan karakter eksudat, ada/tidaknya jaringan nekrotik, ada/tidaknya tanda-tanda infeksi (nyeri, bengkak, kemerahan, peningkatan sushu, penurunan fungsi).</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Permulaan pengkajian yang merupakan langkah awal utnuk memberikan perawatan individual. Penemuan abnormal dapat menjadi data untuk masalah dan dapat digunakan untuk pedoman perencanaan perawatan</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l18 level1 lfo31; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Bersihkan dan ganti balutan (wound care) luka dengan teknik steril.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Pencegahan komplikasi luka terhadap kontaminasi silang dan membantu penyembuhan luka.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l18 level1 lfo31; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Minimalisir penekanan pada bagian luka.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Pencegahan kerusakan kulit merupakan salah satu penanganan mudah masalah sebelum kerusakan kulit berkembang</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l18 level1 lfo31; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pantau tanda-tanda vital dengan sering, perhatikan demam, takipneu, takikardi dan gemetar. Periksa luka dengan sering terhadap bengkak insisi berlebihan, inlamasi drainage.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Pasien dengan kondisi post pembedahan beresiko tinggi mengalami komplikasi. Evaluasi segera dapat menjadi ukuran pencegahan dan penanganan dini.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l18 level1 lfo31; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Waspadai factor resiko lanjut, misal : keganasan, seperti limfasarkoma dan mieloma multiple, terapi radiasi dan sisi operasi.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Indikatif dari pembentukan hematoma atau terjadinya infeksi yang menunjang perlambatan pemulihan luka dan meningkatkan resiko pemisahan luka.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l18 level1 lfo31; tab-stops: 27.0pt 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">f.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Berikan antibiotic sesuai indikasi</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; tab-stops: 27.0pt 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">R/: Menurunkan imunokompentesi, ini mempengaruhi pemulihan luka pada infeksi. Meningkatkan vaskulitis dan fibrosis pada jaringan penyambung, mempengaruhi</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l17 level5 lfo34; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 27.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Risiko infeksi berhubungan dengan adanya tempat masuknya mikroorganisme sekunder akibat pembedahan.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 99.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -70.9pt;"><b><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Kriteria hasil:<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l18 level2 lfo31; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Klien tidak mengakami infeksi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-list: l18 level2 lfo31; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Luka cepat sembuh tanpa komplikasi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 99.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -70.9pt;"><b><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">Intervensi <o:p></o:p></span></b></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l8 level1 lfo32; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12pt; line-height: 115%;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">monitor tanda-tanda vital</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">R/: mengetahui </span><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">tanda awal terjadinya infeksi</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l8 level1 lfo32; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12pt; line-height: 115%;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">lakukan tehnik perawatan luka dengan tehnik septik dan aseptik</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">R/: perawatan luka dengan tekhnik aseptic </span><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">dapat mencegah berkembangbiaknya mikroorganisme penyebab infeksi</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l8 level1 lfo32; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12pt; line-height: 115%;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">observasi penyatuan luka, karakter drainage, adanya inflmasi</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">R/: </span><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">mengetahui secara dini tanda infeksi atau memperburuknya kondisi luka.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l8 level1 lfo32; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12pt; line-height: 115%;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">berikan nutrisi yang adekuat </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">R/: </span><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";"> dengan nutrisi yang baik dapat meningkatkan daya tahan tubuh</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l8 level1 lfo32; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="font-family: Harrington; font-size: 12pt; line-height: 115%;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">kolaborasi dalam pemberian antibiotika</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 45.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">R/: </span><span lang="SV" style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV; mso-fareast-font-family: "Times New Roman";">antibiotika menurunkan jumlah mikroorganisme dan juga dapat membunuh mikroorganisme dengan penggunaan secara teratur.</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
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</div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">BAB 5<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">ANALISA KASUS SEMU<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
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</div><h1 style="text-indent: .5in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">I.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington;">Pengkajian <o:p></o:p></span></h1><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.75in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Identitas<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Nama : Ny. K Tgl MRS : 11 Oktober 2011<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Umur : 24 tahun<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Jenis Kelamin : Perempuan<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Suku/bangsa : Jawa/Indonesia<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Agama : Islam<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Pekerjaan : Tidak bekerja ( Ibu Rumah tangga )<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Pendidikan : SMA ( tamat )<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Nama Suami : Tn. As<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Umur : 28 tahun<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Pendidikan : SMU ( tamat )<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Pekerjaan : Karyawan Pabrik<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Alamat : Gadung No.100, Surabaya<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><br />
</div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Alasan dirawat: Nyeri luka operasi<o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Keluhan Utama sebelumnya : Nyeri perut kanan bawah<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Upaya yang telah dilakukan : operasi ( Apendiktomy ) tanggal 7 Oktober 2011 jam 13.35 WIB.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Riwayat Keperawatan<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.1<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Riwayat Penyakit sebelumnya :<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 1.0in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Klien mengatakan :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 1.25in; mso-add-space: auto; mso-list: l2 level1 lfo7; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri;">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Sering mengalami tekanan darah rendah<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 1.25in; mso-add-space: auto; mso-list: l2 level1 lfo7; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri;">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Waktu SMA pernah sakit typhus dan sakit kuning, dengan berobat jalan sembuh<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.2<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Riwayat Penyakit Sekarang :<o:p></o:p></span></div><div class="MsoBodyTextIndent2" style="margin-left: 1.0in; text-indent: 27.0pt;"><span style="color: #7030a0; font-family: Harrington;">Nyeri luka operasi daerah perut kanan bawah. Nyeri bertambah hebat terutama bila bergerak, oleh karena itu klien sangat berhati-hati saat bergerak. Nyeri seperti ditusuk-tusuk hilang timbul tiap 10 menit.<o:p></o:p></span></div><div class="MsoBodyTextIndent2" style="margin-left: 1.0in; text-indent: 27.0pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.3<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Riwayat Kesehatan Keluarga :<o:p></o:p></span></div><div class="MsoBodyTextIndent3" style="text-align: justify;"><span lang="IN" style="color: #7030a0; font-family: Harrington;">Dari keluarga ayah maupun ibunya tidak ada yang menderita sakit kencing manis, ataupun sakit berat yang lainnya.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Pemeriksaan Fisik :<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Keadaan umum :<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Klien terbaring terlentang dengan posisi tangan kiri memegang perut saat bergerak, merintih kesakitan dan ekspresi wajah gelisah.<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Tanda Vital :<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Suhu axilla 36,1 ° C Nadi 88 x/menit, Tensi 120/70 mmHg, RR 22 x/menit<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Pengkajian Sistem :<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">4.1 Sistem Pernafasan :<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Hidung bersih, pernafasan spontan, bentuk dada bulat datar tidak ditemukan tarikan otot bantu pernafasan saat bernafas, suara nafas vesikuler, tidak ditemukan suara nafas tambahan.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">4.2 Sistem Cardiovaskuler :<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Suara jantung S1 S2 suara tunggal lupdub. Ictus Cordis teraba 1 cm pada ICS med Clavicula kiri, percusi sonor, tidak ditemukan oedema pada palpebrae maupun extremitas, KRT kembali dalam detik pertama. Tensi : 120/70 mmHg, Nadi : 88x/menit, Suhu 36,1 ° C.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">4.2 Sistem Persyarafan :<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">-Kesadaran Composmentis, GCS : E 4 V 5 M 6 dengan total nilai 15.<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">-Kepala dan Wajah :<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Mata : Konjungtiva merah muda , Sklera : Warna putih terdapat gambaran tipis pembuluh darah, Pupil isocor.<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">-Leher : Pergerakan bebas, tidak ditemukan pembesaran/bendungan vena jugularis, pembesaran kelenjar gondok maupun limphe. <o:p></o:p></span></div><div class="MsoNormal" style="text-indent: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">-Persepsi Sensori :<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Klien mampu mendengar suara berbisik, mampu membedakan rasa manis, asin dan pahit, penglihatan sampai tak terhingga, ambang rasa raba terhadap hangat, dingin dan raba masih mampu membedakan.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">4.3 Sistem Perkemihan :<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Bak lancar warna kuning jernih 5-6 kali sehari, jumlah </span><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">±</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;"> 1500-200 cc perhari , baik sebelum sakit maupun selama dirawat dirumah sakit, tidak ada keluhan nyeri saat BAK.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">4.4 Sistem Pencernaan :<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Mulut dan tenggorok :<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Bibir dan lidah kering tidak ditemukan stomatitis maupun aptea, gigi bersih tidak ada caries, tonsil/ovula warna merah muda tidak ada oedema.<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Abdomen :<o:p></o:p></span></div><div class="MsoBodyTextIndent" style="margin-left: .25in; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington;">Saat bergerak, klien menahan perut , terdapat luka operasi abdomen bagian kanan bawah dengan panjang </span><span style="color: #7030a0;">±</span><span style="color: #7030a0; font-family: Harrington;"> 15 cm, luka bersih dengan jahitan. Luka tertutup oleh kasa steril, rembesan darah minimal, luka kering, tidak bengkak, jahiten belum menutup sempurna.<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">4.5 Sistem Tulang Otot – Integumen<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Kemampuan pergerakan sendi bebas, ekstremitas pergerakan bebas. Kekuatan tot 5, Flaping tremor -, KRT dan turgor kulit kembali detik pertama. Akral hangat.<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">4.6 Sistem Endokrin :<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .25in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Klien mengatakan tidak pertumbuhan dan perkembangan fisiknya berjalan sebagaimana orang lainnya. Tidak mempunyai keluhan yang berkaitan dengan hormonal misalnya poluri, polidipsi maupun kelemahan.<o:p></o:p></span></div><div class="MsoNormal"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Pemeriksaan Penunjang :<o:p></o:p></span></b></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Pada pemeriksaan laboratorium pada 6 oktober 2011<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Hb 12 gr % <o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Leukosit 9830 g/dL<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Trombosit 162000<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Analisa Data<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; width: 553px;"><tbody>
<tr> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 28.5pt;" valign="top" width="38"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">No.<o:p></o:p></span></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 192.9pt;" valign="top" width="257"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Symptom <o:p></o:p></span></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 94.5pt;" valign="top" width="126"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Etiologi<o:p></o:p></span></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 99.0pt;" valign="top" width="132"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;"> Problem<o:p></o:p></span></div></td> </tr>
<tr> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 28.5pt;" valign="top" width="38"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">1.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 192.9pt;" valign="top" width="257"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">DS :<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l21 level1 lfo3; mso-pagination: none; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Klien mengeluh nyeri luka operasi daerah perut kanan bawah, nyeri bertambah hebat terutama bila bergerak.<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l21 level1 lfo3; mso-pagination: none; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Nyeri seperti ditusuk-tusuk<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l21 level1 lfo3; mso-pagination: none; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Skala 2 (0-4)<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l21 level1 lfo3; mso-pagination: none; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Nyeri hilang timbul tiap 10 menit<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-pagination: none; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">DO :<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l21 level1 lfo3; mso-pagination: none; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Klien merintih kesakitan<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l21 level1 lfo3; mso-pagination: none; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Ekspresi wajah gelisah<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l21 level1 lfo3; mso-pagination: none; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Post operasi hari 4<o:p></o:p></span></div><div class="MsoNormal"><br />
</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 94.5pt;" valign="top" width="126"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Adanya insisi bedah<o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 99.0pt;" valign="top" width="132"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Gangguan rasa nyaman (nyeri)<o:p></o:p></span></div><div class="MsoNormal"><br />
</div></td> </tr>
<tr> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 28.5pt;" valign="top" width="38"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">2.<o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 192.9pt;" valign="top" width="257"> <div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-pagination: none; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">DS : -<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-pagination: none; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">DO :<o:p></o:p></span></div><div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .5in; mso-list: l21 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0;">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington;">terdapat luka operasi abdomen bagian kanan bawah dengan panjang </span><span style="color: #7030a0;">±</span><span style="color: #7030a0; font-family: Harrington;"> 15 cm<o:p></o:p></span></div><div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .5in; mso-list: l21 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0;">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington;">luka bersih dengan jahitan<o:p></o:p></span></div><div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .5in; mso-list: l21 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0;">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington;">Luka tertutup oleh kasa steril<o:p></o:p></span></div><div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .5in; mso-list: l21 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0;">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington;">rembesan darah minimal<o:p></o:p></span></div><div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .5in; mso-list: l21 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0;">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington;">luka kering<o:p></o:p></span></div><div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .5in; mso-list: l21 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0;">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington;">tidak bengkak<o:p></o:p></span></div><div class="MsoBodyTextIndent" style="line-height: 115%; margin-left: .5in; mso-list: l21 level1 lfo3; tab-stops: list .5in; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0;">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington;">jahitan belum menutup sempurna.<o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 94.5pt;" valign="top" width="126"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">trauma pembedahan</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;"><o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 99.0pt;" valign="top" width="132"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Kerusakan integritas kulit</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;"><o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="text-indent: -27.0pt;"><br />
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</div><div class="MsoNormal" style="margin-left: -27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Diagnosa Keperawatan menurut Dongoes (1999):<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -27.0pt; margin-right: 0in; margin-top: 0in; mso-list: l22 level1 lfo5; mso-pagination: none; tab-stops: list -9.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Gangguan rasa nyaman ( nyeri ) b/d </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Adanya insisi bedah</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -27.0pt; margin-right: 0in; margin-top: 0in; mso-list: l22 level1 lfo5; mso-pagination: none; tab-stops: list -9.0pt; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kerusakan integritas kulit b/d trauma pembedahan</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: -27.0pt;"><br />
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</div><div class="MsoNormal" style="margin-left: -27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Rencana Tindakan Keperawatan menurut Dongoes (1999)<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: -27pt; width: 648px;"><tbody>
<tr> <td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: .45in;" valign="top" width="43"> <div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">No. Dx.<o:p></o:p></span></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 134.4pt;" valign="top" width="179"> <div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Tujuan dan Kriteria hasil<o:p></o:p></span></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 135.0pt;" valign="top" width="180"> <div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Intervensi<o:p></o:p></span></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 2.0in;" valign="top" width="192"> <div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Rasional<o:p></o:p></span></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 40.5pt;" valign="top" width="54"> <div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Nama Ns.<o:p></o:p></span></div></td> </tr>
<tr> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: .45in;" valign="top" width="43"> <div class="MsoListParagraph" style="margin-bottom: 0.0001pt; margin-left: 0in; margin-right: 0in; margin-top: 0in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">1.<o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 134.4pt;" valign="top" width="179"> <div class="MsoNormal"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Tujuan</span></b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">: Setelah diberikan tindakan keperawatan selama 3x24 jam nyeri hilang/terkontrol<o:p></o:p></span></div><div class="MsoNormal"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Kriteria hasil</span></b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;"> :<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Klien menyatakan sudah tidak nyeri atau nyeri berkurang.<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Klien tampak rileks, mampu istirahat dengan tenang<o:p></o:p></span></div><div class="MsoNormal"><br />
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</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 135.0pt;" valign="top" width="180"> <div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Kaji nyeri, catat lokasi, karakteristik, beratnya (skala 0-4), selidiki dan laporkan nyri dengan tepat.<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in;"><br />
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</div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Dorong ambulasi dini<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in;"><br />
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</div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in;"><br />
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</div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Berikan aktivitas hiburan<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
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</div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Kolaborasi dalam pemerian analgesik sesuai indikasi<o:p></o:p></span></div><div align="left" class="MsoBodyText2" style="text-align: left;"><br />
</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 2.0in;" valign="top" width="192"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Berguna dalam pengawasan keefektifan obat, kemajuan penyembuhan. Perubahan pada karakteristik nyeri menunjukkan terjadinya abses/peritonitis, memerlukan upaya evaluasi medic dan intervensi<o:p></o:p></span></div><div align="left" class="MsoBodyText2" style="text-align: left;"><span lang="IN" style="color: #7030a0; font-family: Harrington;">Meningkatkan normalisasi fungsi organ </span><span style="color: #7030a0; font-family: Harrington; mso-ansi-language: EN-US;">(</span><span lang="IN" style="color: #7030a0; font-family: Harrington;">merangsang peristaltik dan </span><span style="color: #7030a0; font-family: Harrington; mso-ansi-language: EN-US;">kelancaran </span><span lang="IN" style="color: #7030a0; font-family: Harrington;">flatus, menurunkan ketidaknyamanan abdomen</span><span style="color: #7030a0; font-family: Harrington; mso-ansi-language: EN-US;">)<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Meningkatkan relaksasi dan kemampuan koping.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Menghilangkan nyeri, mempermudah kerjasamna dengan intervensi terapi lain.<o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 40.5pt;" valign="top" width="54"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Ns. A<o:p></o:p></span></div><div class="MsoNormal"><br />
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<tr> <td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: .45in;" valign="top" width="43"> <div class="MsoNormal" style="margin-bottom: 0.0001pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2.<o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 134.4pt;" valign="top" width="179"> <div class="MsoNormal" style="margin-bottom: 0.0001pt;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Tujuan</span></b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">: setelah dilakukan tindakan keperawatan selama 3x24 jam diharapkan integritas kulit klien tetap terjaga.<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><b><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Kriteria hasil:<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="margin-bottom: 0.0001pt; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Menunjukkan penyembuhan luka sesuai waktu tanpa komplikasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">-<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Menunjukkan perilaku untuk menurunkan tegangan jahitan<o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 135.0pt;" valign="top" width="180"> <div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; margin-left: 13.2pt; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Observasi insisi secara periodic, catat penyambungan tepi luka, pembentukan hematoma dan penyembuhan, perdarahan/drainase.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; margin-left: 13.2pt; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoListParagraphCxSpLast" style="margin-bottom: 0.0001pt; margin-left: 13.2pt; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Sokong insisi bila mengubah posisi, batuk, napas dalam dan ambulasi<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoListParagraph" style="margin-bottom: 0.0001pt; margin-left: 13.2pt; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Berikan perawatan insisi hati-hati untuk mempertahankan balutan kering dan steril<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="margin-bottom: 0.0001pt; margin-left: 13.2pt; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Berikan perawatan kulit; berikan perhatian khusus pada lipatan kulit<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; margin-left: 13.2pt; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; margin-left: 13.2pt; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoListParagraphCxSpLast" style="margin-bottom: 0.0001pt; margin-left: 13.2pt; margin-right: 0in; margin-top: 0in; text-indent: -0.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Kolaborasi dalam pemberian terapi kinetic sesuai indikasi<o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 2.0in;" valign="top" width="192"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Mempengaruhi pilihan intervensi<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Menurunkan kemungkinan dehisens dan hernia insisi lanjut.<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Meningkatkan penyembuhan. Akumulasi drainase seroanguinosa pada lapisan subkutan meningkatkan tegangan jahitan, sehingga dapat memperlambat penyembuhan luka dan memberikan medium pertumbuhsn bakteri<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Kelembaban atau ekskoriasi meningkatkan pertumbuhan bakteri yang menimbulkan infeksi pasca operasi.<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Menurunkan tekanan kulit dan meningkatkan sirkulasi<o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 40.5pt;" valign="top" width="54"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Ns. A<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal"><br />
</div><div class="MsoNormal" style="margin-left: -27.0pt;"><br />
</div><div class="MsoNormal" style="margin-left: -27.0pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Implementasi dan evaluasi keperawatan<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: -27pt; width: 632px;"><tbody>
<tr> <td style="border: solid #000064 1.0pt; mso-border-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 23.4pt;" valign="top" width="31"> <div align="center" class="MsoNormal" style="margin-left: -4.5pt; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">No. dx<o:p></o:p></span></div></td> <td style="border-left: none; border: solid #000064 1.0pt; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 53.4pt;" valign="top" width="71"> <div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Hari,<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Tgl, jam<o:p></o:p></span></div></td> <td style="border-left: none; border: solid #000064 1.0pt; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 148.4pt;" valign="top" width="198"> <div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Implementasi<o:p></o:p></span></div></td> <td style="border-left: none; border: solid #000064 1.0pt; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 36.7pt;" valign="top" width="49"> <div align="center" class="MsoNormal" style="margin-left: -4.7pt; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Nama<o:p></o:p></span></div><div align="center" class="MsoNormal" style="margin-left: -4.7pt; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Perawat<o:p></o:p></span></div></td> <td style="border-left: none; border: solid #000064 1.0pt; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 45.0pt;" valign="top" width="60"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Hari,<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Tgl. jam<o:p></o:p></span></div></td> <td style="border-left: none; border: solid #000064 1.0pt; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 130.5pt;" valign="top" width="174"> <div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Catatan perkembangan dan Evaluasi<o:p></o:p></span></div></td> <td style="border-left: none; border: solid #000064 1.0pt; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 36.7pt;" valign="top" width="49"> <div align="center" class="MsoNormal" style="margin-left: -5.4pt; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Nama<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">perawat<o:p></o:p></span></div></td> </tr>
<tr> <td style="border-top: none; border: solid #000064 1.0pt; mso-border-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 23.4pt;" valign="top" width="31"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">1<o:p></o:p></span></div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 53.4pt;" valign="top" width="71"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Selasa,29-11-2011<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">07.00<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">08.00<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">09.00<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">12.30<o:p></o:p></span></div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 148.4pt;" valign="top" width="198"> <div class="MsoNormal" style="margin-bottom: 0.0001pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Mengkaji nyeri, mencatat lokasi, karakteristik, beratnya (skala 0-4), selidiki dan laporkan nyeri dengan tepat.<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Mendorong ambulasi dini<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Memberikan aktivitas hiburan<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Berkolaborasi dalam pemerian analgesik sesuai indikasi<o:p></o:p></span></div><div align="left" class="MsoBodyText2" style="text-align: left;"><br />
</div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 36.7pt;" valign="top" width="49"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Ns.A<o:p></o:p></span></div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 45.0pt;" valign="top" width="60"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Selasa, <o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">29-11-2011<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">14.00<o:p></o:p></span></div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 130.5pt;" valign="top" width="174"> <div class="MsoNormal" style="margin-left: 17.1pt; text-indent: -17.1pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">S: Klien mengatakan masih nyeri.<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 17.1pt; text-indent: -4.5pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Nyeri seperti ditusuk-tusuk<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; mso-pagination: none; text-indent: -4.5pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Skala 1 (0-4)<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 17.1pt; tab-stops: list 8.1pt; text-indent: -17.1pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; mso-pagination: none; tab-stops: 17.1pt; text-indent: -17.1pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">O: Klien merintih kesakitan<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; text-indent: -4.5pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Ekspresi wajah agak tenang<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; text-indent: -4.5pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Tampak sedikit rileks, tapi belum bisa istirahat dengan tenang<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; mso-pagination: none; text-indent: -17.1pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; mso-pagination: none; text-indent: -17.1pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">A: Masalah belum teratasi<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; mso-pagination: none; text-indent: -17.1pt;"><br />
</div><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; mso-pagination: none; text-indent: -17.1pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">P: Lanjutkan intervensi No. 1,2,3,4,5<o:p></o:p></span></div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 36.7pt;" valign="top" width="49"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Ns.A<o:p></o:p></span></div></td> </tr>
<tr> <td style="border-top: none; border: solid #000064 1.0pt; mso-border-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 23.4pt;" valign="top" width="31"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">2<o:p></o:p></span></div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 53.4pt;" valign="top" width="71"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Selasa,29-11-2011<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">07.00<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">08.15<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">11.00<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">11.15<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><br />
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</div><div class="MsoListParagraphCxSpLast" style="margin-bottom: 0.0001pt; margin-left: 0in; margin-right: 0in; margin-top: 0in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Menyokong insisi bila mengubah posisi, batuk, napas dalam dan ambulasi<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoListParagraph" style="margin-bottom: 0.0001pt; margin-left: 0in; margin-right: 0in; margin-top: 0in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Memberikan perawatan insisi hati-hati untuk mempertahankan balutan kering dan steril<o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0.0001pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="margin-bottom: 0.0001pt; margin-left: 0in; margin-right: 0in; margin-top: 0in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Memberikan perawatan kulit; berikan perhatian khusus pada lipatan kulit<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; margin-left: 0in; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoListParagraphCxSpLast" style="margin-bottom: 0.0001pt; margin-left: 0in; margin-right: 0in; margin-top: 0in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">Berkolaborasi dalam pemberian terapi kinetic sesuai indikasi<o:p></o:p></span></div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 36.7pt;" valign="top" width="49"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Ns.A<o:p></o:p></span></div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 45.0pt;" valign="top" width="60"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Selasa, 29-11-2011<o:p></o:p></span></div><div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">14.00<o:p></o:p></span></div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 130.5pt;" valign="top" width="174"> <div class="MsoListParagraph" style="margin-bottom: 0.0001pt; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; text-indent: -17.1pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt;">S: -<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 17.1pt; text-indent: -17.1pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">O: </span><span style="color: #7030a0; font-family: Harrington;">luka bersih dengan jahitan, Luka tertutup oleh kasa steril, rembesan darah minimal, luka kering, tidak bengkak, </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">jahitan belum menutup sempurna.</span><span style="color: #7030a0; font-family: Harrington;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 17.1pt; text-indent: -17.1pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">A: masalah teratasi sebagian<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 17.1pt; text-indent: -17.1pt;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">P: lanjutkan intervensi no. 1,2,3,4,5<o:p></o:p></span></div></td> <td style="border-bottom: solid #000064 1.0pt; border-left: none; border-right: solid #000064 1.0pt; border-top: none; mso-border-alt: solid #000064 .5pt; mso-border-left-alt: solid #000064 .5pt; mso-border-top-alt: solid #000064 .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 36.7pt;" valign="top" width="49"> <div class="MsoNormal"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 115%;">Ns.A<o:p></o:p></span></div></td> </tr>
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</div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">BAB 4<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">PENUTUP<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l6 level2 lfo36; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.1<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Simpulan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-pagination: none; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Laparatomi yaitu insisi pembedahan melalui pinggang (kurang begitu tepat), tapi lebih umum pembedahan perut (harjono. M, 1996).</span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";"> Jenis laparatomi menurut tekhnik pembedahan yakni </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">insisi pada garis tengah abdomen (mid-line incision), Insisi pada garis tranversal abdomen (pfannenstiel incision), insisi cherney, </span><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">paramedian dan transverse upper abdomen incision.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-pagination: none; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Sedangkan menurut indikasi, jenis-jenis laparatomi meliputi Adrenalektomi, apendiktomi, gasterektomi, histerektomi, kolektomi, nefrektomi, pankreatomi, seksiosesaria, siksetomi dan selfigo oofarektomi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-pagination: none; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-list: l6 level2 lfo36; mso-pagination: none; text-align: justify; text-indent: -.25in;"><!--[if !supportLists]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Harrington; mso-fareast-font-family: Harrington;">4.2<span style="font: 7.0pt "Times New Roman";"> </span></span><!--[endif]--><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Saran<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-pagination: none; text-align: justify; text-indent: .5in;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">Bedah laparatomi merupakan tindakan operasi pada daerah abdomen (Spencer) yang dapat dilakukan pada bedah digestif dan kandungan.Oleh karena itu sebagai perawat hendaknya mengetahui tentang tekhnik dan perawatan pada klien dengan laparatomi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: 45.0pt; text-align: justify;"><br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span style="color: #7030a0; font-family: Harrington; font-size: 12.0pt; line-height: 150%;">DAFTAR PUSTAKA<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div style="line-height: 150%; text-align: justify;"><span style="color: #7030a0; font-family: Harrington;">Brunner and suddart. 1988. <i>Textbook of Medical Surgical Nursing</i>. Sixth Edition. Philadelpia: J.B. Lippincott Campany<o:p></o:p></span></div><div style="line-height: 150%; text-align: justify;"><span style="color: #7030a0; font-family: Harrington;">Doenges, Marilynn E. 2000. <i>Rencana Asuhan Keperawatan</i>. Jakarta: EGC<o:p></o:p></span></div><div style="line-height: 150%; text-align: justify;"><span style="color: #7030a0; font-family: Harrington; mso-bidi-font-weight: bold;">Fitzpatrick, JK. </span><span style="color: #7030a0; font-family: Harrington;">1997. <i>Abdominal Surgical Approaches in Danakas GT Pietrantoni M (ed) “The Care Of The Gynecologic / Obstetric Patient”</i>. St Louis, Missouri, Mosby.<o:p></o:p></span></div><div style="line-height: 150%; text-align: justify;"><span style="color: #7030a0; font-family: Harrington;">Long, Barbara C. 1996. <i>Perawatan Medikal Bedah</i>. Bandung: Yayasan IAPK Pajajaran Bandung<o:p></o:p></span></div><div style="line-height: 150%; text-align: justify;"><span style="color: #7030a0; font-family: Harrington;">Soeparman, dkk. 1987. <i>Ilmu Penyakit Dalam</i>. Edisi II. Jakarta: Balai Penerbit FKUI<o:p></o:p></span></div><div style="line-height: 150%; text-align: justify;"><br />
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