tag:blogger.com,1999:blog-55719518058092983612024-03-13T06:15:27.401+07:00Asuhan Keperawatan Aplikasi NANDA, NOC, NICRizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.comBlogger2249125tag:blogger.com,1999:blog-5571951805809298361.post-46450986307767288342019-02-26T06:42:00.000+07:002019-07-27T16:29:49.906+07:00KEPEMIMPINAN GLOBAL DAN KEPEMIMPINAN DALAM KEPERAWATAN KOMUNITAS<!--[if gte mso 9]><xml>
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<br />
<div class="MsoListParagraphCxSpFirst" style="line-height: 115%; margin-left: 21.3pt; mso-add-space: auto; mso-list: l2 level1 lfo1; text-indent: -21.3pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Jelaskan
apa yang dimaksud:</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 21.3pt; mso-add-space: auto; mso-list: l9 level1 lfo2; text-align: justify; text-indent: 0cm;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Kepemimpinan
Global</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 21.3pt; mso-add-space: auto; mso-list: l9 level1 lfo2; text-align: justify; text-indent: 0cm;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Karakteristik</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 21.3pt; mso-add-space: auto; mso-list: l9 level1 lfo2; text-align: justify; text-indent: 0cm;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Gaya
kepemimpinan global</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 21.3pt; mso-add-space: auto; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Jelaskan:</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l4 level1 lfo3; text-align: justify; text-indent: -14.15pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Apa
kepemimpinan di komunitas?</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l4 level1 lfo3; text-align: justify; text-indent: -14.15pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Apa
karakteristik dan alasan kepemimpinan di komunitas memerlukan karakteristik
perilaku kepemimpinan?</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 115%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l4 level1 lfo3; text-align: justify; text-indent: -14.15pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Gaya
kepemimpinan apa yang tepat dipilih di komunitas jelaskan alasannya?</span></div>
<div class="MsoNormal" style="line-height: 115%; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Jawaban:</span></b></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 115%; margin-left: 1.0cm; mso-add-space: auto; mso-list: l7 level1 lfo4; text-align: justify; text-indent: -1.0cm;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Penjelasan:</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 46.35pt; mso-add-space: auto; mso-list: l3 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Kepemimpinan global adalah </span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">suatu hubungan secara sosial dimana satu kelompok
memiliki suatu kemampuan yang lebih besar untuk mempengaruhi perilaku orang
lain daripada untuk dipengaruhi oleh orang lain. Jadi, kepemimpinan didasarkan
pada suatu perbedaan kekuatan diantara orang-orang yang berhubungan (Gillies,
2000)</span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">.</span><span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 46.35pt; mso-add-space: auto; mso-list: l3 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Karakteristik
pemimpin adalah sebagai berikut:</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 115%; margin-left: 46.35pt; mso-add-space: auto; text-align: justify;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Karakteristik
pemimpin menurut </span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Covey
(2004) adalah memiliki visi, keberanian, dan kerendahan hati. Memiliki mimpi
atau visi adalah keharusan, tetapi seseorang harus memiliki keberanian untuk
terus mendefinisikan visi tersebut kepada suatu kelompok dan, pada saat yang
sama, menjadi cukup rendah hati untuk mengetahui kapan untuk mendefinisikan
kembali untuk memenuhi kebutuhan waktu yang berubah dan mempersiapkan diri
untuk masa depan. </span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Bennis dan Nanus (1995) menggambarkan kepemimpinan
mencakup visi, kemampuan untuk berkomunikasi secara efektif, kemampuan untuk
menjadi teguh, dan kemampuan untuk menunjukkan diri yang positif. Memiliki
kemampuan untuk secara konsisten mendorong visi dalam suatu kelompok atau
organisasi membutuhkan kepercayaan diri dan ketegasan. Parse (1997) menggemakan
pemikiran Bennis dan Nanus ketika dia menggambarkan para pemimpin sebagai orang
yang berkomitmen pada visi, mau mengambil risiko ditantang oleh orang lain, dan
menunjukkan rasa hormat kepada orang lain.</span></div>
<div class="MsoNormal" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Karakteristik pemimpin transformasional menurut
Marshall (2011):</span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 115%; mso-list: l5 level1 lfo10; tab-stops: 63.8pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Karismatik
dan Mampu mempengaruhi</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; tab-stops: 63.8pt; text-align: justify;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Seorang pemimpin adalah model bagi
pengikutnya. Pemimpin dipercaya memiliki komitmen dalam mencapai tujuan.
Karismatik memiliki arti bahwa seorang pemimpin mempunyai kemampuan untuk
menginspirasi visinya sehingga orang lain dapat mempercayai dirinya. Kedua hal
ini merupakan kemampuan untuk mempengaruhi dan meginspirasi orang lain.
Pemimpin yang karismatik mengetahui apa tujuan mereka dan bagaimana mencapai
tujuan tersebut. Pemimpin karismatik didasari pada komitmen terhadap nilai
etika, mempengaruhi orang lain untuk berbuat positif. Penelitian menunjukkan
kepuasan yang lebih tinggi dan kebahagiaan pada pemimpin karismatik.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; mso-list: l5 level1 lfo10; tab-stops: 63.8pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Inspirasi
dan tujuan</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; tab-stops: 63.8pt; text-align: justify;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Kepemimpinan harus dilandasi karakter
moral pemimpin, landasan nilai etika dan proses etika. Dari landasan etika,
seorang pemimpin dapat menetapkan tujuan masa depannya. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; mso-list: l5 level1 lfo10; tab-stops: 63.8pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Intelektual</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; tab-stops: 63.8pt; text-align: justify;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Pemimpin adalah individu yang terdidik
dan dapat melihat hal yang lama dengan cara pandang yang baru, memiliki
kreativitas, ide, disiplin, dan dapat mencari solusi. Seorang pemimpin juga
membutuhkan keberanian dan tanggung jawab dalam mengambil resiko. Pemimpi dapat
mengetahui strategi yang perlu diambil. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; mso-list: l5 level1 lfo10; tab-stops: 63.8pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Pertimbangan
individu</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; tab-stops: 63.8pt; text-align: justify;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Seorang pemimpin menggunakan
keterampilan professional, empati, dukungan dari anggotanya dalam mengambil
keputusan. Pemimpin yang efektif mengakui dan meningkatkan kontribusi orang
lain. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 46.35pt; mso-add-space: auto; mso-list: l3 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Gaya
kepemimpinan global</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 46.35pt; mso-add-space: auto; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Kepemimpinan merupakan proses memengaruhi kelompok untuk menentukan dan
mencapai tujuan. Berbicara tentang kepemimpinan maka akan menitikberatkan pada
gaya kepemimpinan. Adapun beragam macam gaya kepemimpinn bermuara dari
terbitnya teori kepemimpinan yang terdiri atas (Swansburg, 2000):</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 64.35pt; mso-add-space: auto; mso-list: l8 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Model
Bersyarat Kefektifan dari Fiedler</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 63.8pt; mso-add-space: auto; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Fiedler mengungkapkan bahwa harus ada kelompok terlebih dahulu sebelum
ada pimpinan. Dalam gaya ini lebih berfokus pada hubungan antara pemimpin
dengan anggota kelompok. Dimana dalam memimpin akan dipengaruhi oleh 3 hal
yakni; Kepribadian dimana kepribadian pemimpin mempengaruhi interaksi anggota
kelompok, Susunan Tugas dimana apabila tugas yang diberikan terlalu berat maka
kekuasaan pimpinan hanya sedikit, tapi bila tugasnya mengutamakan perencanaan
dan pemikiran maka posisi pimpinan memiliki kuasa penuh, dan terakhir adalah
kekuasaan atas posisi pimpinan, dimana gaya kepemimpinan akan bekerja dengan
sangat baik tidak harus dipengaruhi oleh kekuasaan pimpinannya. Apabila
pimpinan memiliki pengaruh yang kuat pada anggota kelompok maka gaya
kepemimpinan yang berorientasi pada hubungan akan bekerja dengan baik. Fiedler
menyimpulkan bahwa ini tentang situasi dimana gaya kepemimpinan akan efektif
atau tidak efektif tergantung pada situasi.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 64.35pt; mso-add-space: auto; mso-list: l8 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Model
Siklus Kehidupan dari Hersey dan Blanchard</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 64.35pt; mso-add-space: auto; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Teori ini meramalkan gaya kepemimpinan yang paling tepat tergantung pada
tingkat kematangan dan ketidakmatangan pemilih gaya. Dengan ketidakmatangan,
gaya kepemimpinan akan memfokuskan pada tugas dimana pemilih gaya akan relatif
pasif dan tergantung. Sementara dengan kematangan gaya kepemimpinan maka akan
berfokus pada hubungan perilaku yang menjadikan pemimpin aktif dan tidak
tergantung. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 64.35pt; mso-add-space: auto; mso-list: l8 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Teori
Organisasi Z</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 64.35pt; mso-add-space: auto; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Berfokus pada pengambilan keputusan yang disepakati bersama. Gaya
kepemimpinan demokratis termasuk desentralisasi, manajemen partisipatif,
keterlibatan pegawai, dan kualitas hidup. Pemimpin berkonsentrasi pada
perkembangan dan memanfaatkan keterampilan interpersonal mereka. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 64.35pt; mso-add-space: auto; mso-list: l8 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Teori
Perilaku</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 64.35pt; mso-add-space: auto; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Dalam teori ini menerbitkan beberapa gaya kepemimpinan yang dicetuskan
oleh Kurt Lewin dan Likert Michigan. Lewin mengungkapkan bahwa gaya
kepemimpinan dikaitkan dengan kekuatan yang ada pada pemimpin, anggota kelompok
dan situasi.<span style="mso-spacerun: yes;"> </span>Studi Gaya Kepemimpinan
menurut Kurt Lewin (Megginson, 1986) :</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 54.0pt; mso-add-space: auto; mso-list: l1 level1 lfo7; tab-stops: 3.0cm; text-align: justify; text-indent: 9.8pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Autokratik</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 3.0cm; mso-add-space: auto; tab-stops: 3.0cm; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Pemimpin membuat keputusan sendiri. Mereka cenderung
memperhatikan penyelesaian tugas daripada karyawan. Kepemimpinan Autokratik
cenderung menimbulkan permusuhan dan sifat agresif atau sama sekali apatis dan
menghilangkan inisiatif</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 54.0pt; mso-add-space: auto; mso-list: l1 level1 lfo7; tab-stops: 3.0cm; text-align: justify; text-indent: 9.8pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Demokratis</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 3.0cm; mso-add-space: auto; tab-stops: 3.0cm; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Pemimpin melibatkan bawahannya dalam proses
pengambilan keputusan. Mereka berorientasi pada bawahan dan menitikberatkan
pada hubungan antar manusia dan kerja kelompok. Kepemimpinan demokratis
menimbulkan peningkatan produktivitas dan kepuasan kerja. Gaya Kepemimpinan
Demokratis bisa disebut juga dengan gaya kepemimpinan partisipatif dimana
anggota tim berpartisipasi dalam proses pengambilan keputusan dan hasilnya para
pengikut merasa lebih terlibat dalam proses manajemen, lebih berkomitmen pada
tujuan dan lebih termotivasi untuk bekerja secara efisien (Gill, 2017; Bass
& Avolio, 1995).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 54.0pt; mso-add-space: auto; mso-list: l1 level1 lfo7; tab-stops: 3.0cm; text-align: justify; text-indent: 9.8pt;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Laissez
Feire</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 3.0cm; mso-add-space: auto; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Pemimpin memberikan kebebasan dan segala serba boleh, dan pantang
memberikan bimbingan kepada staf. Pemimpin tersebut membantu kebebasan kepada
setiap orang dan menginginkan setiap orang merasa senang. Pimpinan Laissez
Faire mengakibatkan produktivitas rendah dan karyawan merasa frustasi.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 63.8pt; mso-add-space: auto; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Sementara itu, Michigan mengidentifikasi empat daya gaya dasar dan
sistem kepemimpinan yang terdiri atas</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l6 level1 lfo8; text-align: justify; text-indent: -14.2pt;">
<span lang="EN-ID" style="font-family: "symbol"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Sistem
I (Kewenangan mengeksploitasi)</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l6 level1 lfo8; text-align: justify; text-indent: -14.2pt;">
<span lang="EN-ID" style="font-family: "symbol"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Sistem
II (Kewenangan lebih baik)</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l6 level1 lfo8; text-align: justify; text-indent: -14.2pt;">
<span lang="EN-ID" style="font-family: "symbol"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Sistem
III (Demokratis Konsultatif)</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l6 level1 lfo8; text-align: justify; text-indent: -14.2pt;">
<span lang="EN-ID" style="font-family: "symbol"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Sistem
IV (Demokratis Partisipatif). Michigan mengakui gaya kepemimpan yang baik dan
efektif adalah pada sistem ini.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 78.0pt; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 64.35pt; mso-add-space: auto; mso-list: l8 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Transformational
Leadership Theory</span></i></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 70.9pt; mso-add-space: auto; text-align: justify;">
<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">K</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">epemimpinan
transformasional adalah</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">hubungan antara pemimpin
dan pengikut di mana mereka</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">saling memotivasi ke
tingkat yang lebih tinggi dan menghasilkan sistem nilai kesesuaian antara
pemimpin dan pengikut.</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Visi dan kepribadian yang
kuat adalah ciri-ciri umum di antara</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">pemimpin
transformasional dimana mereka menggerakkan para </span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">anggota
kelompok</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
mereka</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> di</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">sesuaikan </span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">dengan
memaksimalkan potensi anggota kelompok melalui dorongan inovasi, kreativitas
dan rangsangan intelektual (Krishnan, 2002 ; Bass, 1985; </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Bass dan Avolio, 1994</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 70.9pt; mso-add-space: auto; text-align: justify;">
<span lang="EN-US" style="background: white; color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Secara khusus, teori kepemimpinan transformasional difokuskan
pada perubahan. Para pemimpin yang menggunakan gaya ini dianggap sebagai agen
perubahan yang menggunakan kualitas dan kepribadian mereka untuk memotivasi
anggota mereka untuk mencapai tujuan mereka, berbagi visi bersama, dan
memberdayakan mereka. Pemimpin transformasional mempengaruhi pengikut oleh
mendorong dan menginspirasi mereka untuk mencapai tujuan organisasi. Adapun
bentuk gaya kepemimpan transformasional terdiri dari ; Pertama, para pemimpin
harus membangun hubungan kepercayaan dengan anggota kelompok. Hubungan
kepercayaan ini dapat dibentuk dengan menjadi terbuka, adil, dan jujur dengan
staf dan dengan memotivasi mereka untuk menjadi independen dalam pengambilan
keputusan mereka. Kedua, para pemimpin harus menggunakan komunikasi yang
efektif untuk memimpin staf agar mampu mencapai tujuan akhir. Lebih jauh lagi,
para pemimpin harus memiliki kepercayaan diri yang tinggi, tegas dan percaya
pada visi mereka dan memiliki keberanian untuk mencapai tujuan mereka
(Christian, 2016; Kuhnert & Lewis, 1987).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 63.8pt; mso-add-space: auto; mso-list: l8 level1 lfo6; tab-stops: 3.0cm; text-align: justify; text-indent: -14.15pt;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">6)<span style="font: 7.0pt "Times New Roman";">
</span></span></span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="background: white; color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Transactional Leadership Theory</span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"></span></i></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-left: 70.9pt; mso-add-space: auto; text-align: justify;">
<span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Kepemimpinan transaksional didasarkan pada pengaturan
tujuan yang jelas</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">untuk para </span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">anggota kelompok</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> serta penerapan hadiah</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">dan hukuman untuk memotivasi </span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">mereka</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> dan mendorong kepatuhan.</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Dalam teori kepemimpinan transaksional, bawahan dan pemimpin</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> memiliki kesepakatan</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> di mana pemimpin memberikan imbalan
positif seperti</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">bonus, cuti, manfaat kesehatan, atau hanya
gajinya sebagai gantinya</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">untuk penyelesaian tugas. Di sisi lain,
jika tugas tidak terpenuhi</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">atau tidak memenuhi harapan </span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">pemimpin</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">, para pemimpin juga dapat menggunakan</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">imbalan negatif seperti ancaman melakukan </span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">hal lain </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">atau kehilangan pekerjaan (Aarons, 2006; </span><span lang="EN-US" style="background: white; color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Kuhnert & Lewis, 1987)</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"></span></div>
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<br /></div>
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<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Penjelasan:</span></div>
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<span lang="EN-US" style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Kepemimpinan
di komunitas adalah </span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">perilaku yang
mengarahkan anggota dan menentukan dan mempengaruhi aksi kelompok. Proses
pengaruh yang terjadi antara pemimpin dan individual, kelompok, organisasi,
komunitas, sering dengan menginspirasi, menghidupkan, melibatkan pihak lain
untuk berpartisipasi dalam pencapaian tujuan (Stanhope dan Lancaster, 2016).</span><span lang="EN-US"></span></div>
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<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Karakteristik
dan alasan kepemimpinan di komunitas memerlukan karakteristik perilaku
kepemimpinan</span></div>
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<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Seorang perawat komunitas perlu memiliki
karakteristik karismatik dan mampu mempengaruhi. Perawat komunitas banyak
berinteraksi dengan masyarakat dan memiliki tugas mempengaruhi orang lain dalam
hal melakukan hidup sehat. Tidak hanya itu, visi perawat komunitas juga harus
mampu menginspirasi masyarakat untuk dapat melakukan hal-hal yang berhubungan
dengan kesehatan komunitas. Tak hanya itu, karakteristik menginsiprasi dan
memiliki tujuan di masa depan juga perlu dimiliki oleh perawat komunitas.
Lingkup kerja yang berhubungan dengan kehidupan kesehatan masyarakat membuat
perawat komunitas perlu memikirkan kesehatan apa yang harus dimiliki oleh
masyarakat sehingga kedepannya masyarakat terhindar dari sakit dan meningkatkan
derajat kesehatan masyarakat. Dengan karakteristik intelektual, perawat
komunitas dapat menggunakan keterampilan profesionalnya dalam melakukan
intervensi kepada masyarakat yang didasari oleh riset – riset yang berkualitas.
</span></div>
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<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Kepemimpinan dalam keperawatan komunitas membutuhkan
visi bersama yang jelas dengan melibatkan masyarakat. Pemimpin dalam
keperawatan komunitas perlu mengembangkan pola pikir tentang masalah kesehatan
dan profesi, mengintegrasikan teknologi yang memfasilitasi mobilitasnya dalam
menjalankan misi, mempertimbangkan hal-hal untuk mengambil keputusan, dan
menjadi visioner yang proaktif dalam menanggapi perubahan cepat dalam perawatan
kesehatan sehari-hari.</span></div>
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<span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Gaya
kepemimpinan yang tepat dipilih di komunitas adalah</span></div>
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<span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">G</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">aya kepemimpinan yang
berbeda</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">diperlukan
untuk situasi yang berbeda, dan para pemimpin harus tahu pendekatan mana yang
paling efektif yang sesuai dengan kondisi untuk mencapai tujuan organisasi</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
(Hui Xu, 2017). Dalam pelaksanaannya Keperawatan Komunitas sangat berbeda
dengan kondisi yang ada di klinik, dimana perawatan yang diberikan dalam
lingkup dan cakupan keperawatan komunitas diberikan secara terus menerus dalam
jangka yang panjang dan membutuhkan kerjasama dari beberapa pihak termasuk
keluarga dimana akan dikombinasikan dengan jumlah pasien yang dengan usia tua yang
memiliki kebutuhan yang semakin kompleks dan memiliki harapan yang tinggi dalam
kesehatannya (Quenns Nursing Institute, 2013; Oliver <i style="mso-bidi-font-style: normal;">et al, </i>2014). Sehingga dalam hal ini dibutuhkan perawat komunitas
yang cakap dan handal dalam mengelola tata organisasinya agar mampu memberikan
efektifitas yang besar bagi kesehatan masyarakat (Layton, 2015).<span style="mso-spacerun: yes;"> </span></span></div>
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<span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Beberapa penelitian menyebutkan terdapat
beberapa gaya kepemimpinan yang tepat diterapkan di keperawatan komunitas,
salah satunya adalah menggunakan gaya kepemimpinan transformasional. K</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">epemimpinan
transformasional </span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">dikenal </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">sebagai</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
gaya</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
yang paling</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">efektif karena berbasis hubungan</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">dan
adaptif terhadap situasi yang berubah.</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Pemimpin
transformasional adalah model peran, mereka mampu memotivasi</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">staf
mereka untuk mengadopsi perubahan demi kebaikan yang lebih besar</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
bagi pasien</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> serta layanan, daripada masing-masing</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">anggota
tim yang berfokus pada kepentingan mereka sendiri</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">(Doody</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">&
Doody, 2012). Motivasi ini bermula</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">dari
menggabungkan nilai-nilai tim (yaitu memberi</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">perawatan
yang berpusat pada pasien) dengan orang-orang dari pemerintah. Penggabungan</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">nilai-nilai
</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">ini mampu </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">meningkatkan komitmen
terhadap visi (Gopee</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">dan Galloway 2009).</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Honkavuo
dan Lindstrom (2014) berpendapat bahwa</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">tujuan
utama para perawat adalah untuk meringankan</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">penderitaan.
Ini dicapai dengan menciptakan kepedulian</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">lingkungan
dengan komunikasi terbuka dan</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">pemahaman emosional dalam
tim. Klinis</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">tim berkinerja </span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">dengan
baik</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
ketika para pemimpin mendukung</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">dan menghargai staf, dan
memungkinkan mereka untuk bekerja</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">.</span></div>
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<span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Dalam keperawatan komunitas maka arah kerja
perawat bukan hanya sesama tenaga kesehatan saja, namun juga kepada masyarakat,
tokoh masyarakat, tokoh agama, keluarga bahkan instansi pemerintah yang
memegang kendali penuh dalam hal kebijakan kesehatan masyarakat. Sehingga yang
dibutuhkan dalam penerapan sebuah organisasi adalah kemampuan pemimpin dalam
bersifat terbuka, mampu mengkomunikasikan dengan orang yang menjadi anggota
timnnya. Dalam kepemimpinan transformasional a</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">dalah penting bahwa para
pemimpin di semua tingkatan</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">memahami visi dan rencana
organisasi</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> tentang </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">bagaimana perubahan ini
akan dilaksanakan. Pemimpin</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">tidak memahami visi
kepercayaan, tentu dia tidak akan dapat mengkomunikasikannya secara efektif ke</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">tim
yang lebih luas. Komunikasi yang jelas dengan cara itu</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">membawa
pemahaman dan kepemilikan adalah penting,</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">jika
tidak, setiap perubahan akan terfragmentasi; staf akan</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">merasa
itu adalah perubahan lain yang dilakukan pada mereka</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
dan justru</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> menghasilkan de-motivasi</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
(</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Adair, 2009; Gopee & Galloway, 2009;
Barr & </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Dowding, 2012</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">). P</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">emimpin
jelas memahami apa</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> yang </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">perlu dikomunikasikan
kepada tim. Perawat</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">harus mengerti</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">apa
artinya 6C secara pribadi, menerapkannya pada miliknya</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">atau
pekerjaannya dan menjadi panutan; tidak </span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">hanya
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">berbicara
tentang visi tetapi juga memperagakannya</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">(Olshansky
2007, Schantz 2007, Straughair 2012).</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> Adapun 6C dalam
kepemimpinan Transformasional yang harus dikuatkan adalah </span><i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">care, compassion,
communication, courage,</span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span></i><i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">commitment
dan competence</span></i><span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> (Francis, 2013).</span></div>
<div class="MsoNormal" style="background: white; line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 45.8pt 91.6pt 137.4pt 183.2pt 229.0pt 274.8pt 320.6pt 366.4pt 412.2pt 458.0pt 503.8pt 549.6pt 595.4pt 641.2pt 687.0pt 732.8pt; text-align: justify;">
<span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Pada akhirnya pentingnya gaya
kepemimpinan transformasional begitu penting dimengerti dalam Asuhan
Keperawatan Komunitas karena gaya ini lebih fleksibel untuk diterapkan dimana
gaya ini cenderung menguatkan kerjasama tim sehingga bukan hanya peningkatan
derajat kesehatan masyarakat yang dicapai tapi juga pada komitmen tim terhadap
visi yang telah dirancang sebelumnya. </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Satu yang penting dan
kadang-kadang diabaikan</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">bidang kepemimpinan
adalah merawat anggota staf.</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">Mereka perlu merasa
dihargai dan didukung, bahkan ketika ada yang salah. Dengan merawat staf selama</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
</span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">masa-masa
sulit, budaya yang terbuka dan jujur</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> terus </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">dipupuk
di mana pelajaran dapat dipelajari. Menerapkan</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"> </span><span style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">6C
untuk kepemimpinan akan meningkatkan ketercapaian kesehatan masyarakat</span><span lang="EN-ID" style="color: #212121; font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;">
(Layton, 2015).</span><span lang="EN-US" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 115%;"></span></div>
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<div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-ID" style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">DAFTAR PUSTAKA</span></b></div>
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-27893098625294990242019-02-26T05:54:00.001+07:002019-02-26T05:54:28.505+07:00KEPEMIMPINAN GLOBAL DAN KOMUNITAS DALAM KEPERAWATAN<!--[if gte mso 9]><xml>
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<br />
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l14 level1 lfo1; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Kepemimpinan
global</span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 2.0cm; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Globalisasi adalah terjadinya perubahan
tatanan dalam berbagai aspek kehidupan manusia, baik ekonomi, politik dan
pemerintahan, sosial dan budaya, hukum, dan lain-lain yang berdampak pada
keadilan dan kesejahteraan. Oleh karena itu, pemimpin dituntut dapat menjalan
peran dan fungsinya dengan perilaku kepemimpinannya yang mampu memengaruhi dan
menggerakkan bawahan dalam mengantisipasi dan menghadapi tantangan globalisasi </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-no-proof: yes;">(Jahidi, 2013)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">. Kepemimpinan
dapat didefenisikan sebagai proses yang memiliki pengaruh antara pemimpin
dengan individu, kelompok, organisasi, dan komunitas dengan cara memberikan
inspirasi, melibatkan, dan menarik orang lain untuk ikut berpartisipasi dalam
pencapaian suatu tujuan. (Kelly and Tazbir, 2013).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 2.0cm; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 2.0cm; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kepemimpinan memiliki banyak sekali
pengertian. Kepemimpinan merupakan kegiatan mempengaruhi orang lain.
Kepemimpinan merupakan proses untuk mempengaruhi aktivitas kelompok,
kepemimpinan merupakan kemampuan untuk memperoleh kesepakatan atau kepemimpinan
merupakan suatu usaha untuk mengerahkan oranglain mencapai tujuan tertentu.
Namun pada prinsipnya, kepemimpinan adalah berkenaan dengan seseorang
memengaruhi prilaku orang lain untuk suatu tujuan, tetapi bukan berarti setiap
orang yang memengaruhi orang lain disebut pemimpin </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-no-proof: yes;">(Yudiaatmaja, 2013)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">. Kepemimpinan
merupakan kemampuan untuk mempengaruhi dan memotivasi suatu kelompok ke arah
pencapaian tujuan bersama yang lebih baik </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-no-proof: yes;">(Igiriza, 2017)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 2.0cm; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kepemimpinan menurut Kadarusman, 2012,
terbagi 3, yaitu :</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 107%; margin-bottom: 8.0pt; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Self
Leadership</span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 78.0pt; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Memimpin diri sendiri agar jangan gagal
dalam menjalani hidup.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 107%; margin-bottom: 8.0pt; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Team
Leadership</span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 78.0pt; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Merupakan memimpin orang lain, dan
disini dikenal dengan yang namanya pemimpin kelompok yang memahami apa yang
menjadi tanggung jawab dalam kepemimpinannya, menyelami kondisi bawahannya,
memiliki kesediaan untuk meleburkan diri dengan tuntutan dan konsekuensi dari tanggung
jawab yang dipikulnya, serta memiliki komitmen untuk membawa setiap bawahannya
mengekspolrasi kapasitas dirinya sehingga menghasilkan prestasi tinggi.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 107%; margin-bottom: 8.0pt; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Organizational
Leadership</span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 78.0pt; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Memiliki pemimpin organisasi yang mampu
memahami bisnis perusahaan yang dipimpinnya, membangun visi misi
pengembangannya bisnisnya, kesediaan untuk melebur dengan tuntutan dan
konsekuensi tanggung jawab sosial, serta komitmen yang tinggi untuk menjadikan
perusahaan yang dipimpinnya sebagai pembawa keuntungan bagi komunitas baik
ditingkat lokal, nasional, maupun internasional.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 78.0pt; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Kepemimpinan dalam keperawatan ini
mengacu kepada pengaruh atau peranan perawat atau usaha perawat dalam
meningkatkan kesehatan klien, baik klien secara individu, keluarga, kelompok,
atau komunitas. Kepemimpinan dalam keperawatan berfungsi dalam menentukan arah
oleh karena itu seorang perawat untuk menjadi pemimpin harus memiliki
kepemimpinan klinis yang kuat dan kemampuan management yang efektif meskipun
tidak menempati posisi manajemen. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l14 level1 lfo1; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Karakteristik</span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 2.0cm; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Menrut
Levinson, 2006, karakteristik kepemimpinan;</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Kemampuan
berpikit (thinking)</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Kemampuan
berpikir abstrak, yaitu mampu membuat konsep, mengorganisasi dan menginterogasi
data yang berbeda ke dalam kerangka referensi yang sama.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Toleransi
terhadap ambiguitas, yaitu dapat mengatasi kekacauan sampai mencapai kejelasan</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Cerdas,
yaitu mempunyai kapasitas tidak hanya abstrak tapi juga kemampuan praktis</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">d)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Membuat
keputusan, yang berarti mengetahui apa yang harus dilakukan</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Feeling
and Interrelationship</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Memiliki
otoritas, yaitu mempunyai perasaan bahwa dia memiliki peran sebagai pemimpin</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Aktif,
yaitu memiliki semangat dalam mengatasi masalah dan kebutuhan organisasi</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Prestasi,
yaitu orientasi ke arah keberhasilan organisasi dari pada kekuasaan pribadi</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">d)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Kepekaan</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">e)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Keterlibatan,
yaitu melibatkan diri karena berpartisipasisebagai anggota organisasi</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">f)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Matang,
yang berarti mempunyai hubungan yang baik.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">g)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Kemampuan
berartikulasi dalam membuat impresi atau kesan yang bagus</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">h)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Menyesuaikan
diri dan mengelola stres dengan baik</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">i)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Memiliki rasa humor yang baik dan tidak
terlalu serius</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Outward
Behavior characteristic</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Visi,
yaitu menjelaskan tentang kemajuan dalam kehidupan dan karirnya, sebaik
organisasi dimana dia berada</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Tekun,
yaitu mampu mengatasi tugas dan melepas dari kesulitan yang dihadapi</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Integritas,
yaitu memiliki sistem nilai yang sudah terbentuk dengan baik, yang sudah diuji
dalam berbagai cara di masa lalu</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">d)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 107%;">Tanggung
jawab sosial, yaitu menghargai perlunya untuk mengasumsikan kepemimpinan yang
berkaitan dengan tanggung jawab itu</span></div>
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<br /></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Gaya
kepemimpinan global</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 2.0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Secara
terminologi </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">gaya setara dengan perilaku pemimpin. Gaya adalah cara di mana pemimpin
mempengaruhi bawahan (Luthans, 1977 dalam Saqib Khan et al., 2015). Chung-Hsiung
Fang dkk (2009) dalam Nanjudeswaras & Swamy (2014) mengidentifikasi gaya
kepemimpinan <span style="mso-spacerun: yes;"> </span>dapat mempengaruhi komitmen
organisasi dan kepuasan kerja <span style="mso-spacerun: yes;"> </span>secara
positif dan kepuasan kerja magang dapat mempengaruhi <span style="mso-spacerun: yes;"> </span>komitmen organisasi dan kinerja kerja. Ada
banyak cara untuk memimpin dan setiap pemimpin memiliki gaya tersendiri. Beberapa
gaya umum termasuk otokratis, laissez-faire, demokratis, transformasional dan
transaksional (Marquis & Huston, 2015 dalam Stanhope & Lancaster, 2016).
Gaya yang berbeda diperlukan untuk situasi yang berbeda dan setiap pemimpin perlu
tahu kapan harus memperlihatkan gaya pendekatan khusus. </span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya
Kepemimpinan Otokratis</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 70.9pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya kepemimpinan ini sering dianggap sebagai
pendekatan klasik, dimana manajer mempertahankan sebanyak mungkin kekuasaan dan
<span style="mso-spacerun: yes;"> </span>otoritas pengambilan keputusan </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">(Saqib Khan et al., 2015)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">. Manajer tidak berkonsultasi dengan
karyawan dan karyawan tidak diizinkan memberi <span style="mso-spacerun: yes;"> </span>masukan apa pun. Karyawan diharapkan mematuhi
perintah tanpa menerima penjelasan apa pun. Motivasi <span style="mso-spacerun: yes;"> </span>lingkungan dihasilkan dengan menciptakan
serangkaian penghargaan dan hukuman terstruktur. <span style="mso-spacerun: yes;"> </span>Gaya kepemimpinan ini telah banyak dikritik
selama 30 tahun terakhir. Beberapa penelitian menunjukkan organisasi dengan
banyak pemimpin otokratis memiliki perputaran dan absensi yang lebih tinggi
daripada organisasi lain</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">(Saqib Khan et al., 2015)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">. Studi-studi ini menunjukkan bahwa pemimpin
otokratis: </span></div>
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<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">
Mengandalkan ancaman dan hukuman untuk mempengaruhi karyawan </span></div>
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<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Tidak
mempercayai karyawan </span></div>
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<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Tidak izinkan
masukan karyawan </span></div>
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<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">
Kepemimpinan otokratis tidaklah buruk. Terkadang ini adalah gaya paling efektif
untuk digunakan. </span></div>
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<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan
baru yang tidak terlatih yang tidak tahu tugas yang harus dilakukan atau
prosedur mana yang harus diikuti. </span></div>
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<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Pengawasan
yang efektif hanya dapat diberikan melalui perintah dan instruksi terperinci. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 3.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Ada waktu
terbatas untuk membuat keputusan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya
kepemimpinan otokratis tidak boleh digunakan saat: </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 3.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan tegang,
takut, atau kesal </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 3.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan
berharap agar pendapat mereka didengar </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 3.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan
mulai bergantung pada manajer mereka untuk membuat semua keputusan mereka </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 3.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Terdapat
moral karyawan yang rendah, perputaran dan absensi yang tinggi </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Keuntungan Gaya Kepemimpinan Otokratis</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 70.9pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Kontrol
yang bagus </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 70.9pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Program
tidak terganggu </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 70.9pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Hukum:
Hukum perlindungan pemuda </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 70.9pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Tidak ada
diskusi panjang </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 70.9pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Anggota
kelompok tahu apa yang harus mereka lakukan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 70.9pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Aturan
memberi keamanan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 70.9pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Disiplin </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kekurangan Gaya Kepemimpinan Otokratis</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Tidak ada
pengembangan kebebasan memilih </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Kurang
inisiatif sendiri (ketakutan, kebencian terhadap anggota lain) </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Tidak ada
kepercayaan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Kurang atau
tidak percaya diri </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Minat grup
ditekan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Grup tidak
santai </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Persaingan
di antara anggota kelompok </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Kemampuan
mengkritik ditekan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">
Independensi kelompok dilemahkan oleh otoritas pemimpin </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 14.2pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Talenta
tidak diakui dan karenanya tidak dipromosikan </span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l7 level1 lfo10; tab-stops: 14.2pt 21.3pt; text-align: justify; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya
Kepemimpinan yang Otoriter</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemimpin
otoriter, juga dikenal sebagai pemimpin otokratis, memberikan harapan yang
jelas untuk apa yang perlu dilakukan, kapan harus dilakukan, dan bagaimana itu
harus dilakukan </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">(Saqib Khan et al., 2015)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">. Ada juga pembagian yang jelas
antara pemimpin dan pengikut. Pemimpin otoriter membuat keputusan secara mandiri
dengan sedikit atau tanpa masukan dari anggota kelompok lainnya. Para peneliti
menemukan bahwa pengambilan keputusan kurang kreatif di bawah kepemimpinan
otoriter. Penyalahgunaan gaya ini <span style="mso-spacerun: yes;"> </span>biasanya
dipandang sebagai pengendali, suka memerintah, dan diktator. Kepemimpinan
otoriter paling baik diterapkan pada situasi di mana ada sedikit waktu untuk
pengambilan keputusan kelompok. </span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l7 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya
Kepemimpinan Demokratis</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya
kepemimpinan demokratis juga disebut gaya partisipatif karena mendorong
karyawan untuk menjadi bagian dari pengambilan keputusan </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">(Saqib Khan et al., 2015)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">. Manajer demokratis membuat
karyawannya selalu mendapat informasi tentang semua hal yang memengaruhi pekerjaan
mereka dan berbagi pengambilan keputusan dan tanggung jawab pemecahan masalah. Gaya
ini menuntut pemimpin untuk menjadi seorang pelatih yang memiliki keputusan
terakhir, tetapi mengumpulkan informasi dari anggota staf sebelum membuat
keputusan. Kepemimpinan demokratis dapat menghasilkan karya berkualitas tinggi
dan kuantitas tinggi untuk jangka waktu yang lama. Banyak karyawan menyukai
kepercayaan yang mereka terima dan tanggapi dengan kerja sama, semangat tim,
dan semangat kerja yang tinggi. Ciri pemimpin demokratis: </span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Mengembangkan rencana untuk membantu karyawan
mengevaluasi kinerja mereka sendiri </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Memungkinkan karyawan untuk menetapkan tujuan </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Mendorong karyawan untuk tumbuh di pekerjaan dan
dipromosikan </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Mengakui dan mendorong pencapaian</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Seperti gaya lain, gaya demokrasi tidak selalu tepat.
Gaya ini paling berhasil bila digunakan dengan karyawan yang sangat terampil
atau berpengalaman atau ketika menerapkan perubahan operasional atau
menyelesaikan masalah individu atau kelompok. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kepemimpinan
demokratis tidak boleh digunakan ketika: </span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 3.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l16 level1 lfo17; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tidak ada cukup waktu untuk memasukkan pendapat banyak
orang</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 3.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l16 level1 lfo17; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Lebih mudah dan lebih hemat biaya bagi manajer untuk
membuat keputusan. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 3.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l16 level1 lfo17; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Manajer merasa terancam oleh jenis kepemimpinan ini. </span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 3.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l16 level1 lfo17; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Keselamatan karyawan merupakan masalah penting. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Keuntungan Gaya Kepemimpinan yang Demokratis</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Cukup swadaya </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Kompromi disepakati </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Memotivasi </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Berbagai gagasan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Memiliki kepercayaan diri dari anggota kelompok </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Memperkuat kepentingan publik </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Larangan dipahami </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Pemahaman tentang sebagian besar masalah </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Kemungkinan untuk tumbuh secara kreatif diberikan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Kebebasan beropini </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Hak yang sama </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Membuat integrasi orang luar mungkin </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kekurangan gaya kepemimpinan Demokrat</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">
Menghabiskan banyak waktu untuk pemimpin </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Sulit bagi
pemimpin </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Sangat
bergantung pada usia </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Tidak ada
solusi optimal </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Banyak
diskusi dapat menjadi membosankan </span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l7 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya Kepemimpinan Laissez-Faire</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya
kepemimpinan Laissez-Faire juga dikenal sebagai <i style="mso-bidi-font-style: normal;">hands-off¨style</i> di mana manajer menyediakan sedikit atau tidak ada
arahan dan memberi karyawan kebebasan sebanyak mungkin </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">(Saqib Khan et al., 2015)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">. Semua otoritas atau kekuasaan
diberikan kepada karyawan dan mereka harus menentukan tujuan, membuat
keputusan, dan menyelesaikan masalah sendiri. Gaya kepemimpinan ini efektif digunakan
saat: </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 28.4pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan
sangat terampil, berpengalaman, dan terdidik. </span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l13 level1 lfo11; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Karyawan
memiliki kebanggaan dalam pekerjaan mereka dan dorongan untuk melakukannya
dengan sukses sendiri. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l13 level1 lfo11; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ahli luar,
seperti staf spesialis atau konsultan digunakan </span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l13 level1 lfo11; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Karyawan
dapat dipercaya dan berpengalaman. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya ini tidak boleh digunakan saat: </span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo12; text-align: justify; text-indent: -14.7pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya ini
membuat karyawan merasa tidak aman karena tidak adanya manajer. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo12; text-align: justify; text-indent: -14.7pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Manajer
tidak dapat memberikan umpan balik secara teratur untuk memberi tahu karyawan
seberapa baik kinerja mereka. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo12; text-align: justify; text-indent: -14.7pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Manajer
tidak dapat berterima kasih kepada karyawan atas kerja bagus mereka. </span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo12; text-align: justify; text-indent: -14.7pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Manajer
tidak memahami tanggung jawabnya dan berharap karyawan dapat melindunginya </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Keuntungan Gaya
Kepemimpinan Laissez-faire</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Kebebasan
memilih </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Tidak ada
beban pada anggota tim </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Terkadang:
independen </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Pemimpin
grup sangat membutuhkan waktu persiapan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Ada banyak
kebebasan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Struktur
sosial sendiri </span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo13; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kurangnya
peluang pemimpin menjadi tidak populer </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kerugian Gaya Kepemimpinan
Laissez-faire</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Minoritas
yang tidak puas </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Toleransi
antara anggota grup dihancurkan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">
Penyalahgunaan aturan </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Anggota tim
tidak lagi dianggap serius </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Anggota
yang lemah menahan diri </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Pengunduran
diri </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 21.3pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Bahaya
cedera yang tinggi terhadap hukum pengawasan. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l7 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya Kepemimpinan Birokratis</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kepemimpinan
birokrasi adalah tempat manajer mengelola "dengan buku" segala
sesuatu harus dilakukan sesuai prosedur atau kebijakan </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">(Saqib Khan et al., 2015)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">. Jika tidak dicakup oleh buku,
manajer mengacu pada tingkat berikutnya di atas dia. Manajer benar-benar lebih
dari seorang perwira polisi daripada seorang pemimpin. Dia menegakkan aturan.
Gaya ini bisa efektif ketika: </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -7.05pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan
sedang melakukan tugas rutin berulang kali. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -7.05pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan
perlu memahami standar atau prosedur tertentu. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 63.8pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan
bekerja dengan peralatan yang berbahaya atau rumit yang membutuhkan serangkaian
prosedur tertentu mengoperasikan. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -7.05pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Pelatihan
keamanan atau keamanan sedang dilakukan. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -7.05pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan
sedang melakukan tugas yang membutuhkan penanganan uang tunai. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: 7.65pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya ini tidak efektif ketika: </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -7.05pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Bentuk
kebiasaan kerja yang sulit dihilangkan, terutama jika tidak berguna lagi. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -7.05pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan
kehilangan minat mereka dalam pekerjaan mereka dan rekan kerja mereka. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -7.05pt;">
<span style="font-family: "Segoe UI Symbol","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Segoe UI Symbol"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">➢</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> Karyawan
hanya melakukan apa yang diharapkan dari mereka dan tidak lebih. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.55pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 137.25pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span></span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l7 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya
Kepemimpinan Transformasional</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bass &
Avolio (1993) dalam <span style="mso-spacerun: yes;"> </span>Nanjudeswaras &
Swamy (2014) membagi gaya kepemimpinan menjadi kepemimpinan transformasional dan
kepemimpinan transaksional. Kepemimpinan transformasional dimaknai sebagai
kepemimpinan yang melibatkan perubahan organisasi (Bass, 1985 dalam Hasanati,
2012).</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">
Gaya kepemimpinan transformasional menghargai nilai dan ideal karyawan,<br />
memotivasi mereka untuk menempatkan kepentingan organisasi di tempat pertama,
dan<br />
mendorong mereka untuk mencapai keadaan diri terbaik (Burns, 1978 dalam </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">Xie et al., 2018)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">. Gaya kepemimpinan
transformasional membantu karyawan<br />
mencapai tingkat permintaan yang lebih tinggi dan membangun suasana kepercayaan<br />
antara pemimpin dan anggota tim.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></div>
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<br /></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kepemimpinan
transformasional terjadi ketika pemimpin menjadi lebih luas dan menjunjung
tinggi kepentingan karyawan, setelah mereka menghasilkan kesadaran dan
penerimaan untuk tujuan dan penugasan kelompok, jadi ketika mereka memadukan
karyawan untuk tampil bukan untuk kepentingan diri mereka sendiri tetapi untuk
kebaikan kelompok, pemimpin transformasional mendorong bawahan untuk melihat
masalah dari perspektif baru, memberikan dukungan dan dorongan mengkomunikasikan
suatu visi, menstimulasi emosi dan identifikasi </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">(Nanjundeswaras & Swamy, 2014)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">. Bruce dkk (1995) dalam
Nanjudeswaras & Swamy (2014) mengatakan kepemimpinan transformasional dapat
mendefinisikan dan mengartikulasikan visi untuk organisasi mereka dan gaya
kepemimpinan mereka dapat mempengaruhi atau<span style="mso-spacerun: yes;">
</span>"mengubah" variabel tingkat individu seperti meningkatkan motivasi
dan variabel tingkat organisasi, seperti<span style="mso-spacerun: yes;">
</span>menengahi konflik antar kelompok atau tim. Kepemimpinan transformasional
yang diungkapkan telah aktif mempengaruhi hasil individu dan organisasi seperti
itu sebagai kepuasan dan kinerja karyawan. Tingkat yang lebih tinggi kepemimpinan
transformasional dikaitkan dengan lebih tinggi<span style="mso-spacerun: yes;">
</span>tingkat potensi kelompok.</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Menurut Bass
dkk (1990) dalam </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">Gopal, Rima, & Chowdhury (2014)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> seorang pemimpin dapat
mentransformasikan bawahannya melalui empat cara:</span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l10 level1 lfo14; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Idealized</span></i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> <i style="mso-bidi-font-style: normal;">Influence</i> (kharisma): mempunyai
pengetahuan yang luas dibindangnya, membangkitkan kepercayaan dan memberi teladan
dalam hal sikap, perilaku, prestasi maupun komitme kepada bawahannya.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l10 level1 lfo14; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Inspirational Motivation</span></i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">:
menantang dan memberikan inspirasi pada bawahan dengan melatih kepekaan</span><span style="font-family: "TimesNewRomanPSMT","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: TimesNewRomanPSMT;"> dan menciptakan kegembiraan dalam
menyelesaikan pekerjaannya, membangkitkan semangat, optimisme</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l10 level1 lfo14; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Intellectual Stimulation</span></i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-style: italic;">: mendorong bahwan memunculkan ide-ide baru dan
inovatif atas masalah yang dihadapi</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l10 level1 lfo14; text-align: justify; text-indent: -14.15pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Individualized
Consideration</span></i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">: memberikan perhatian sesuai dengan kebutuhan
individu untuk berprestasi dan berkembang. </span></div>
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<br /></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 35.45pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemimpin yang menerpakan gaya transformasional akan
membawa dampak positif bak untuk organisasi maupun pengikutnya. Iklim dan
akibat yang diperoleh bawahanadalah meningkat motivasi kerja, antusiasme,
komitmen, kepuasan kerja, kesejahteraan, dan kesehatan. </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l7 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gaya
Kepemimpinan Transaksional </span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Berbeda
dengan kepemimpinan transformasional, kepemimpinan transaksional melibatkan
suatu proses pertukaran (<i style="mso-bidi-font-style: normal;">exchange
proccess</i>) antara di mana para bawahan mendapatkan imbalan yang segera dan
nyata untuk melakukan perintah-perintah pemimpin (Bass, 1985 dalam </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">Hasanati, 2012)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">. Burn (1978) menerangkan
keterkaitan antara konsep kepemimpinan transformasional-transaksional dengan
teori tingkat kebutuhan dari Maslow, dijelaskan bahwa kebutuhan karyawan level
rendah seperti kebutuhan fisik, kebutuhan rasa aman, dan diterima oleh orang
lain dipenuhi dengan kepemimpinan transaksional, sedang untuk memenuhi
kebutuhan karyawan dengan level lebih tinggi yaitu harga diri dan aktualisasi
diri hanya bisa dipengaruhi oleh gaya kepemimpinan transformasional (Hasanati,
2012). </span></div>
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<br /></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemimpin
transaksional pertama akan memvalidasi hubungan antara kinerja dan hadiah dan
kemudian menukarkannya dengan tanggapan yang tepat yang mendorong bawahan untuk
meningkatkan kinerja </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">(Nanjundeswaras & Swamy, 2014)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">. Pemimpin transaksional cenderung
fokus pada tugas penyelesaian dan kepatuhan karyawan dan para pemimpin ini sangat
bergantung pada penghargaan organisasi dan<span style="mso-spacerun: yes;">
</span>hukuman untuk mempengaruhi kinerja karyawan. Berbagai identifikasi jenis
perilaku yang melekat pada kepemimpinan transaksional </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-no-proof: yes;">(Gopal et al., 2014; Xie et al., 2018)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> : </span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 39.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l11 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Contingen
Reward </span></i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>: Bawahan menerima hadiah untuk
kinerja yang baik. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 39.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l11 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Management
by Exception (Active) </span></i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">: Bawahan dimonitor dan kemudian dikoreksi jika perlu
untuk mereka tampil efektif </span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 39.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l11 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Management
by Exception (Passive) </span></i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">: Bawahan menerima hukuman kontingen sebagai respons
jika standar kinerja tidak tercapai</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l12 level1 lfo2; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Apa
kepemimpinan komunitas</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Robbins
dan Coulter (2018) mendefinisikan kepemimpinan sebagai proses mempengaruhi
anggota kelompok untuk mencapai tujuan. Demikian pula, kepemimpinan merupakan
proses mempengaruhi antara pemimpin dan individu, kelompok, organisasi,
komunitas, atau masyarakat dengan menginspirasi, mencerahkan, dan melibatkan
orang lain untuk berpartisipasi dalam pencapaian tujuan (Stanhope &
Lancaster, 2016). Pemimpin dalam masyarakat merupakan agen perubahan yang dapat
menciptakan kohesi dan pengaruh positif terhadap budaya organisasi melalui
perilaku dan praktik kepemimpinan yang dilakukan </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">(Marcellino de Melo Lanzoni, Hörner Schlindwein
Meirelles, & Cummings, 2016)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">(The University of Cambridge Insitute for
Sustainability Leadership, 2017)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Sementara
kepemimpinan di semua domain berbagi beberapa kesamaan, kepemimpinan komunitas adalah
khas, karena kepemimpinan dalam domain komunitas beroperasi di bawah struktur
atau tujuan yang berbeda dari organisasi atau individu tertentu. Apa yang
membuat Kepemimpinan masyarakat yang khas adalah bahwa pemimpin komunitas tidak
dapat hanya mengandalkan kekuasaan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">dan
otoritas formal untuk menyelesaikan sesuatu. Sebaliknya, seperti Pigg (1999)
menyampaikan, komunitas pemimpin harus bergantung pada jaringan dan pengaruh,
dan khususnya hubungan yang dikembangkan melalui interaksi ekstensif dalam
komunitas. Ini diklasifikasikan oleh sosiolog sebagai pendekatan interaksional,
dan secara khusus berfokus pada hubungan individu atau kelompok-kelompok yang
terlibat dalam suatu urutan tindakan, seringkali dalam konteks tertentu
(Fanelli, 1956). <span style="mso-spacerun: yes;"> </span>Wilkinson (1986)
mendefinisikan kepemimpinan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">sebagai
tindakan yang dilakukan oleh individu yang membuat kontribusi khusus dan khusus
untuk aksi komunitas. Bonjean (1963) menyamakan reputasi dengan kepemimpinan
dan didefinisikan pemimpin sebagai anggota komunitas yang paling kuat dan
berpengaruh. Angell (1951) struktur kepemimpinan bergambar dengan
mengidentifikasi enam komponen yang berbeda dari interaksi dalam kepemimpinan
masyarakat: karakteristik pemimpin pada saat induksi ke kepemimpinan,
representasi kelompok dalam populasi, tingkat kepemimpinan kelompok di-tumbuh,
hubungan dengan populasi umum, hubungan di antara para pemimpin, dan teknik
kepemimpinan.</span></div>
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<br /></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Salah
satu definisi kepemimpinan komunitas saat ini berasal dari Goeppinger (2002)
yang memandangnya sebagai proses interaktif antara individu dalam lokasi umum. Menurut
Gibb (1948), tiga prinsip terpenting dalam mendefinisikan kepemimpinan</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">1.
Relativitas terhadap situasi - bahwa ada masalah umum dan tujuan kelompok;</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">2.
Termasuk bekerja menuju beberapa tujuan obyektif; dan</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">3.
Menjadi proses rangsangan bersama - fenomena interaktif di mana</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">sikap,
cita-cita, dan aspirasi para pengikut memainkan peran penting dalam</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">menentukan
pemimpin.</span></div>
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<span style="font-family: "Times New Roman","serif";">Kepemimpinan masyarakat adalah
strategi penting yang memungkinkan masyarakat untuk menanggapi proyek
pengembangan masyarakat melalui partisipasi aktif dan mengambil tanggung jawab </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">(Ricketts, 2005)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">.</span><span style="font-family: "Times New Roman","serif";"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Kepemimpinan
masyarakat berbeda dari gagasan klasik kepemimpinan adalah "tentang"
pemimpin "yang meminta, membujuk, dan mempengaruhi 'pengikut'.
Kepemimpinan masyarakat biasanya kurang hierarkis, pemimpin informal,
non-terpilih dan sering didasarkan pada tindakan sukarela (serta bertindak
sebagai simbol untuk perubahan. Kepemimpinan harus dilihat tidak hanya sebagai
posisi dan otoritas tetapi juga sebagai yang muncul, interaktif dinamis </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">(Martiskainen, 2017)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">. Pemimpin dalam
komunitas harus memiliki pemahaman yang jelas dalam menetapkan prioritas dan
menjalin kerjasama yang baik di dalam maupun dil luar organisasi yang
diinginkan dan memiliki dampak pada pra syarat untuk perawatan<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">(Bondas, 2006)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Kepemimpinan
keperawatan komunitas diperlukan untuk memastikan keseimbangan antara perawatan
akut jangka pendek di masyarakat dan penyediaan perawatan kesehatan primer yang
holistik sehingga tercipta keseimbangan antara kepedulian pasien, ramah
keluarga, dan ketertarikan masyarakat serta efektif secara ekonomis </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">(Bondas, 2006</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">; </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">Kemp, Harris, & Comino, 2005)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">. Kepemimpinan
dalam masyarakat harus mampu untuk menilai kebutuhan dan tren dengan cepat,
menggunakan semua data dan sumber informasi yang tersedia, kemudian
dikembangkan tindakan inovatif, merencanakan dan mengevaluasi hasil menggunakan
sistem pemantauan kualitas (Stanhope & Lancaster, 2016). </span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Apa
karakteristik dan alasan kepemimpinan di komunitas memerlukan karakteristik
perilaku kepemimpinan </span></b></div>
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</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Karakteristik perilaku kepemimpinan di
komunitas</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Kepemimpinan dilihat sebagai
kemampuan untuk memengaruhi, kualitas yang harus dimiliki oleh seorang pemimpin
dalam keperawatan komunitas adalah integritas, keberanian, inisiatif, energi,
optimisme, ketekunan, keseimbangan, kemampuan untuk menangani stres dan
kesadaran diri. Pencapaian kualitas kepemimpinan yang efektif dalam keperawatan
komunitas memerlukan perilaku kepemimpinan yang efektif. Berikut adalah
beberapa karakteristik perilaku kepemimpinan perawat di komunitas </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">(Whitebead, Weiss, & Tappen, 2010)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">:</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Menetapkan
prioritas. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Merencanakan perawatan untuk
kelompok klien atau pengaturan rencana strategis organisasi. Pemimpin Anda perlu
mengingat tiga hal dari prioritas yaitu mengevaluasi, mengeliminasi dan
mengestimasi. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Berpikir
kritis. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Berpikir kritis adalah berpikir hati-hati,
menganalisis segala sesuatu dalam mencapai keputusan tentang apa yang harus
dipercaya atau apa yang harus dilakukan. Inti dari pemikiran kritis adalah menumbuhkan
keinginan untuk bertanya dan menjadi terbuka terhadap ide-ide baru, serta cara-cara
baru untuk melakukan sesuatu. Untuk menghindari asumsi dan bias dari pemimpin dan
orang lain, tanyakan pada diri sendiri “Apakah saya memiliki informasi yang
saya butuhkan? Apakah ini akurat? Apakah saya memprediksikan situasi?”.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Menyelesaikan
masalah. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Kepemimpinan yang efektif terjadi
saat pemimpin membantu orang untuk mengidentifikasi masalah dan bekerja melalui
proses pemecahan masalah dengan menemukan solusi yang masuk akal.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Menghormati
individu. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Masing-masing individu memiliki
perbedaan keinginan dan kebutuhan. Misalnya, sebagian orang ingin nilai imbalan
psikologis yang lebih dominan; orang lain lebih senang mendapatkan gaji yang
layak. Tidak ada yang salah dengan salah satu dari sudut pandang ini. Pemimpin
yang efektif menerima perbedaan-perbedaan ini pada orang dan membantu mereka temukan
imbalan dalam pekerjaan mereka yang berarti untuk mereka.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Terampil
dalam komunikasi. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Terdiri dari mendengarkan orang
lain, mendorong pertukaran informasi dan memberikan umpan balik.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Mengomunikasikan
visi untuk masa depan. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Pemimpin yang efektif memiliki visi
untuk masa depan. Mengkomunikasikan visi ini kepada kelompok dan melibatkan
semua orang dalam bekerja menuju visi dapat menciptakan inspirasi yang membuat
orang terus melangkah maju ketika hal-hal menjadi sulit. Bahkan lebih baik,
visi yang dirumuskan tidak hanya memuaskan bagi karyawan tetapi juga memiliki
potensi yang kreatif dan inovatif. Visi ini adalah visi yang membantu membuat
pekerjaan menjadi berarti.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Mengembangkan
diri sendiri dan orang lain. </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Belajar tidak hanya berhenti di
sekolah. PaPerawat berpengalaman mengatakan bahwa sekolah hanyalah permulaan, sekolah
itu hanya mempersiapkan seseorang untuk terus belajar. Pemimpin yang efektif tidak
hanya terus belajar tetapi juga mendorong yang lain melakukan hal yang sama.
Terkadang, pemimpin berfungsi sebagai guru. Di sisi lain, peran mereka terutama
untuk mendorong dan membimbing orang lain untuk mencari lebih banyak
pengetahuan </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">(Whitebead et al., 2010)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">. </span></div>
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<span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Alasan mengapa keperawatan komunitas
memerlukan karakteristik perilaku kepemimpinan</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Pemimpin keperawatan komunitas
bekerja sama dengan sejawat ataupun tenaga kesehatan lain serta masyarakat
untuk meningkatkan derajat kesehatan masyarakat. Perawat komunitas juga bertanggung
jawab pada populasi rentan dan risiko tinggi yang memerlukan perhatian lebih
banyak dalam hal pemeliharaan status kesehatan. Maka dari itu, pemimpin dalam
keperawatan komunitas harus dapat berpartisipasi dalam menyusun peraturan
publik dan organisasi, menyusun program promosi kesehatan serta lingkungan
hidup dan mampu bekerja sama secara interprofesional <span style="mso-spacerun: yes;"> </span>(Stanhope & Lancaster, 2016). Perilaku
kepemimpinan yang efektif seperti yang telah dijelaskan di atas sangat
diperlukan karena perawat yang memimpin di komunitas tidak hanya bekerja dengan
tim perawat saja, tetapi juga dengan tenaga kesehatan lain, masyarakat serta
pemangku kebijakan. Hal ini juga disebutkan oleh </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">Cameron, Harbison, Lambert, & Dickson<span style="mso-spacerun: yes;"> </span>(2012)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"> bahwa keperawatan
komunitas di Britania Raya (Inggris) telah pindah dari struktur datar praktisi
spesialis ke multidisiplin yang lebih bervariasi berbagai tingkatan, baik yang
terdaftar maupun tidak terdaftar. Meningkatnya kompleksitas tim, struktur
organisasi dan laju perubahan menimbulkan tantangan dalam membangun kepemimpinan
perawatan yang efektif, dan kepemimpinan klinis dalam keperawatan komunitas.
Selain itu, karakteristik kepemimpinan yang efektif juga berpengaruh pada
kesehatan klien. Hal ini dijelaskan oleh </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"><span style="mso-no-proof: yes;">Holm & Severinsson (2014)</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"> bahwa salah
satu keunggulan dari perawatan berbasis komunitas untuk lansia adalah
memungkinkan lansia untuk mendapatkan kembali atau mempertahankan tingkat
kemandirian dan kesejahteraannya. Kepemimpinan dan manajemen keperawatan yang
efektif dapat meningkatkan hasil perawatan lansia yang lebih baik di komunitas.</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Karakteristik kepemimpinan yang
baik sangat diperlukan oleh pemimpin keperawatan komunitas yang sesuai dengan
definisi kepemimpinan keperawatan dengan tujuan untuk memengaruhi perawat dalam
melaksanakan perannya dalam meningkatkan derajat kesehatan individu, keluarga,
kelompok dan komunitas sehingga derajat kesehatan masyarakat optimal.</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l12 level1 lfo2; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Gaya
kepemimpinan apa yang tepat dipilih di komunitas, jelaskan alasannya.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 2.0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Setiap
pemimpin di dalam keperawatan komunitas mengembangkan gaya kepemimpinan mereka
sendiri. Gaya kepemimpinan yang diterapkan di keperawatan komunitas harus dapat
diadaptasikan dan dapat digunakan dalam berbagai situasi untuk mencapai hasil
yang maksimal. Gaya Kepemimpinan di dalam keperawatan cukup bervariasi,
diantaranya yaitu otoriter, lasissez-faire, demokrasi, transformasi, dan
transaksional (Marquis & Huston, 2015). Adams (2010) menyebutkan bahwa gaya
kepemimpinan dibagi berdasarkan tingkat yang berbeda sesuai dengan tanggung
jawab perawat komunitas sebagai tenaga professional. Terdapat 3 struktur
tanggung jawab perawat dalam kepemimpinan di komunitas, yaitu tanggung jawab
kepada klien (sebagai klien yang bertemu dengan klinisian), tanggung jawab
kepada klinisian spesialis, dan tanggung jawab kepada perawat komunitas
spesialis (sebagai direktur kunjungan kesehatan).</span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: 8.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo18; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Perawat
Bertanggung Jawab kepada Klien</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21.3pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Dalam
peran ini, perawat menggunakan gaya kepemimpinan otoriter, demokrasi, dan
transformasional. Melalui gaya kepemimpinan otoriter, perawat yang turun
langsung ke klien memiliki otoritas dan otonomi untuk memimpin dan memberikan
layanan atas nama klien dengan tetap memperhatikan kebutuhan masing-masing
individu. Selain itu, perawat pada peran ini juga dapat menerapkan gaya
kepemimpinan demokratis, seperti bekerja sama dengan spesialis klinis atau
bidang keilmuan lain untuk membangun layanan inovatif baru, mengumpulkan data,
dan menunjukkan hasil dari kegiatan yang telah dilakukan. Sedangkan gaya
transformasional dilakukan jika perawat tersebut juga berperan sebagai pemimpin
tim, perawat harus mampu memimpin tim secara bercampur, memastikan efektivitas,
dan memberikan hasil sesuai dengan standar pelaporan yang ada (Adams, 2010; </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-no-proof: yes;">Saqib Khan et al., 2015)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">.</span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: 8.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo18; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Perawat
Bertanggung Jawab kepada Klinisian Spesialis </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 21.3pt; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 21.3pt; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Dalam peran perawat
bertanggung jawab kepada klinisian, perawat menggunakan gaya kepemimpinan
otoriter, demokratis, dan transformasional. Masing-masing gaya kepemimpinan
digunakan dalam tugas yang berbeda. Gaya kepemimpinan otoriter pada peran
penanggung jawab kepada klinisian digambarkan bahwa perawat komunitas memiliki
otoritas dan otonomi untuk memberikan dukungan profesional, pengawasan klinis,
dan bimbingan kepada rekan-rekan perawat komunitas lain yang terjun langsung
kepada masyarakat (Masterson & Gough, 2010; Adams, 2010; </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN; mso-no-proof: yes;">Saqib Khan et al., 2015)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">. </span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 21.3pt; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 21.3pt; mso-add-space: auto; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Pada gaya kepemimpinan
demokrratis, hal yang dilakukan oleh perawat komunitas berkaitan dengan peran
penanggung jawab kepada klinisian spesialis diantaranya yaitu menentukan
pendidikan dan pelatihan perawat komunitas yang turun ke masyarakat, mendukung
pengembangan dan evaluasi layanan perawat komunitas, dan memastikan bahwa
seluruh praktik yang dilakukan adalah berdasarkan pada <i style="mso-bidi-font-style: normal;">evidence based practice</i> (Adams, 2010). Selian itu, dengan gaya
transformasional, perawat komunitas dapat terus mengupayakan layanan kesehatan
terbaik, mengembangkan mekanisme untuk mensosialisasikan keberhasilan melalui
publikasi maupun konferensi dengan dukungan penggunaan teknologi informasi.
Gaya trasformasi juga memungkinkan perawat komunitas untuk merangkul
kepemimpinan tim, baik di kementerian kesehatan atau organisasi-organisasi non
pemerintah, misalnya dalam kasus perawat komunitas yang bekerja dengan staf NGO
TB Care (Masterson & Gough, 2010; Adams, 2010).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 21.3pt; mso-add-space: auto; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: 8.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo18; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Perawat
Bertanggung Jawab kepada Perawat Komunitas di Jenjang Direktur</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21.3pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Dalam
peran penanggung jawab di jajaran direksi, perawat komunitas berperan sebagai
pemimpin paling senior dari layanan keperawatan dan kunjungan kesehatan, posisi
ini setara dengan direktur yang berada di dewan komisi konsorsium (The Prime
Minister’s Commission on the Future Nursing and Midwifery, 2010). Sebagai
bagian dari direksi, perawat komunitas memastikan bahwa layanan mencerminkan
kebutuhan holistik, tidak hanya berfokus pada kondisi medis dan perawatan medis
yang diberikan perawat. Gaya kepemimpinan yang digunakan dalam peran ini adalah
demokrasi, transformasional, dan </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">laissez-faire.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21.3pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Gaya
kepemimpinan demokrasi di dalam peran ini ditunjukkan perawat komunitas dengan
cara menjadi pemimpin yang inspiratif serta mendukung pengembangan keterampilan
kepemimpinan untuk jajaran di bawahnya. Pada saat yang sama, perawat komunitas
harus bertindak sebagai advokat di tingkat anggota dewan dengan membawa
aspirasi dari para professional kesehatan dan klien di masyarakat serta bekerja
bersama komisaris layanan dan prospek klinis (The Prime Minister’s Commission
on the Future Nursing and Midwifery, 2010; Adams, 2010).</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21.3pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Gaya
kepemimpinan transformasional di dalam peran penanggug jawab di jenjang direksi
dilakukan dengan cara memastikan bahwa risiko masalah kesehatan telah dikelola
dengan tepat, kualitas layanan kesehatan terjamin, dan hasil yang telah dicapai
disampaikan dengan baik. Tujuan keseluruhan perawat komunitas pada bagian ini adalah
membangun kapasitas kepemimpinan dan kemampuan tenaga kerja seluruh perawat di
dalamnya.( The Prime Minister’s Commission on the Future Nursing and Midwifery,
2010) Kesuksesan dalam peran ini dapat terlihat pada perawat yang memiliki visi
yang jelas, mampu mengelola kompleksitas, mengambil pendekatan dari bawah ke
atas, mampu berkomunikasi, serta mampu mendengarkan perawat lain yang berada di
garis depan (Adams, 2010). Setelah program pengembangan pelayanan tercapai,
para direktur keperawatan harus memastikan mekanisme komunikasi
diimplementasikan untuk dialog reguler dengan perawat yang memberikan layanan,
serta memfasilitasi dan memotivasi perawat klinis spesialis untuk merangkul
tanggung jawab kepemimpinan mereka sendiri (Masterson dan Gough, 2010).</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21.3pt; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Keberhasilan
kepemimpinan pada tingkat ini terlihat pada kemampuan perawat yang berada di
bawah kepemimpinannya untuk menerapkan gaya kepemimpinan l</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">aissez-faire.</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">
Pada tingkat apapun di masyarakat, perawat komunitas diharapkan mampu menggunakan
kapasitas dan kemampuan profesional mereka untuk memberikan hasil yang efiesien
biaya dan secara mandiri menentukan kegiatan mereka (Adams, 2010; Masterson dan
Gough, 2010). </span></div>
<div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Daftar Pustaka</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Adams,
C (2010). What Leadership Skills Will Community Nurses Need to Improve Outcomes
in the New NHS. <i style="mso-bidi-font-style: normal;">Nursing Times</i>, Vol
106 No. 48 </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Masterson,
A. & Gough, P. (2010). Adaptable leaders are crucial to the new NHS. <i style="mso-bidi-font-style: normal;">Nursing Times</i>; 106: 34, 23</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">Saqib
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">The Prime
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Midwifery in England 2010. </i>London: DH. </span><a href="http://tryurl.com/PM-commision"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">http://tryurl.com/PM-commision</span></a><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;"></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-no-proof: yes;">Bondas, T. (2006). Paths to nursing leadership. <i>Journal
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">Cameron, S., Harbison, J., Lambert, V., & Dickson, C. (2012).
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">Holm, A. L., & Severinsson, E. (2014). Effective nursing leadership of
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">Marcellino de Melo Lanzoni, G., Hörner Schlindwein Meirelles, B., &
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">Martiskainen, M. (2017). The role of community leadership in the
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">Ricketts, K. G. (2005). The importance of community leadership to
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">The University of Cambridge Insitute for Sustainability Leadership.
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">Whitebead, D. K., Weiss, S. A., & Tappen, R. M. (2010). <i>Essentials
of nursing leadership and management</i> (5th ed.). Philadelphia: F.A Davis
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">Stanhope, M.
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;"><span style="mso-no-proof: yes;">Bondas, T. (2006). Paths to nursing leadership. <i>Journal
of Nursing Management</i>, <i>14</i>(5), 332–339.
https://doi.org/10.1111/j.1365-2934.2006.00620.x</span></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 24.0pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: -24.0pt;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">Cameron, S., Harbison, J., Lambert, V., & Dickson, C. (2012).
Exploring leadership in community nursing teams. <i>Journal of Advanced Nursing</i>,
<i>68</i>(7), 1469–1481. https://doi.org/10.1111/j.1365-2648.2011.05869.x</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 24.0pt; margin-right: 0cm; margin-top: 0cm; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: -24.0pt;">
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-37485703510324735552018-04-08T05:45:00.000+07:002018-04-08T05:45:02.102+07:00ASUHAN KEPERAWATAN PASIEN DENGAN KERACUNAN <!--[if !mso]>
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<h2 style="line-height: 150%;">
<span style="font-size: small;"><span lang="EN-US">PENGERTIAN</span></span></h2>
<h3 style="line-height: 150%;">
<span style="font-size: small;"><span lang="EN-US">INTOKSIKASI<span> </span>=<span>
</span>KERACUNAN</span></span></h3>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US" style="line-height: 150%;">Masuknya zat/senyawa kimia
dalam tubuh manusia yang menimbulkan efek merugikan pada yang menggunakannya.</span></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="font-size: small;"><span style="height: 2px; left: 0px; margin-left: 249px; margin-top: 19px; position: absolute; width: 50px; z-index: 251625472;"><img height="2" src="file:///C:\Users\User\AppData\Local\Temp\msohtmlclip1\01\clip_image001.png" width="50" /></span><span style="height: 12px; left: 0px; margin-left: 249px; margin-top: 14px; position: absolute; width: 70px; z-index: 251624448;"><img height="12" src="file:///C:\Users\User\AppData\Local\Temp\msohtmlclip1\01\clip_image002.png" width="70" /></span><span lang="EN-US" style="line-height: 150%;">PERAWATAN PASIEN<span>
</span>DENGAN<span> </span>INTOKSIKASI</span></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="font-size: small;"><span lang="EN-US" style="line-height: 150%;">Perawatan pasien
intoksikasi adalah suatu bentuk pelayanan perawatan yang komprehensif pada
pasien yang intoksikasi dengan menggunakan proses perawatan yang bertujuan<span> </span>mempertahankan vitalitas kehidupan pasien
serta mencegah penyerapan<span> </span>racun dengan
cara menghambat absorbsi dan menghilangkan racun dalam tubuh.</span></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="font-size: small;"><span lang="EN-US" style="line-height: 150%;">PENYEBAB<span> </span>KERACUNAN</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="line-height: 150%;"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Usaha bunuh diri </span><span lang="EN-US" style="font-family: Wingdings; line-height: 150%;"><span>à</span></span><span lang="EN-US" style="line-height: 150%;"> umur 10 – 30 tahun.</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="line-height: 150%;"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Pembunuhan (Humiside)</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="line-height: 150%;"><span>3.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Tidak sengaja</span></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="font-size: small;"><span lang="EN-US" style="line-height: 150%;">ASUHAN<span> </span>KEPERAWATAN KERACUNAN DI FOKUSKAN PADA:</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="line-height: 150%;"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">PENGKAJIAN</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Diarahkan pada masalah yang mendesak</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Wingdings; line-height: 150%;"><span>F<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="EN-US" style="line-height: 150%;">Jalan nafas</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Wingdings; line-height: 150%;"><span>F<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="EN-US" style="line-height: 150%;">Sirkulasi yang mengancam
jiwa</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Adanya perdarahan</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Adanya cidera yang berkaitan dengan penyakit lain</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Adanya gangguan asam basa</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Keadaan status jantung</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Status kesadaran</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="line-height: 150%;"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">RIWAYAT KESEHATAN</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Riwayat keracunan</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Bahan racun yang digunakan</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Berapa lama diketahui setelah keracunan</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Ada masalah lain sebagai pencetus keracunan</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol; line-height: 150%;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Syndroma toksik yang ditimbulkan</span></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="font-size: small;"><span lang="EN-US" style="line-height: 150%;">TATA<span> </span>LAKSANA<span>
</span>SECARA<span> </span>UMUM</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="line-height: 150%;"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Pertolongan pertama</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="line-height: 150%;"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Tata laksana darurat</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="line-height: 150%;"><span>3.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="line-height: 150%;">Perawatan jiwa</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21pt; text-align: justify; text-indent: -18pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="line-height: 150%;"><b>DOWNLOAD FILE WORD LENGKAP <a href="http://sprysphere.com/GbCT" target="_blank">KLIK DISINI !</a></b> </span></span></div>
Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-66640552317721411182018-04-08T05:39:00.001+07:002018-04-08T05:39:10.786+07:00ASUHAN KEPERAWATAN PASIEN DENGAN KEGAGALAN PERNAPASAN PADA TORAKOTOMI AKIBAT HEMATOTORAK YANG DIPASANG VENTILATOR MEKANIK <div style="text-align: justify;">
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<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pengertian</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Hematotorak
adalah adanya darah pada rongga pleura (Reksoprodjo S, 1995).</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Torakotomi
adalah tindakan life saving untuk menhentikan kelainan yang terjadi karena
pendarahan (Reksoprodjo, S, 1995).</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Gagal
pernapasan<span style="mso-spacerun: yes;"> </span>akut (GPA) adalah tidak
berfungsinay pernapsan pada derajad dimana pertukaran gas tidak adekuat untuk
mempertahankan gas darah secar adekuat ( Hudak and Gallo, 1994).</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Patofisiologi dikaitkan dengan
perubahan kebutuhan dasar manusia.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoTitle" style="text-align: justify;">
<span lang="EN-US">Kecelakaan Lalulintas</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menyebabkan
ruda paksa tumpul pada toraks dan abdoment. </span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Diikuti
dengan patah tulang tertutup.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 134.65pt;" valign="top" width="180"><div align="center" class="MsoNormal" style="text-align: center;">
<span style="height: 32px; left: 0px; margin-left: 114px; margin-top: 51px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251658240;"><img height="32" src="file:///C:\Users\User\AppData\Local\Temp\msohtmlclip1\01\clip_image001.png" width="12" /></span><span lang="EN-US">Trauma torak
(Hematotorak)</span></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Trauma
abdoment</span></div>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 134.65pt;" valign="top" width="180"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Patah
tulang</span></div>
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</tr>
<tr style="mso-yfti-irow: 1;">
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 134.65pt;" valign="top" width="180"><div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189"><div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 134.65pt;" valign="top" width="180"><div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2; mso-yfti-lastrow: yes;">
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 134.65pt;" valign="top" width="180"><div class="MsoNormal">
<span lang="EN-US">Pendarahan jaringan interstitium,
Pendarahan Intra alviolar, kolaps arteri dan kapiler, kapiler kecil, hingga
tahanan periver pembuluh darah paru naik , aliran darah menurun.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">HB turun, sesak napas nyeri dada,
pergerakan napas pendek</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.75pt; mso-list: l2 level1 lfo4; tab-stops: list 18.75pt; text-indent: -18.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Gangguan pertukaran gas.</span></div>
<div class="MsoNormal" style="margin-left: 18.75pt; mso-list: l2 level1 lfo4; tab-stops: list 18.75pt; text-indent: -18.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pola pernapasan tidak efektif</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Kompensasi untuk mengurangi nyeri pasien
berbaring dan takut bergerak, takut ngantuk.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Reflek batuk menurun.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.75pt; mso-list: l2 level1 lfo4; tab-stops: list 18.75pt; text-indent: -18.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pembersihan jalan nafas tidak
efektif.</span></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 5.0cm;" valign="top" width="189"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Pecahnya
usus sehingga terjadi pendarahan</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Vs
: T </span><span lang="EN-US" style="font-family: "symbol"; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span><span lang="EN-US"> , t </span><span lang="EN-US" style="font-family: "symbol"; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">¯</span></span><span lang="EN-US">, DN </span><span lang="EN-US" style="font-family: "symbol"; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;"></span></span><span lang="EN-US"> </span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.75pt; mso-list: l2 level1 lfo4; tab-stops: list 18.75pt; text-indent: -18.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Hipertermi</span></div>
<div class="MsoNormal" style="margin-left: 18.75pt; mso-list: l2 level1 lfo4; tab-stops: list 18.75pt; text-indent: -18.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resiko defisit volume cairan </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Nyeri tekanan +, defance muskular +,
suara bising usus -, kembung.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.75pt; mso-list: l2 level1 lfo4; tab-stops: list 18.75pt; text-indent: -18.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Gangguan rasa nyaman (nyeri).</span></div>
<div class="MsoNormal" style="margin-left: 18.75pt; mso-list: l2 level1 lfo4; tab-stops: list 18.75pt; text-indent: -18.75pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Gangguan pola pernapasan.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 134.65pt;" valign="top" width="180"><div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Terputusnya
/ hilangnya kontinuitas dari struktur tulang.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Nyeri
gerak, deformitas, krepitase.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Gerakan
abnormal di lokasi patah tulang</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">8.<span style="mso-spacerun: yes;">
</span>Gangguan mobilitas</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Data fokus</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.1<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Aktifitas/istirahat : adanya sesak nafas</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.2<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Sirkulasi : adanya takhikardia, frekuensi denyut nadi tidak teratur,
tekanan darah menurun, didapatkan adanya S3 atau S4 /irama gallop</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.3<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Integritas : ketakutan dan gelisah</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.4<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Makanan/cairan : adanya pemasangan infus IV line</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.5<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Nyeri/kenyamanan : Nyeri dada unilateral, meningkat bila bernapas
dan batuk, wajah berkerut karena menahan nyeri</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.6<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Pernapasan : takipnea, peningkatan kerja napas, retraksi
interkostal, perkusi pekak, palpasi gerakan dada tidak simetri (paradoksal).</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Kulit pucat,
sianosis, berkeringat</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Penggunaan
ventilator mekanik</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.7<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Keamanan : riwayat trauma</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">3. Pemeriksaan diagnostik :</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.1<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Sinar x dada menyatakan adanya akumulasi cairan</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.2<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Analisa gas darah : PaCO2 meningkat > 45, PaO2 menurun< 80,
saturasi oksigen menurun</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.3<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Kadar Hb menurun < 10 gr %</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.4<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Volume tidak menurun < 500 ml</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.5<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Kapasital vital paru menurun</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">4. Prioritas keperawatan :</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Meningkatkan ventilasi dan
oksigenisasi secara adekuat</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Mencegah komplikasi</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Memberikan dukungan emosional
kepada pasien dan keluarga</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Memberikan informasi tentang
proses penyakit dan kebutuhan pengobatan</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Rencana keperawatan</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">5.1<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Diagnosa keperawatan : pola pernapasan tidak efektif berhubungan
dengan gangguan rasio O2 dan CO2.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-24482861637127250052018-04-07T20:12:00.001+07:002018-04-07T20:12:20.147+07:00Asuhan Keperawatan Katarak Aplikasi NANDA, NOC, NIC <div style="text-align: justify;">
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 5"/>
<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Closing"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Default Paragraph Font"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
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<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><b><span lang="EN-US" style="font-family: "Arial", "sans-serif";"><span>I.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial", "sans-serif";">Konsep
dasar</span></b></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>A.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Pengertian</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Katarak merupakan keadaan di
mana terjadi kekeruhan pada serabut atau bahan lensa di dalam kapsul lensa
(Sidarta Ilyas, 1998). Katarak adalah proses terjadinya opasitas secara
progresif pada lensa atau kapsul lensa, umumnya akibat dari proses penuaan yang
terjadi pada semua orang lebih dari 65 tahun (Marilynn Doengoes, dkk. 2000).</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Katarak adalah suatu keadaan
patologik lensa di mana lensa rnenjadi keruh akibat hidrasi cairan lensa, atau
denaturasi protein lensa. Kekeruhan ini terjadi akibat gangguan metabolisme
normal lensa yang dapat timbul pada berbagai usia tertentu. Katarak dapat
terjadi pada saat perkembangan serat lensa masih berlangsung atau sesudah serat
lensa berhenti dalam perkembangannya dan telah memulai proses degenerasl.</span></span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 18pt;">
<span style="font-size: small;"><span lang="EN-US">Katarak dapat
diklasifikasikan dalam golongan berikut :</span></span></div>
<ol start="1" style="margin-top: 0cm; text-align: justify;" type="1">
<li class="MsoNormal"><span style="font-size: small;"><span lang="EN-US">Katarak
perkembangan (developmenta!) dan degeneratif.</span></span></li>
<li class="MsoNormal"><span style="font-size: small;"><span lang="EN-US">Katarak
kongenital, juvenil, dan senil.</span></span></li>
<li class="MsoNormal"><span style="font-size: small;"><span lang="EN-US">Katarak
komplikata.</span></span></li>
<li class="MsoNormal"><span style="font-size: small;"><span lang="EN-US">Katarak
traumatik.</span></span></li>
</ol>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US">Berdasarkan usia
pasien, katarak dapat di bagi dalam :</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">katarak kongenital, katarak
yang terlihat pada usia di bawah 1 tahun</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">katarak juvenil, katarak yang
terlihat pada usia di atas 1 tahun dan di bawah 40 tahun</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">katarak presenil, yaltu katarak
sesudah usia 30 - 40<span> </span>tahun</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: Symbol;"><span>·<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">katarak senil, yaitu katarak
yang mulai terjadi pada usia lebih dari 40 tahun</span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>B.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Penyebab</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US">Penyebab
terjadinya kekeruhan lensa ini dapat :</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: 0cm;">
<span style="font-size: small;"><span lang="EN-US"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Primer, berdasarkan gangguan
perkernbangan dan metabalisme dasar lensa</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: 0cm;">
<span style="font-size: small;"><span lang="EN-US"><span>3.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Sekunder, akibat tindakan
pembedahan lensa, </span></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: 0cm;">
<span style="font-size: small;"><span lang="EN-US"><span>4.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Komplikasi penyakit lokal ataupun
umum.</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>C.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Patogenesa</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Pasien
dengan katarak dini akan menimbulkan keluhan penglihatan seperti meiihat di
belakang tabir kabut atau asap, akibat terganggu oleh lensa yang keruh. Keluhan
penderita akan bertambah bila pasien melihat benda dengan<span> </span>melawan arah sumber cahaya atau menghadap ke
arah pintu yang terang. Hal ini diakibatkan pupil menjadi kecil yang akan
menambah gangguan penglihatan. Kadang-kadang pasien mengeluh rasa silau, hal
ini diakibatkan karena terjadinya pembiasan tidak teratur oleh lensa yang
keruh. Pasien katarak akan merasa kurang silau bila memakai kacamata berwarna
sedikit gelap. </span></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Penglihatan
penderita akan berkurang perlahan-lahan. Mata tidak merah atau tenang tanpa
tanda-tanda radang. Reaksi pupil normal karena fungsi retina masih baik. Pada
pupil terdapat bercak putih atau apa yang disebut sebagai leukokoria. Bila
proses berjalan progresif, maka makin nyata terlihat kekeruhan pupil ini. Untuk
melihat kelainan lensa yang keruh sebaiknya pupill dilebarkan sehingga dapat didiferensiasi
lokalisasi lensa yang terkena karena bentuknya dapat berupa : katarak kortikal
anterior, katarak kortikal posterior, katarak nuklear, katarak subkapsular, dan
katarak total. </span></span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Akibat
kekeruhan lensa ini, maka fundus sukar terlihat. Bila pada katarak kongenital
fundus sukar dilihat, maka perkembangan penglihatan akan terganggu atau akan
terjadi ambliopia.</span></span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 36pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><i><span lang="EN-US"><span>a.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></i><i><span lang="EN-US">Katarak kongenital</span></i></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><i><span lang="EN-US"><span> </span></span></i><span lang="EN-US">Katarak kongenital merupakan kekeruhan lensa yang didapatkan sejak
lahir, dan terjadi akibat gangguan perkembangan embrio intrauterin. Biasanya
kelainan ini tidak meluas mengenai seluruh lensa. Letak kekeruhan sangat
tergantung pada saat terjadinya gangguan metabolisme serat lensa: Katarak
kongenital yang terjadi sejak perkembangan serat lensa terlihat segera setelah
bayi IahIr sampai berusia 1 tahun. Katarak ini terjadi karena gangguan
metabolisme serat-serat lensa pada saat pembentukan serat lensa akibat infeksi
virus atau gangguan metabolisme jaringan lensa pada saat bayi masih di dalam
kandungan, dan gangguan metabolisme oksigen. </span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Pada bayi
dengan katarak kongenital akan terlihat bercak putih di depan pupil yang
disebut sebagai leukokoria (pupil berwarna putih). Setiap bayi dengan
leukokoria sebaiknya dipikirkan diagnosis bandingnya seperti retinoblastorrma,
endoftalmitis, fibroplasi retrolental, hiperplastik vitreus primer, dan miopia
tinggi di samping katarak sendiri. </span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Katarak
kongenital merupakan katarak perkembangan sehingga sel-sel atau serat lensa
masih muda dah berkonsistensi cair. Umumnya tindakan bedah dilakukan dengan
disisio lentis atau ekstraksi linear. Tindakan bedah biasanya dilakukan pada
usia 2 bulah untuk mencegah ambliopia eks-anopsia. Pasca bedah pasien
memerlukan koreksi untuk kelainan refraksi matanya yang telah menjadi afakia.</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><i><span lang="EN-US"><span>b.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></i><i><span lang="EN-US">Katarak juvenil</span></i></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Katarak
juvenil yang terlihat setelah usia 1 tahun dapat terjadi karena lanjutan
katarak kongenital yang makin nyata, penyulit penyakit lain, katarak
komplikata, yang dapat terjadi akibat penyakit lokal pada satu mata, seperti
akibat uveitis anterior. glaukoma, ablasi retina, miopia tinggi, ftisis bulbi,
yang mengenai satu mata, penyakit sistemik, seperti diabetes, hipoparatiroid,
dan miotowa distrofi,'yang mengenai kedua mata dan akibat trauma tumpul.</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Biasanya
katarak juvenil ini merupakan katarak yang didapat dan banyak dipengaruhi oleh
beberapa faktor.</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><i><span lang="EN-US"><span>c.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></i><i><span lang="EN-US">Katarak senil</span></i></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<span style="font-size: small;"><i><span lang="EN-US"><span> </span></span></i><span lang="EN-US">Katarak senil biasanya mulai pada usia 50 tahun, kecuali bila
disertai dengan penyakit lainnya seperti diabetes melitus yang akan terjadi
lebih cepat. Kedua mata dapat terlihat dengan derajat kekeruhan yang sama
ataupun berbeda. Proses degenerasi pada lensa dapat terlihat pada beberapa
stadium katarak senil.</span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Tabel
Perbedaan stadium katarak senil</span></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 0px; margin-right: 0px; text-align: left; width: 528px;">
<tbody>
<tr style="height: 18.75pt;">
<td style="height: 18.75pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 18.75pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Insipien</span></span></div>
</td>
<td style="height: 18.75pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Imatur</span></span></div>
</td>
<td style="height: 18.75pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Matur</span></span></div>
</td>
<td style="height: 18.75pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Hipermatur</span></span></div>
</td>
</tr>
<tr style="height: 21.35pt;">
<td style="height: 21.35pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Kekeruhan</span></span></div>
</td>
<td style="height: 21.35pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Ringan</span></span></div>
</td>
<td style="height: 21.35pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Sebagian</span></span></div>
</td>
<td style="height: 21.35pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Seluruh</span></span></div>
</td>
<td style="height: 21.35pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Masif</span></span></div>
</td>
</tr>
<tr style="height: 12.95pt;">
<td style="height: 12.95pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Besar Iensa</span></span></div>
</td>
<td style="height: 12.95pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Normal</span></span></div>
</td>
<td style="height: 12.95pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Lebih besar</span></span></div>
</td>
<td style="height: 12.95pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Normal</span></span></div>
</td>
<td style="height: 12.95pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Kecil</span></span></div>
</td>
</tr>
<tr style="height: 12pt;">
<td style="height: 12pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Cairan lensa</span></span></div>
</td>
<td style="height: 12pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Normal</span></span></div>
</td>
<td style="height: 12pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">8ertambah</span></span></div>
</td>
<td style="height: 12pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Normal</span></span></div>
</td>
<td style="height: 12pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Berkurang</span></span></div>
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<tr style="height: 12.35pt;">
<td style="height: 12.35pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 12.35pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 12.35pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">(air masuk)</span></span></div>
</td>
<td style="height: 12.35pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 12.35pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">(air + masa</span></span></div>
</td>
</tr>
<tr style="height: 12.5pt;">
<td style="height: 12.5pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 12.5pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 12.5pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 12.5pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 12.5pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Lensa ke luar)</span></span></div>
</td>
</tr>
<tr style="height: 13.45pt;">
<td style="height: 13.45pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Iris</span></span></div>
</td>
<td style="height: 13.45pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Normal</span></span></div>
</td>
<td style="height: 13.45pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Terdarong</span></span></div>
</td>
<td style="height: 13.45pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Normal</span></span></div>
</td>
<td style="height: 13.45pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Trcmulans</span></span></div>
</td>
</tr>
<tr style="height: 13.45pt;">
<td style="height: 13.45pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Bilik mata depan depan</span></span></div>
</td>
<td style="height: 13.45pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Normal</span></span></div>
</td>
<td style="height: 13.45pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Dangkal</span></span></div>
</td>
<td style="height: 13.45pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Normal</span></span></div>
</td>
<td style="height: 13.45pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Dalam</span></span></div>
</td>
</tr>
<tr style="height: 13.7pt;">
<td style="height: 13.7pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Sudut bilik mata</span></span></div>
</td>
<td style="height: 13.7pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Normal</span></span></div>
</td>
<td style="height: 13.7pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Sempit</span></span></div>
</td>
<td style="height: 13.7pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Normal</span></span></div>
</td>
<td style="height: 13.7pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Terbuka</span></span></div>
</td>
</tr>
<tr style="height: 13.2pt;">
<td style="height: 13.2pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Penyulit</span></span></div>
</td>
<td style="height: 13.2pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">--</span></span></div>
</td>
<td style="height: 13.2pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">Glaukoma</span></span></div>
</td>
<td style="height: 13.2pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">-</span></span></div>
</td>
<td style="height: 13.2pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">' Uveitis</span></span></div>
</td>
</tr>
<tr style="height: 15.65pt;">
<td style="height: 15.65pt; padding: 0cm; width: 171pt;" width="228">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 15.65pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 15.65pt; padding: 0cm; width: 63pt;" width="84">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 15.65pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
<td style="height: 15.65pt; padding: 0cm; width: 54pt;" width="72">
<div class="MsoNormal" style="line-height: normal;">
<span style="font-size: small;"><span lang="EN-US">' Glaukoma</span></span></div>
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Pada
katarak senil akan terjadi degenerasi lensa secara perlahan-lahan. Tajam
penglihatan akan menurun secara berangsur-angsur. Katarak senil merupakan
katarak yang terjadi akibat terjadinya degenerasi serat lensa karena proses
penuaan.</span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Katarak
senil dapat dibagi dalarn 4 stadium, yaitu :</span></span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><i><span lang="EN-US">Stadium insipien</span></i><span lang="EN-US">, di mana mulai timbul katarak akibat proses degenerasi lensa.
Kekeruhan lensa berbentuk bercak-bercak kekeruhan yang tidak teratur. Pasien
akan mengeluh gangguan penglihatan seperti melihat ganda dengan satu matanya.
Pada stadium ini., proses degenerasi belum menyerap cairan mata ke dalarn lensa
sehingga akan terlihat biiik mata depan dengan kedalaman yang normal, iris
dalarn posisi biasa disertai dengan kekeruhan ringan pada lensa. Tajam
penglihatan pasien belum terganggu.</span></span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><i><span lang="EN-US">Stadium imatur</span></i><span lang="EN-US">, di mana pada stadium ini lensa yang degeneratif mulai menyerap
cairan mata ke dalarn lensa sehingga lensa menjadi cembung. Pada stadium ini,
terjadi pembengkakan lensa yang disebut sebagai katarak intumesen. Pada stadium
ini dapat terjadi miopisasi akibat lensa mata menjadi cembung, sehingga pasien
menyatakan tidak perlu kacamata sewaktu membaca dekat. Akibat lensa yang
bengkak, iris terdorong ke depan, biiik mata dangkal dan sudut bilik mata akan
sempit atau tertutup. Pada stadium ini dapat terjadi glaukoma sekunder.</span></span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Pada pemeriksaan uji
bayangan iris atau shadow test akan terlihat bayangan iris pada lensa. Uji
bayangan iris positif.</span></span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>3.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><i><span lang="EN-US">Stadium matur, </span></i><span lang="EN-US">merupakan proses degenerasi lanjut lensa. Pada stadium terjadi kekeruhan
seluruh lensa. Tekanan cairan di dalam lensa sudah dalam keadaan seimbang
dengan cairan dalam mata sehingga ukuran lensa akan menjadi normal kembali.
Pada pemeriksaan terlihat iris dalam posisi normal, bilik mata depan normal,
sudut bilik mata depan terbuka normal, uji bayangan iris negatif. Tajam
penglihatan sangat menurun dan dapat hanya tinggal proyeksi sinar positif. </span></span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>4.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><i><span lang="EN-US">Stadium hipermatur</span></i><span lang="EN-US">, di mana pada stadium ini terjadi proses degenerasi lanjut lensa
dan korteks lensa dapat mencair sehingga nukleus lensa tenggelam dalam korteks
lensa (katarak Morgagni). Pada stadium ini jadi juga degenerasi kapsul lensa
sehingga bahan lensa ataupun korteks yang cair keluar dan masuk ke dalam bilik
mata depan. Pada stadium matur akan terlihat lensa yang lebih kecil daripada
normal, yang akan mengakibatkan iris tremulans, dan bilik mata depan terbuka.
Pada uji bayangan iris tertihat positif walaupun seluruh lensa telah keruh
sehingga stadium ini disebut uji bayangan iris pseudopositif. Akibat bahan
lensa keluar dari kapsul, maka akan tirnbul reaksi jaringan uvea berupa
uveitis. Bahan lensa ini juga dapat menutup jalan keluar cairan bilik mata
sehingga timbul glaukoma fakolitik.</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><i><span lang="EN-US"><span>d.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></i><span lang="EN-US"><span> </span><i>Katarak traumatik</i></span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Kekeruhan
lensa dapat terjadi akibat trauma tumpul atau trauma tajam yang menembus kapsul
anterior. Tindakan bedah pada katarak traumatik dilakukan setelah mata tenang
akibat trauma tersebut. Bila pecahnya kapsul mengakibatkan gejala radang berat,
maka dilakukan aspirasi secepatnya.</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><i><span lang="EN-US"><span>e.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></i><i><span lang="EN-US">Katarak komplikata</span></i></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Katarak
komplikata terjadi akibat gangguan keseimbangan susunan sel lensa oleh faktor
fisik atau kimiawi sehingga terjadi gangguan kejernihan lensa. Katarak
komplikata dapat terjadi akibat iridosiklitis, koroiditis, miopia tinggi,
ablasio retina, dan glaukoma. Katarak komplikata dapat terjadi akibat kelainan
sistemik yang akan mengenai kedua mata atau kelainan lokal yang akan mengenai
satu mata.</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><i><span lang="EN-US"><span>f.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></i><i><span lang="EN-US">Katarak sekunder</span></i></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Pada tindakan bedah lensa dimana
terjadi reaksi radang yang berakhir dengan terbentuknya jaringan fibrosis sisa
lensa yang tertinggal maka keadaan ini disebut sebagai katarak sekunder.
Tindakan bedah yang dapat menimbulkan katarak sekunder adalah sisa disisio
lentis, ekstraksi linear dan ekstraksi lensa ekstrakpsular. Pada katarak
sekunder yang menghambat masuknya sinar ke dalam bola mata atau mengakibatkan
turunnya tajam penglihatan maka dilakukan disisio lentis sekunder atau
kapsulotomi pada katarak sekunder tersebut.</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-77431325340076865202018-04-06T05:58:00.000+07:002018-04-06T05:58:06.694+07:00ASUHAN KEPERAWATAN KARSINOMA MEDIASTINUM <div style="text-align: justify;">
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="page number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="endnote reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="endnote text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="table of authorities"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="macro"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="toa heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 5"/>
<w:LsdException Locked="false" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Closing"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Default Paragraph Font"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
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<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
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<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
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</div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pengertian</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Karsinoma
mediastinum merupakan suatu kondisi dimana timbulnya hiperplasia sel-sel
jaringan (tulang, penyokong) pada area tertentu (mediastinum) secara progresif
dalam bentuk jaringan longgar yang menimbulkan manifestasi tumor (pembesaran)
pada mediastinum.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Patofisiologi</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Sebagaimana
bentuk kanker /karsinoma lain, penyebab dari timbulnya karsinoma jaringan
mediastinum belum diketahui secara pasti; namun diduga berbagai faktor
predisposisi yang kompleks berperan dalam menimbulkan manifestasi tumbuhnya jaringan
/ sel-sel kanker pada jaringan mediastinum.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Adanya
pertumbuhan sel-sel karsinoma dapat terjadi dalam waktu yang relatif singkat
maupun timbul dalam suatu proses yang memakan waku bertahun-tahun untuk
menimbulkan manifestasi klinik. Adakalanya berbagai bentuk karsinoma sulit
terdeteksi secara pasti dan cepat oleh tim kesehatan. Diperlukan berbagai
pemeriksaan akurat untuk menentukan masalah adanya kanker pada suatu jaringan.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Dengan semakin
meningkatnya volume massa sel-sel yang berproliferasi maka secara mekanik
menimbulkan desakan pada jaringan sekitarnya; pelepasan berbagai substansia
pada jaringan normal seperti prostalandin, radikal bebas dan protein-protein
reaktif secara berlebihan sebagai ikutan dari timbulnya karsinoma meningkatkan
daya rusak sel-sel kanker terhadap jaringan sekitarnya; terutama jaringan yang
memiliki ikatan yang relatif lemah.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Kanker sebagai
bentuk jaringan progresif yang memiliki ikatan yang longgar mengakibatkan
sel-sel yang dihasilkan dari<span style="mso-spacerun: yes;"> </span>jaringan
kanker lebih mudah untuk pecah dan menyebar ke berbagai organ tubuh lainnya
(metastase) melalui kelenjar, pembuluh darah maupun melalui peristiwa mekanis
dalam tubuh.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Adanya
pertumbuhan sel-sel progresif pada mediastinum secara mekanik menyebabkan
penekanan (direct pressure/indirect pressure) serta dapat menimbulkan destruksi
jaringan sekitar; yang menimbulkan manifestasi seperti penyakit infeksi
pernafasan lain seperti sesak nafas, nyeri inspirasi, peningkatan produksi
sputum, bahkan batuk darah atau lendir berwarna merah (hemaptoe) manakala telah
melibatkan banyak kerusakan pembuluh darah. </span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Kondisi kanker
juga meningkatkan resiko timbulnya infeksi sekunder; sehingga kadangkala
manifestasi klinik yang lebih menonjol mengarah pada infeksi saluran nafas
seperti pneumonia, tuberkulosis walaupun mungkin secara klinik pada kanker ini
kurang dijumpai gejala demam yang menonjol.<span style="mso-spacerun: yes;">
</span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Tanda dan Gejala</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Mengeluh sesak nafas, nyeri dada unilateral, nyeri dan sesak pada
posisi tertentu (menelungkup)</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Sekret berlebihan</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Batuk dengan atau tanpa dahak</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Riwayat kanker pada keluarga atau pada klien</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Pernafasan tidak simetris</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US"><span style="mso-spacerun: yes;"> </span>Unilateral Flail Chest</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Effusi pleura </span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Egophonia pada daerah sternum</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Pekak/redup abnormal pada mediastinum serta basal paru</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Wheezing unilateral/bilateral</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Ronchii</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Penatalaksanaan </span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Tindakan yang
dilakukan pada klien yang mengalami karsinoma mediastinum meliputi tindakan
operatif dan konservatif. Tindakan konservatif terdiri atas :</span></div>
<ol start="1" style="margin-top: 0cm; text-align: justify;" type="a">
<li class="MsoNormal"><span lang="EN-US">Pengurangan gejala-gejala dasar, seperti penurunan gejala sesak
nafas, koreksi gangguan keseimbangan gas.</span></li>
<li class="MsoNormal"><span lang="EN-US">Koreksi/perbaikan kondisi umum serta pencegahan komplikasi</span></li>
</ol>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Pemenuhan
kebutuhan nutrisi, cairan dan elektrolit serta aktivitas merupakan langkah yang
perlu iambil secara terpadu untuk meningkatkan fungsi dasar dan perbaikan
kondisi umum klien.</span></div>
<ol start="3" style="margin-top: 0cm; text-align: justify;" type="a">
<li class="MsoNormal"><span lang="EN-US">Adaptasi biologis dan psikologis</span></li>
<li class="MsoNormal"><span lang="EN-US">Pengngunaan obat-obatan : Berbagai citostatika mungki digunakan
dalam terapi kausatif seperti : tryetilenthiophosporamide, nitrogen
mustard, dan penggunaan zat-zat lainnya seperti atabrine<span style="mso-spacerun: yes;"> </span>atau penggunaan talc poudrage</span></li>
<li class="MsoNormal"><span lang="EN-US">Citostatic intra pleura :</span></li>
</ol>
<div class="MsoNormal" style="margin-left: 35.45pt; text-align: justify;">
<span lang="EN-US">Zat-zat yang
digunakan biasanya :</span></div>
<div class="MsoNormal" style="margin-left: 2cm; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Mustargen 0,4 mg per kg berat badan digunakan dosis 20-40 mg dalam
100 cc larutan garam.</span></div>
<div class="MsoNormal" style="margin-left: 2cm; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Theothepa 20-50 mg intra pleura</span></div>
<div class="MsoNormal" style="margin-left: 2cm; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Atabrine 250 mg dalam 10 cc aquades</span></div>
<div class="MsoNormal" style="margin-left: 2cm; text-align: justify; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">*<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Fluoro uracil dan mitomycine</span></div>
<ol start="6" style="margin-top: 0cm; text-align: justify;" type="a">
<li class="MsoNormal"><span lang="EN-US">Radiasi</span></li>
</ol>
<div class="MsoNormal" style="margin-left: 35.45pt; text-align: justify; text-indent: 1.65pt;">
<span lang="EN-US">Radiasi pada tumor justru menimbulkan effusi pleura disebabkan oleh
karena kerusakan aliran limphe dari fibrosis. Akan tetapi beberapa publikasi
terdapat laporan berkurangnya cairan setelah radiasi pada tumor mediastinum.</span></div>
<div class="MsoNormal" style="margin-left: 38.7pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Proses Keperawatan</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Pengkajian</span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify;">
<span lang="EN-US">Identitas<span style="mso-tab-count: 2;"> </span>: </span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify;">
<span lang="EN-US">Umur <span style="mso-tab-count: 2;"> </span>: Karsinoma cenderung
ditemukan pada usia dewasa</span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify;">
<span lang="EN-US">Jenis kelamin<span style="mso-tab-count: 1;"> </span>: Laki-laki lebih bersesiko daripada
wanita</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Riwayat Masuk</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Keluhan utama yang sering muncul saat masuk
adalah adanya sesak nafas dan nyeri dada yang berulang tidak khas; mungkin
disertai/tidak disertai dengan batuk atau batuk darah. Pada beberapa kasus
sering dilaporkan keluhan infeksi lebih menjadi sebab klien melakukan kunjungan
ke profesional kesehatan.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Riwayat Penyakit Dahulu</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Predileksi penyakit saluran pernafasan lain
seperti ISPA, influenza sering terjadi dalam rentang waktu yang relatif lama
dan berulang, adanya riwayat tumor pada organ lain, baik pada diri sendiri
maupun dari keluarga.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Penyakit paru, jantung serta kelainan organ
vital bawaan dapat memperberat klinis penderita</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br />
<div class="MsoNormal" style="text-align: justify;">
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="35" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="1" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
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<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
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<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
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<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
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<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
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<w:LsdException Locked="false" Priority="21" QFormat="true"
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<w:LsdException Locked="false" Priority="31" QFormat="true"
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<w:LsdException Locked="false" Priority="32" QFormat="true"
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<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
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<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
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<br />Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-32155656375465261202018-04-06T05:55:00.004+07:002018-04-06T05:55:58.438+07:00 ASUHAN KEPERAWATAN PASIEN DENGAN KARSINOMA LARING <div style="text-align: justify;">
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<span lang="EN-US"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pengertian</span>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.3pt;">
<span lang="EN-US">Secara anatomi tumor laring dibagi atas tiga bagian yaitu supra
glotik, tumor pada plika ventrikularis, aritenoid, epiglotis dan sinus
piriformis (Glotis : tumor pada korda vokalis , Subglotis : tumor dibawah korda
vokalis).</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.85pt; text-indent: -21.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Patofisiologi</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.3pt;">
<span lang="EN-US">Karsinoma laring banyak dijumpai pada usia lanjut diatas 40 tahun.
Kebanyakan pada orang laki-laki.Hal ini mungkin berkaitan dengan kebiasaan
merokok, bekerja dengan debu serbuk kayu, kimia toksik atau serbuk, logam
berat. Bagaimana terjadinya belum diketahui secara pasti oleh para ahli.Kanker
kepala dan leher menyebabkan 5,5% dari semua penyakit keganasan.Terutama
neoplasma laringeal 95% adalah karsinoma sel skuamosa.Bila kanker terbatas pada
pita suara (intrinsik) menyebar dengan lambat.Pita suara miskin akan pembuluh
limfe sehingga tidak terjadi metastase kearah kelenjar limfe.Bila kanker
melibatkan epiglotis (ekstrinsik) metastase lebih umum terjadi.Tumor
supraglotis dan subglotis harus cukup besar, sebelum mengenai pita suara
sehingga mengakibatkan suara serak.Tumor pita suara yang sejati terjadi lebih
dini biasanya pada waktu pita suara masih dapat digerakan.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.3pt; text-indent: -21.3pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.85pt; text-indent: -21.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Gambaran klinik</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.3pt;">
<span lang="EN-US">Paling dini adalah berupa suara parau atau serak kronik, tidak
sembuh-sembuh walaupun penderita sudah menjalani pengobatan pada daerah glotis
dan subglotis. Tidak seperti suara serak laringitis, tidak disertai oleh gejala
sistemik seperti demam.Rasa tidak enak ditenggorok, seperti ada sesuatu yang
tersangkut. Pada fase lanjut dapat disertai rasa sakit untuk menelan atau
berbicara.Sesak napas terjadi bila rima glotis tertutup atau hampir tertutup
tumor 80%. Sesak napas tidak timbul mendadak tetapi perlahan-lahan. Karena itu
penderita dapat beradaptasi, sehingga baru merasakan sesak bila tumor sudah
besar (terlambat berobat). Stridor terjadi akibat sumbatan jalan napas.Bila
sudah dijumpai pembesaran kelenjar berarti tumor sudah masuk dalam stadium
lanjut.Bahkan kadang-kadang tumornya dapat teraba, menyebabkan pembengkakan
laring.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.3pt;">
<span lang="EN-US">Bila tumor laring mengadakan perluasan ke arah faring akan timbul
gejala disfagia, rasa sakit bila menelan dan penjalaran rasa sakit kearah
telinga.Apabila dijumpai kasus dengan jelas diatas, khususnya dengan keluhan
suara parau lebih dari dua minggu yang dengan pengobatan tidak sembuh, diderita
orang dewasa atau tua, sebaiknya penderita segera dirujuk.</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.85pt; text-indent: -21.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Stadium</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.3pt;">
<span lang="EN-US">Tergantung keadaan tumor (T), pembesaran kelenjar regional ( N ),
dan metastasis jauh ( M ).</span></div>
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<span lang="EN-US">Stadium :<span style="mso-tab-count: 1;"> </span>I<span style="mso-spacerun: yes;"> </span>: T1 No Mo</span></div>
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<span lang="EN-US">II<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;"> </span>T2 No Mo</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 70.9pt;">
<span lang="EN-US">III<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;"> </span>T3 No
Mo, T2 N1 Mo, T3 N1 Mo</span></div>
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<span lang="EN-US">IV<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;"> </span>T4 No Mo, semua T N2 M1, semua T semua N dan
M.</span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.85pt; text-indent: -21.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Diagnostic studies</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.3pt;">
<span lang="EN-US">Pemeriksaan laring dengan kaca laring atau laringoskopi langsung
dapat menunjukkan tumor dengan jelas.Tempat yang sering timbul tumor dapat dilihat
pada gambar.Sinar X dada,scan tulang, untuk mengidentifikasi kemungkinan
metastase. Darah lengkap, dapat menyatakan anemi yang merupakan masalah umum.
Laringografi dapat dilakukan dengan kontras untuk pemeriksaan pembuluh darah
dan pembuluh limfe., Kemudian laring diperiksa dengan anestesi umum dan
dilakukan biopsi pada tumor.Gigi yang berlubang, sebaiknya dicabut pada saat
yang sama.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.85pt; text-indent: -21.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Medical<span style="mso-spacerun: yes;"> </span>Managament</span></div>
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<span lang="EN-US">Pada kasus karsinoma laring dapat dilakukan pengobatan dengan
radiasi dan pengangkatan laring (Laringektomi).Pengobatan dipilih berdasar
stadiumnya.Radiasi diberikan pada stadium 1 dan 4.Alasannya mempunyai
keuntungan dapat mempertahankan suara yang normal, tetapi jarang dapat
menyembuhkan tumor yang sudah lanjut,lebih-lebih jika sudah terdapat pembesaran
kelenjar leher.Oleh karena itu radioterapi sebaiknya dipergunakan untuk
penderita dengan lesi yang kecil saja tanpa pembesaran kelenjar leher.Kasus
yang ideal adalah pada tumor yang terbatas pada satu pita suara, dan masih
mudah digerakkan. Sembilan dari sepuluh penderita dengan keadaan yang demikian
dapat sembuh sempurna dengan radioterapi serta dapat dipertahankannya suara
yang normal.Fiksasi pita suara menunjukkan penyebaran sudah mencapai<span style="mso-spacerun: yes;"> </span>lapisan otot. Jika tumor belum menyebar
kedaerah supraglotik atau subglotik, lesi ini masih dapat diobati dengan
radioterapi, tetapi dengan prognosis yang lebih buruk.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 21.3pt;">
<span lang="EN-US">Penderita dengan tumor laring yang besar disertai dengan pembesaran
kelenjar limfe leher, pengobatan terbaik adalah laringektomi total dan diseksi
radikal kelenjar leher.Dalam hal ini masuk stadium 2 dan 3. Ini dilakukan pada
jenis tumor supra dan subglotik.Pada penderita ini kemungkinan sembuh tidak
begitu besar, hanya satu diantara tiga penderita akan sembuh
sempurna.Laringektomi diklasifikasikan kedalam :</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 43.65pt; text-indent: -21.8pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Laringektomi parsial. Tumor
yang terbatas pada pengangkatan hanya satu pita<span style="mso-spacerun: yes;">
</span>suara dan trakeotomi sementara yang di lakukan untuk mempertahankan
jalan napas. Setelah sembuh dari pembedahan suara pasien akan parau.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 43.65pt; text-indent: -21.8pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Hemilaringektomi atau vertikal.
Bila ada kemungkinan kanker termasuk pita suara satu benar dan satu
salah.Bagian ini diangkat sepanjang kartilago aritenoid dan setengah kartilago
tiroid.Trakeostomi sementara dilakukan dan suara pasien akan parau setelah
pembedahan.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 43.65pt; text-indent: -21.8pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Laringektomi supraglotis atau
horisontal. Bila tumor berada pada epiglotis atau pita suara yang salah,
dilakukan diseksi leher radikal dan trakeotomi. Suara pasien masih utuh atau
tetap normal.Karena epiglotis diangkat maka resiko aspirasi akibat makanan
peroral meningkat.</span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 43.65pt; text-indent: -21.8pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Laringektomi total. Kanker
tahap lanjut yang melibatkan sebagian besar laring, memerlukan pengangkatan
laring, tulang hihoid, kartilago krikoid,2-3 cincin trakea, dan otot penghubung
ke laring.Mengakibatkan kehilangan suara dan sebuah lubang ( stoma )
trakeostomi yang permanen. Dalam hal ini tidak ada bahaya aspirasi makanan
peroral, dikarenakan trakea tidak lagi berhubungan dengan saluran udara –
pencernaan.Suatu sayatan radikal telah dilakukan dileher pada jenis
laringektomi ini.Hal ini meliputi pengangkatan pembuluh limfatik, kelenjar
limfe di leher, otot sternokleidomastoideus, vena jugularis interna, saraf
spinal asesorius, kelenjar salifa submandibular dan sebagian kecil kelenjar
parotis (Sawyer, 1990).Operasi ini akan membuat penderita tidak dapat bersuara
atau berbicara. Tetapi kasus yang dermikian dapat diatasi dengan mengajarkan
pada mereka berbicara menggunakan esofagus (Esofageal speech), meskipun
kualitasnya tidak sebaik bila penderita berbicara dengan menggunakan organ
laring.Untuk latihan berbicara dengan esofagus perlu bantuan seorang
binawicara.</span></div>
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-15170314808510413242018-04-06T05:54:00.000+07:002018-04-06T05:54:10.987+07:00ASUHAN KEPERAWATAN KLIEN DENGAN KEGAWAT DARURATAN SISTEM KARDIOVASKULER AKIBAT DISRITMIA DAN GANGGUAN KONDUKSI <div style="text-align: justify;">
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="35" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
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<w:LsdException Locked="false" Priority="19" QFormat="true"
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<w:LsdException Locked="false" Priority="21" QFormat="true"
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<w:LsdException Locked="false" Priority="31" QFormat="true"
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<w:LsdException Locked="false" Priority="32" QFormat="true"
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<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
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<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
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<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
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<w:LsdException Locked="false" Priority="52"
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<span style="font-size: small;"><b><span lang="EN-US" style="line-height: 150%;">Pendahuluan</span></b></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: small;"><span lang="EN-US">Stimulasi irama
jantung bermula dari nodus SA di dinding atrium kanan dekat muara vena kava
superior. Menyebar seluruh dinding atrium dan sampai ke nodus AV terletak di
dasar atrium kanan diatas katup trikuspidalis. Stimulasi diteruskan melalui
berkas his dan membagi 2 jaras menuju miokard ventrikel melalui serat purkinje.</span></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: small;"><span lang="EN-US">Depolarisasi
miokard atrium digambarkan sebagai gelombang P pada EKG dan perlambatan di
nodus AV terrekam sebagai interval PR. Depolarisasi miokard ventrikel
digambarkan sebagai gelombang QRS dan disusul proses repolarisasi kedua
ventrikel terrekam sebagai gelombang T.</span></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: small;"><i><span lang="EN-US">Disritmia dapat
diketahui dari gambaran irama dan morfologi EKG.</span></i></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: small;"><span lang="EN-US">Pada akhir
perkuliahan ini diharapkan mahasiswa adakan dapat :</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Menjelaskan pengertian
disritmia dan gangguan konduksi.</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Menyebutkan klasifikasi
disritmia.</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>3.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Menjelaskan penanggulangan
kegawat daruratan jantung (disritmia).</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>4.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Merumuskan diagnosa keperawatan
klien dengan disritmia.</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>5.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Menyusun rencana keperawatan
klien dengan disritmia.</span></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: small;"><b><span lang="EN-US" style="line-height: 150%;">Pengertian.</span></b></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: small;"><span lang="EN-US">Disritmia adalah
suatu kelainan ireguler dari denyut jantung yang disebabkan oleh pembentukan
impuls yang abnormal dan kelainan konduksi impuls atau keduanya.\</span></span></div>
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<br /></div>
<br />
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
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<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
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<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
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<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
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<w:LsdException Locked="false" Priority="31" QFormat="true"
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<w:LsdException Locked="false" Priority="52"
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<w:LsdException Locked="false" Priority="52"
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<w:LsdException Locked="false" Priority="46"
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<w:LsdException Locked="false" Priority="52"
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<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
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<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
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<w:LsdException Locked="false" Priority="52"
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<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/>
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Name="List Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
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<w:LsdException Locked="false" Priority="46"
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<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/>
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Name="List Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
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<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
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</w:LatentStyles>
</xml><![endif]--><!--[if gte mso 10]>
<style>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-style-noshow:yes;
mso-style-priority:99;
mso-style-parent:"";
mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
mso-para-margin-top:0cm;
mso-para-margin-right:0cm;
mso-para-margin-bottom:8.0pt;
mso-para-margin-left:0cm;
line-height:107%;
mso-pagination:widow-orphan;
font-size:11.0pt;
font-family:"Times New Roman","serif";}
</style>
<![endif]-->
</span></span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span style="font-size: small;"><b><span lang="EN-US" style="line-height: 150%;">Kegawat daruratan jantung.</span></b></span></div>
<span style="font-size: small;">
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<b><span lang="EN-US"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></b><b><span lang="EN-US">Takiaritmia / SVT</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
<span lang="EN-US">Supraventrikular Takiaritmia terjadi karena adanya faktor<span> </span>reentri impuls pada SA node / atrium. Tekan
karotid & manuver valsava dapat memperlambat denyut jantung.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
<span lang="EN-US">SVT dapat diketahui dengan perubahan gelombang P:</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">50 % terjadi gel. P menghilang
& terbenam dalam QRS atau retrograde gelombang.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">10 - 30 % terjadi anterograde
atau polimorf gel. P, reentri pada AV node.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">5 - 10 % terdapat reentri SA
node yaitu intra arterial reentri yang ditandai dengan gelombang p anterograde.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Sisanya adalah intra aterial
reentri ditandai dengan bifasik gelombang<span>
</span>P.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<b><span lang="EN-US"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></b><b><span lang="EN-US">Fibrilasi ventrikuler.</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
<span lang="EN-US">Adalah sebagian depolarisasi ventrikel yang tidak efektif, cepat,
tak teratur. Ini terjadi karena iskemik, infark miokard, manipulasi kateter dan
karena sengatan listrik. Disritmia ventrikel merupakan permulaan dari fibrilasi
ventrikel. Fibrilasi ventrikel ditandai dengan perpanjangan interval Q - T dan
HR 150 - 2000 X / menit atau bahkan lebih. Fibrilasi ventrikel merupakan
penyebab kematian tiba-tiba bila resusitasi tidak dilakukan segera.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<b><span lang="EN-US"><span>3.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></b><b><span lang="EN-US">Flutter.</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
<span lang="EN-US">Sering dikenal dengan flutter arterial karena flutter ventrikel
biasanya mengikuti setengahnya seperti perbandingan 2 : 1. 3 : 1 & 4 : 1.
Flutter merupakan irama ektopik atrium cepat dengan frekuensi 250 - 350 X /
menit.<span> </span>Frekuensi cepat menimbulkan
gelombang EKG seperti gigi gergaji atau picket fence. Gelombang flutter secara
parsial tersembunyi didalam QRS atau gelombang T. penyebab flutter adalah
jantung koroner, cor-pulmonarle dan jantung reumatik. Jika frekuensi ventrikel
cepat, dilakukan masase sinus karotid (stimulasi / manuver vagal) yang akan
meningkatkan derajat block AV.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<b><span lang="EN-US"><span>4.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></b><b><span lang="EN-US">Fibrilasi aterial.</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
<span lang="EN-US">Sebagai gangguan irama ektopik atrium yang cepat dengan frekuensi
atrium 400 - 650 X / menit. Respon ventrikuler biasanya 140 - 170 X / menit
atau tergantung kondisi AV junction. Penyebabnya adalah CHF, RHD, Post op
jantung terbuka dengan kelainan paru, penyakit otot atrium dan distensi atrium
dengan penyakit nodus sinus. Fibrilasi menyebabkan CO berkurang dimana HR cepat
mengakibatkan berkurangnya pengisian ventrikel dan hilangnya efektifitas
kontraksi atrium.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<b><span lang="EN-US"><span>5.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></b><b><span lang="EN-US">AV Block derajat 1
sampai<span> </span>3</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
<span lang="EN-US">Heart block merupakan suatu keadaan gangguan konduksi di AV node dan
interval PR adalah waktu yang dibutuhkan oleh impuls listrik untuk menjalar
dari atrium ke AV node - bundle his - cabang ventrikel. Interval PR normal
berkisar (0,12 - 0,20 detik).</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><b><span lang="EN-US">AV Block derajat 1</span></b><span lang="EN-US"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt;">
<span lang="EN-US">Terjadi perpanjangan interval PR yaitu > 0,20 detik sampai 0,24
detik, tetapi setiap gelombang P masih diikuti kompleks QRS. Gangguan terjadi
pada konduksi proksimal bundle his yang disebabkan oleh intoksikasi digitalis,
peradangan, degenerasi dan variasi normal.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt;">
<i><span lang="EN-US">Biasanya tidak membutuhkan terapi apa-apa.</span></i></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><b><span lang="EN-US">AV Block derajat 2</span></b><span lang="EN-US"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt;">
<span lang="EN-US">Dibagi dalam 2 type yaitu :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<span lang="EN-US"><span>a.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Mobitz type 1 ( wenckebach
block)</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt;">
<span lang="EN-US">Wenckebach block merupakan perpanjangan interval PR yang progresif
kegagalan impuls yang intermiten sehingga impuls tidak dapat sampai ventrikel
akhirnya kompleks QRS tidak muncul. Mobitz type 1 ini terjadi karena blokade
impuls di proksimal bundle his oleh karena penekanan vagal reflek, digitalis
dan iskemik miokard sampai gangguan haemodinamik.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -18pt;">
<span lang="EN-US"><span>b.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Mobitz type 2</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt;">
<span lang="EN-US">Yaitu merupakan berkurangnya denyut ventrikel (dropped beat) tetapi
interval PR tetap sama. Kekurangan denyut ventrikel bisa tidak teratur dan
blokade terjadi pada distal bundel his. Penyebabnya adalah IMA, miokarditis dan
degeneratif. Mobitz type 2 sering menimbulkan serangan sinkope dan membutuhkan
pemasangan pace maker.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><b><span lang="EN-US">AV Block derajat 3</span></b><span lang="EN-US"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt;">
<span lang="EN-US">Ini adalah bentuk blokade jantung yang komplit yaitu tidak adan
impuls atrium yang mencapai ventrikel sehingga ventrikel berdenyut sendiri
berasal dari nodus ventrikel sendiri. Gambaran EKG memperlihatkan gelombang P
teratur dengan frekuensi 60 - 90 X / menit, sedangkan kompleks QRS mempunyai
frekuensi 40 - 60 X / menit. Penyebabnya adalah degenerasi, IMA, peradangan,
intoksikasi, infark sering terjadi sementara. Bila blokade menetap perlu
pemasangan pace maker permanen. Type ini dapat menyebabkan sinkope, kelelahan,
sesak dan angina pada orang tua karena gangguan haemodinamik.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<b><span lang="EN-US" style="line-height: 150%;">Komponen Penangulangan
Kegawatdaruratan.</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Komponen luar RS (Pra RS) .</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Meliputi ketenagaan.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Transportasi </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Komunikasi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Komponen dalam RS (Intra RS),
meliputi:</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Melakukan resusitasi dan life
support.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Melakukan referal klien sesuai
kondisi dan kemampuan.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Penampungan dan penangulangan.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Melakukan komunikasi.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: "MapInfo Cartographic";"><span>g<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Menangulangi "True &
False Emergency" baik medical / surgical.</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
</span><br />
<div class="MsoNormal" style="line-height: 150%;">
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Name="List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 5"/>
<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Closing"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Signature"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="true"
UnhideWhenUsed="true" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-5498913620264145572018-04-05T17:59:00.000+07:002018-04-05T17:59:05.592+07:00ASUHAN KEPERAWATAN PASIEN DENGAN INTOKSIKASI INSEKTISIDA<div style="text-align: justify;">
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</div>
<ol start="1" style="margin-top: 0cm; text-align: justify;" type="A">
<li class="MsoNormal"><span lang="EN-US">Pengertian.</span></li>
</ol>
<div class="MsoNormal" style="text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Intoksikasi atau
keracunan adalah masuknya zat atau senyawa kimia dalam tubuh manusia yang
menimbulkan efek merugikan pada yang menggunakannya.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Istilah
peptisida pada umumnya dipakai untuk semua bahan yang dipakai manusia untuk
membasmi hama
yang merugikan manusia.Termasuk peptisida ini adalah insektisida. Ada 2 macam insektisuda
yang paling benyak digunakan dalam pertanian :</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Insektisida hidrokarbon khorin
( IHK=Chlorinated Hydrocarbon )</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Isektida fosfat organic ( IFO
=Organo Phosphatase<span style="mso-spacerun: yes;"> </span>insectisida )</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US"><span style="mso-spacerun: yes;">
</span>Yang paling sering digunakan adalah<span style="mso-spacerun: yes;">
</span>IFO yang pemakaiannya terus menerus meningkat. Sifat dari IFO adalah
insektisida poten yang paling banyak digunakan dalam pertanian dengan toksisitas
yang tinggi. Salah satu derivatnya adalah<span style="mso-spacerun: yes;">
</span>Tabun dan Sarin. Bahan ini dapat menembusi kulit yang normal (intact)
juga dapaat diserap diparu dan saluran makanan,namun tidak berakumulasi dalam
jaringan tubuh seperti golongan IHK. </span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span>Macam-macam
IFO adalah malathion ( Tolly ) Paraathion,diazinon,Basudin,Paraoxon dan
lain-lain. IFO ada 2 macam adalah IFO Murni dan golongan carbamate.Salah satu
contoh gol.carbamate adalah baygon.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<ol start="2" style="margin-top: 0cm; text-align: justify;" type="A">
<li class="MsoNormal"><span lang="EN-US">Patogenesis.</span></li>
</ol>
<div class="MsoNormal" style="text-align: justify; text-indent: 36pt;">
<span lang="EN-US">IFO bekerja<span style="mso-spacerun: yes;"> </span>dengan cara menghabat ( inaktivasi ) enzim
asetikolinesterase<span style="mso-spacerun: yes;"> </span>tubuh ( KhE).Dalam
keadaan normal enzim KhE bekerja untuk menghidrolisis arakhnoid( AKH ) dengan
jalan mengikat Akh –KhE yang bersifat inaktif.Bila konsentrasi<span style="mso-spacerun: yes;"> </span>racun lebih tinggi dengan ikatan IFO- KhE
lebih banyak terjadi. Akibatnya akan terjadi<span style="mso-spacerun: yes;">
</span>penumpukan Akh ditempat-tempat tertentu, sehingga timbul gejala gejal;a
ransangan Akh yang berlebihan ,yang akan menimbulkan efek muscarinik, nikotinik
dan SSP ( menimbulkan stimulasi kemudian depresi SSP )</span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Pada keracunan
IFO ,ikatan Ikatan IFO – KhE bersifat menetap (ireversibel ) ,sedangkan
keracunan carbamate<span style="mso-spacerun: yes;"> </span>ikatan ini bersifat
sementara (reversible ).Secara farmakologis efek Akh<span style="mso-spacerun: yes;"> </span>dapat dibagi 3 golongan :</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Muskarini,terutama pada saluran
pencernaan,kelenjar ludah dan keringat,pupil,bronkus dan jantung.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Nikotinik,terutama pada
otot-otot skeletal,bola mata,lidah,kelopak mata dan otot pernafasan.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">SSP, menimbulkan nyeri
kepala,perubahan emosi,kejang-kejang(Konvulsi ) sampai koma.<span style="mso-tab-count: 1;"> </span></span></div>
<ol start="3" style="margin-top: 0cm; text-align: justify;" type="A">
<li class="MsoNormal"><span lang="EN-US">Gambaran Klinik.</span></li>
</ol>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Yang paling menonjol adalah kelainan
visus,hiperaktifitas kelenjar ludah,keringat<span style="mso-spacerun: yes;">
</span>dan ggn saluran pencernaan,serta kesukaran bernafas.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Gejala ringan meliputi : Anoreksia, nyeri
kepala, rasa lemah,rasa takut, tremor pada lidah,kelopak mata,pupil miosis.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Keracunan sedang : nausea, muntah-muntah,
kejang atau kram perut, hipersaliva, hiperhidrosis,fasikulasi otot dan
bradikardi.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Keracunan berat<span style="mso-spacerun: yes;"> </span>: diare, pupil pi- poin, reaksi cahaya
negatif ,sesak nafas, sianosis, edema paru .inkontenesia urine dan feces,
kovulsi,koma, blokade jantung akhirnya meningal.</span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: -18pt;">
<br /></div>
<ol start="4" style="margin-top: 0cm; text-align: justify;" type="A">
<li class="MsoNormal"><span lang="EN-US">Pemeriksaan.</span></li>
</ol>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Laboratorik.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Pengukuran kadar
KhE dengan sel darah merah dan plasma, penting untuk memastikan diagnosis
keracunan IFO akut maupun kronik (Menurun sekian %<span style="mso-spacerun: yes;"> </span>dari harga normal ).</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Kercunan akut
:<span style="mso-spacerun: yes;"> </span>Ringan<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>40<span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;"> </span>70 %</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US"><span style="mso-tab-count: 3;"> </span>Sedang<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>20<span style="mso-spacerun: yes;">
</span>-<span style="mso-spacerun: yes;"> </span>40 %</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US"><span style="mso-tab-count: 3;"> </span>Berat<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span><<span style="mso-spacerun: yes;">
</span>20 %</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span>Keracunan kronik bila
kadar KhE menurun sampai 25<span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;"> </span>50 % setiap individu yang berhubungan dengan
insektisida ini harus segara disingkirkan dan baru diizinkan bekerja kemballi kadar
KhE telah meningkat<span style="mso-spacerun: yes;"> </span>> 75 % N</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Patologi Anatomi ( PA ).</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Pada keracunan
acut,hasil pemeriksaan patologi biasanya tidak khas.sering hanya ditemukan
edema paru,dilatsi kapiler,hiperemi paru,otak dan organ-oragan lainnya.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<br /></div>
<ol start="5" style="margin-top: 0cm; text-align: justify;" type="A">
<li class="MsoNormal"><span lang="EN-US">Penatalaksanaan.</span></li>
</ol>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resusitasi.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Setelah jalan
nafas dibebaskan dan dibersihkan,periksa pernafasan dan nadi.Infus dextrose 5 %
kec.<span style="mso-spacerun: yes;"> </span>15-<span style="mso-spacerun: yes;">
</span>20 tts/menit .,nafas buatan,oksigen,hisap lendir dalam saluran
pernafasan,hindari obat-obatan depresan saluran nafas,kalu perlu respirator
pada kegagalan nafas berat.Hindari pernafasan buatan dari mulut kemulut, sebab
racun organo fhosfat akan meracuni lewat mlut penolong.Pernafasan buatan hanya
dilakukan dengan meniup face mask atau menggunakan alat bag – valve – mask.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Eliminasi.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Emesis,
merangsang penderita supaya muntah pada penderita yang sadar atau dengan pemeberian
sirup ipecac<span style="mso-spacerun: yes;"> </span>15<span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;"> </span>30
ml. Dapat diulang setelah 20 menit bila tidak berhasil.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Katarsis,(
intestinal lavage ), dengan pemberian laksan bila diduga racun telah sampai
diusus halus dan besar.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Kumbah lambung
atau gastric lavage, pada penderita yang kesadarannya menurun,atau pada
penderita yang tidak kooperatif.Hasil paling efektif bila kumbah lambung
dikerjakan dalam 4 jam setelah keracunan.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Keramas
rambut<span style="mso-spacerun: yes;"> </span>dan memandikan seluruh tubuh
dengan sabun.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Emesis,katarsis
dan kumbah lambung sebaiknya hanya dilakukan bila keracunan terjadi kurang dari
4 – 6 jam . pada koma derajat sedang hingga berat tindakan kumbah lambung
sebaiknya dukerjakan dengan bantuan pemasangan pipa endotrakeal berbalon,untuk
mencegah aspirasi pnemonia.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US"><span style="mso-tab-count: 2;"> </span></span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Anti dotum.</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Atropin sulfat (
SA )<span style="mso-spacerun: yes;"> </span>bekerja dengan menghambat efek
akumulasi Akh pada tempat penumpukan.</span></div>
<div class="MsoNormal" style="margin-left: 153pt; text-align: justify; text-indent: -99pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Mula-mula diberikan bolus
IV<span style="mso-spacerun: yes;"> </span>1<span style="mso-spacerun: yes;">
</span>-<span style="mso-spacerun: yes;"> </span>2,5 mg</span></div>
<div class="MsoNormal" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Dilanjutkan dengan<span style="mso-spacerun: yes;"> </span>0,5 – 1 mg setiap 5<span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;">
</span>10<span style="mso-spacerun: yes;"> </span>-<span style="mso-spacerun: yes;"> </span>15<span style="mso-spacerun: yes;">
</span>menitsamapi timbulk gejala-gejala atropinisasi ( muka merah,mulut
kering,takikardi,midriasis,febris dan psikosis).</span></div>
<div class="MsoNormal" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kemudian interval diperpanjang
setiap 15 – 30 -<span style="mso-spacerun: yes;"> </span>60 menit selanjutnya
setiap 2 – 4 –6 – 8 dan 12 jam.</span></div>
<div class="MsoNormal" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pemberian SA dihentikan minimal
setelaj 2 x 24 jam. Penghentian yang mendadak dapat menimbulkan rebound effect
berupa edema paru dan kegagalan pernafasan akut yang sering fatal.</span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: -27pt;">
<span lang="EN-US"> </span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: -27pt;">
<span lang="EN-US"> ASUHAN
KEPERAWATAN.</span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: -27pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 45pt; text-align: justify; text-indent: -36pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pengkajian.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Pengkajian difokusakan padfa masalah yang
mendesak seperti jalan nafas dan sirkulasi yang mengancam jiwa,adanya gangguan
asam basa,keadaan status jantung,status kesadran.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Riwayat kesadaran : riwayat keracunan,bahan
racun yang digunakan,berapa lama diketahui setelah keracunan,ada masalah lain
sebagi pencetus keracunan dan sindroma toksis yang ditimbulkan dan kapan
terjadinya.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-41177725825578225072018-04-05T16:54:00.000+07:002018-04-05T16:57:54.989+07:00ASUHAN KEPERAWATAN KLIEN DENGAN INTOKSIKASI INSEKTISIDA (IFO) <div style="text-align: justify;">
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<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pengertian</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: 18pt;">
<span lang="EN-US">Intoksikasi (keracunan) adalah masuknya zat atau senyawa kimia dalam
tubuh manusia yang menimbulkan efek merugikan pada yang menggunakannya.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Istilah
peptisida pada umumnya dipakai untuk semua bahan yang dipakai manusia untuk
membasmi hama yang merugikan manusia. Termasuk peptisida ini adalah
insektisida. Ada dua macam insektisida<span style="mso-spacerun: yes;">
</span>yang paling banyak digunakan dalam pertanian adalah :</span></div>
<ol start="1" style="margin-top: 0cm; text-align: justify;" type="1">
<li class="MsoNormal"><span lang="EN-US">insektisida hidrokarbo khlorin (IHK = chlorinated hydrocarbon)</span></li>
<li class="MsoNormal"><span lang="EN-US">insektisida fosfat organic (IFO = organo phosphate insecticide).</span></li>
</ol>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: 18pt;">
<span lang="EN-US">Yang<span style="mso-spacerun: yes;"> </span>paling sering digunakan
adalah IFO yang pemakaiannya terus menerus meningkat. Sifat<span style="mso-spacerun: yes;"> </span>- sifat dari IFO adalah insektisida
poten<span style="mso-spacerun: yes;"> </span>yang paling banyak digunakan dalam
pertanian dengan toksisitas yang tinggi. Salah satu derivatnya adalah Tabun dan
Sarin. Bahan ini menembus kulit yang normal (intact), juga dapat diserap di
paru dan saluran makanan, namun tidak berakumulasi dalam jaringan tubuh seperti
halnya golongan IHK.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: 18pt;">
<span lang="EN-US">Macam – macam IFO adalah Malathion (Tolly), Paraathion, Diazinon,
Basudin, Paraoxon dan lain – lain. IFO sebenarnya dibagi 2 macam yaitu IFO
murni dan golongan carbamate. Salah satu contoh golongan carbamate adalah
baygon.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Patogenesis</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: 18pt;">
<span lang="EN-US">IFO bekerja dengan cara menghambat (inaktivasi) enzim
asetilkolinesterase tubuh (KhE). Dalam<span style="mso-spacerun: yes;"> </span>keadaan
normal enzim KhE bekerja untuk menghidrolisis Akh dengan jalan mengadakan
ikatan Akh- KhE yang bersifat inaktif. Bila konsentrasi racun lebih tinggi
ikatan IFO – KhE lebih banyak terjadi. Akibatnya akan terjadi penumpukan AKh di
tempat – tempat tertentu, sehingga timbul gejala – gejala rangsangan AKh yang
berlebihan, yang akan menimbulkan efek muscarinik, nikotinik dan SSP
(menimbulkan stimulasi kemudian depresi SSP). </span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: 18pt;">
<span lang="EN-US">Pada keracunan IFO, ikatan IFO –KhE bersifat menetap (irreversible),
sedangkan pada keracunan carbamate ikatan ini bersifat sementara (reversible).
Secara farmakologis efek AKh dapat dibagi dalan 3 bagian, yaitu :</span></div>
<ol start="1" style="margin-top: 0cm; text-align: justify;" type="1">
<li class="MsoNormal"><span lang="EN-US">Muskarini, terutama pada saluran pencernaan, kelenjar ludah dan
keringat, pupil, bronkus dan jantung.</span></li>
<li class="MsoNormal"><span lang="EN-US">Nikotinik, terutama pada otot – otot skeletal, bola mata,
lidah, kelopak mata dan otot pernapasan.</span></li>
<li class="MsoNormal"><span lang="EN-US">SSP, menimbulkan nyeri kepala, perubahan emosi, kejang – kejang
(konvulsi) sampai koma.</span></li>
</ol>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Gambaran klinik</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Yang paling
menonjol adalah kelainan visus, hiperaktivitas kelenjar ludah, keringat dan
saluran pencernaan, serta kesukaran bernapas. </span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Keracunan ringan
: anoreksia, nyeri kepala, rasa lemah, rasa takut, tremor lidah, kelopak mata,
pupil miosis.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Keracunan sedang
: nausea, muntah – muntah, kejang atau kram perut, hipersaliva, hiperhidrosis,
fasikulasi otot dan bradikardi.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Keracunan berat
: diare, pupil pi – point, reaksi cahaya negatif, sesak napas, sianosis, edema
paru, inkontinensia urine dan feses, konvulsi, koma, blokade jantung, akhirnya
meninggal. </span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pemeriksaan .</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Laboratorik.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Pengukuran kadar KhE dalam sel darah merah dan plasma, penting untuk
memastikan diagosis keracunan IFO akut maupun kronik (menurun sekian % dari
harga normal).</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Keracunan akut :
ringan<span style="mso-spacerun: yes;"> </span>: 40 – 70 %</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US"><span style="mso-spacerun: yes;"> </span>sedang<span style="mso-spacerun: yes;"> </span>: 20 – 40 %</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US"><span style="mso-spacerun: yes;"> </span>berat<span style="mso-spacerun: yes;"> </span>: < 20 %.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Keracunan<span style="mso-spacerun: yes;"> </span>kronik bila kadar
KhE menurun sampai 25<span style="mso-spacerun: yes;"> </span>- 50 %, setiap
individu yang berhubungan dengan insektisida ini harus segera disingkirkan dan
baru diizinkan bekerja kembali bila kadar KhE telah meningkat > 75 % N.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Patologi Anatomi (PA)</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Pada keracunan
akut, hasil pemeriksaan patologi biasanya tidak khas. Sering hanya ditemukan
edema paru, dilatasi kapiler, hiperemi paru, otak dan organ – organ lain. </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Penatalaksanaan</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Resusitasi</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Setelah jalan napas dibebaskan dan dibersihkan, periksa pernapasan
dan nadi. Infus dextrose 5 % kecepatan 15 – 20 tts/mnt, napas buatan + oksigen,
hisap lendir dalam saluran napas, hindari obat – obat depresan saluran napas,
kalau perlu respirator pada kegagalan napas berat. Hindar pernapasan buatan
dari mulut ke mulut sebab racun organofosfat<span style="mso-spacerun: yes;">
</span>akan meracuni<span style="mso-spacerun: yes;"> </span>lewat mulut
penolong. Pernapasan buatan hanya dilakukan dengan meniup face mask atau
menggunakan alat bag – valve – mask.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Eliminasi</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Emesis, merangsang penderita supaya muntah pada penderita yang sadar
atau dengan pemberian sirup ipecac 15 –30 ml. Dapat diulan setelah 20 menit
bila tidak berhasil.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Katarsis (intestinal lavage), dengan pemberian laksans bila diduga
racun telah sampai di usus halus dan tebal. </span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Kumbah lambung (KL atau gastric lavage), pada penderita yang
kesadaran yang menurun,<span style="mso-spacerun: yes;"> </span>atau pada mereka
yang tidak kooperatif. Hasil paling efektif bila KL dikerjakan dalam 4 jam
setelah keracunan.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Keramas rambut dan mandikan seluruh tubuh dengan sabun. </span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Emesis, katarsis dan KL sebaiknya hanya dilakukan bila keracunan
terjadi kurang daari 4 – 6 jam. Pada koma derajat sedang hingga berat<span style="mso-spacerun: yes;"> </span>tindakan KL sebaiknya<span style="mso-spacerun: yes;"> </span>dikerjakan dengan bantuan pemasangan pipa
endotrakeal berbalon, untuk mencegah aspirasi pneumonia.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Antidotum</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Atropin sulfat
(SA) bekerja dengan menghambat efek akumulasi AKh pada tempat penumpukan. </span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Mula –mula diberikan bolus iv 1
– 2,5 mg</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Dilanjutkan dengan 0,5 – 1 mg
setiap 5 – 10 – 15 menit sampai timbul gejala – gejala atropinisasi (muka
merah, mulut kering, takikardi, midriasis, febris, dan psikosis).</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kemudian interval diperpanjang
setiap 15 – 30 – 60 menit, selanjutnya setiap 2 – 4 – 6 – 8<span style="mso-spacerun: yes;"> </span>dan 12 jam</span></div>
<div class="MsoNormal" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pemberian SA dihentikan minimal
setelah 2 X 24 jam. Penghentian yang mendadak dapat menimbulkan rebound effect
berupa edema paru dan kegagalan pernapasan akut yang sering fatal. </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">ASUHAN KEPERAWATAN</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pengkajian</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Pengkajian
difokuskan pada masalah yang mendesak seperti jalan napas dan sirkulasi yang
mengancam jiwa, adaya gangguan asam basa, keadaan status jantung, status
kesadaran. Riwayat kesehatan : riwayat keracunan, bahan racun yang digunakan,
berapa lama<span style="mso-spacerun: yes;"> </span>diketahui setelah keracunan,
ada masalah lain sebagai pencetus keracunan dan sindroma toksis yang ditimbulkan
dan kapan terjadinya.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify;">
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-80453608514810707362018-04-05T16:48:00.000+07:002018-04-05T16:48:59.890+07:00ASUHAN KEPERAWATAN HYALINE MEMBRANE DISEASE – RESPIRATORY DISTRESS SYDROME (RDS) APLIKASI NANDA, NOC, NIC<!--[if gte mso 9]><xml>
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Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 6"/>
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<![endif]--><span style="font-size: small;"></span><br />
<h1 style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: "Baskerville", "serif";"><span>I.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US" style="font-family: "Baskerville", "serif";">DEFINISI</span></span></h1>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">Dikenal juga sebagai respiratory distress
sydrom yang idiopatik, hyaline membrane disease merupakan keaadaan akut yang
terutama ditemukan pada bayi prematur saat lahir atau segera setelah lahir,
lebih sering pada bayi dengan usia gestasi dibawah 32 yang mempunyai berat
dibawah 1500 gram. Kira-kira 60% bayi yang lahir sebelum gestasi 29 minggu
mengalami RDS.</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">Bangunan paru janin dan produksi surfactan
penting untuk fungsi respirasi normal. Bangunan paru dari produksi surfaktan
bervariasi pada masing-masing bayi. Bayi prematur lahir sebelum produksi
surfactan memadai. Surfactan, suatu senyawa lipoprotein yang mengisi alveoli,
mencegah alveolar colaps dan menurunkan kerja respirasi dengan menurunkan
tegangan permukaan. Pada defisiensi surfactan, tegangan permukaan meningkat,
menyebabkan kolapsnya alveolar dan menurunnya komplians paru, yang mana akan
mempengaruhi ventilasi alveolar<span> </span>sehingga
terjadi hipoksemia dan hiperkapnia dengan acidosis respiratory. Reduksi pada
ventilasi akan menyebabkan ventilasi dan perfusi sirkulasi paru menjadi buruk,
menyebabkan keadaan hipoksemia. Hipoksia jaringan dan acidosis metabolik
terjadi berhubungan dengan atelektasis dan kegagalan pernafasan yang progresif.
</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">RDS merupakan penyebab utama kematian dan
kesakitan pada bayi prematur, biasanya setelah 3 – 5 hari. Prognosanya buruk
jika support ventilasi lama diperlukan, kematian bisa terjadi setelah 3 hari
penanganan.</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><h1 style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: "Baskerville", "serif";"><span>II.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="EN-US" style="font-family: "Baskerville", "serif";">ETIOLOGY
DAN FAKTOR PRESIPITASI</span></span></h1>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Prematuritas dengan
paru-paru yang imatur (gestasi dibawah 32 minggu) dan tidak adanya, gangguan
atau defisiensi surfactan</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Bayi prematur yang lahir
dengan operasi caesar</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Penurunan suplay oksigen
saat janin atau saat kelahiran pada bayi matur atau prematur.</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><h1 style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: "Baskerville", "serif";"><span>III.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="EN-US" style="font-family: "Baskerville", "serif";">PENGKAJIAN</span></span></h1>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">Riwayat maternal</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Menderita penyakit
seperti diabetes mellitus</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Kondisi seperti
perdarahan placenta</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Tipe dan lamanya
persalinan</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Stress fetal atau
intrapartus</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">Status infant saat lahir</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Prematur, umur kehamilan</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Apgar score, apakah
terjadi aspiksia</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Bayi prematur yang lahir
melalui operasi caesar</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">Cardiovaskular</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Bradikardi (dibawah 100
x per menit) dengan hipoksemia berat</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Murmur sistolik</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Denyut jantung dalam
batas normal</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">Integumen </span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Pallor yang disebabkan
oleh vasokontriksi periferal</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Pitting edema pada
tangan dan kaki </span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Mottling</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">Neurologis</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Immobilitas, kelemahan,
flaciditas</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Penurunan suhu tubuh</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">Pulmonary</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Takipnea (pernafasan
lebih dari 60 x per menit, mungkin 80 – 100 x )</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Nafas grunting</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Nasal flaring</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Retraksi intercostal,
suprasternal, atau substernal</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Cyanosis (sentral
kemudian diikuti sirkumoral)<span> </span>berhubungan
dengan persentase desaturasi hemoglobin</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Penurunan suara nafas,
crakles, episode apnea</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><h1 style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: "Baskerville", "serif";"><span>IV.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="EN-US" style="font-family: "Baskerville", "serif";">STATUS
BEHAVIORAL</span></span></h1>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Lethargy</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><h1 style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: "Baskerville", "serif";"><span>V.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="EN-US" style="font-family: "Baskerville", "serif";">STUDY
DIAGNOSTIK</span></span></h1>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Seri rontqen dada, untuk
melihat densitas atelektasis dan elevasi diaphragma dengan overdistensi duktus
alveolar</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Bronchogram udara, untuk
menentukan ventilasi jalan nafas.</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">Data laboratorium</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Profil paru, untuk
menentukan maturitas paru, dengan bahan cairan amnion (untuk janin yang
mempunyai predisposisi RDS)</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: Wingdings;"><span>Ø<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Lecitin/Sphingomielin
(L/S) ratio</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">2 : 1 atau lebih
mengindikasikan maturitas paru</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: Wingdings;"><span>Ø<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Phospatidyglicerol :
meningkat saat usia gestasi 35 minggu</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: Wingdings;"><span>Ø<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Tingkat
phosphatydylinositol</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Analisa Gas Darah, PaO2
kurang dari 50 mmHg, PaCO2 kurang dari 60 mmHg, saturasi oksigen 92% - 94%, pH
7,31 – 7,45</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><span>-<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span style="font-family: "Baskerville", "serif";">Level pottasium,
meningkat sebagai hasil dari release potassium dari sel alveolar yang rusak</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><h1 style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: "Baskerville", "serif";"><span>VI.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="EN-US" style="font-family: "Baskerville", "serif";">DIAGNOSA
KEPERAWATAN</span></span></h1>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: "Baskerville", "serif";">Kolaboratif problem : Insufisiensi
respiratory berhubungan dengan penurunan volume dan komplians paru, perfusi
paru dan vintilasi alveolar</span></span></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";">Tujuan 1 : Tanda dan gejala disstres
pernafasan, deviasi dari fungsi dan resiko infant terhadap RDS dapat
teridentifikasi</span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span style="font-family: "Baskerville", "serif";"><b>DOWNLOAD FILE WORD LENGKAP <a href="http://sprysphere.com/9Xmi" target="_blank">KLIK DISINI !</a></b> </span></span></div>
Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-58770054933826788482018-04-05T16:45:00.000+07:002018-04-05T16:45:00.269+07:00ASUHAN KEPERAWATAN PASIEN DENGAN HIV-AIDS APLIKASI NANDA, NOC, NIC<div style="text-align: justify;">
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<span lang="EN-US" style="mso-ansi-language: EN-US;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="mso-ansi-language: EN-US;">Pengertian</span></div>
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<span lang="EN-US" style="mso-ansi-language: EN-US;">AIDS adalah sindroma yang
menunjukkan defisiensi imun seluler pada seseorang tanpa adanya penyebab yang
diketahui untuk dapat menerangkan tejadinya defisiensi, tersebut seperti
keganasan, obat-obat supresi imun, penyakit infeksi yang sudah dikenal dan sebagainya.
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<br /></div>
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<span lang="EN-US" style="mso-ansi-language: EN-US;"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="mso-ansi-language: EN-US;">Etiologi</span></div>
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<span lang="EN-US" style="mso-ansi-language: EN-US;">Penyebab adalah golongan
virus retro yang disebut human immunodeficiency virus (HIV). HIV pertama kali
ditemukan pada tahun 1983 sebagai retrovirus dan disebut HIV-1. Pada tahun 1986
di Afrika ditemukan lagi retrovirus baru yang diberi nama HIV-2. HIV-2 dianggap
sebagai virus kurang pathogen dibandingkaan dengan HIV-1. Maka untuk memudahkan
keduanya disebut HIV.</span></div>
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<span lang="EN-US" style="mso-ansi-language: EN-US;">Transmisi infeksi HIV
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jendela. Lamanya 4 minggu sampai 6 bulan setelah infeksi. Tidak ada
gejala.</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US" style="mso-ansi-language: EN-US;">Fase
infeksi HIV primer akut. Lamanya 1-2 minggu dengan gejala flu likes
illness.</span></li>
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asimtomatik. Lamanya 1-15 atau lebih tahun dengan gejala tidak ada.</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US" style="mso-ansi-language: EN-US;">Supresi
imun simtomatik. Diatas 3 tahun dengan gejala demam, keringat malam hari,
B menurun, diare, neuropati, lemah, rash, limfadenopati, lesi mulut.</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US" style="mso-ansi-language: EN-US;">AIDS.
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ditegakkan. Didapatkan infeksi oportunis berat dan tumor pada berbagai
system tubuh, dan manifestasi neurologist.</span></li>
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<span lang="EN-US" style="mso-ansi-language: EN-US;">AIDS dapat menyerang
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resiko tinggi adalah :</span></div>
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<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US" style="mso-ansi-language: EN-US;">Lelaki
homoseksual atau biseks.<span style="mso-spacerun: yes;"> </span></span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US" style="mso-ansi-language: EN-US;">Orang
yang ketagian obat intravena</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US" style="mso-ansi-language: EN-US;">Partner
seks dari penderita AIDS</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US" style="mso-ansi-language: EN-US;">Penerima
darah atau produk darah (transfusi).</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US" style="mso-ansi-language: EN-US;"><span lang="EN-US" style="mso-ansi-language: EN-US;"><span style="mso-spacerun: yes;"> </span>Bayi dari ibu/bapak terinfeksi.</span> </span></li>
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<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><b>DOWNLOAD FILE WORD LENGKAP <a href="http://sprysphere.com/9XFL" target="_blank">KLIK DISINI !</a></b><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-12581709878913934012018-04-05T16:18:00.003+07:002018-04-05T16:18:44.149+07:00ASUHAN KEPERAWATAN DIARE APLIKASI NANDA, NOC, NIC<div style="text-align: justify;">
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<span lang="EN-US"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">KONSEP DASAR</span></div>
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<div class="MsoNormal" style="line-height: normal; margin-left: 36pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pengertian</span></div>
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<span lang="EN-US">Diare adalah pengeluaran tinja yang tidak normal atau cair
(Hipocrates)</span></div>
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<span lang="EN-US">Diare adalah buang air besar yang tida nomral dan cair, dengan
frekuensi lebih banyak dari biasanya (Neonatus > 4 kali dan bayi-anak > 3
kali dalam sehari) (Lab IKA FKUI, 1988).</span></div>
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<span lang="EN-US"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Etiologi</span></div>
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<span lang="EN-US">Penyebab diare (Lab IKA FKUA, 1984)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Infeksi</span></div>
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<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Bakteri <span style="mso-tab-count: 1;"> </span>: Vibrio,
entamoeba coli, salmonella, shigela</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Virus <span style="mso-tab-count: 1;"> </span>: enterovorus,
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Parasit <span style="mso-tab-count: 1;"> </span>: cacing,
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<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
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alat pencernaan ( ISPA, saluran kemih dan OMA)</span></div>
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<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Malabsorbsi</span></div>
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<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
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<div class="MsoNormal" style="line-height: normal; margin-left: 36pt; text-indent: 18pt;">
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 5"/>
<w:LsdException Locked="false" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Closing"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Default Paragraph Font"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
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<div class="WordSection1">
<div class="MsoNormal" style="line-height: normal;">
<span lang="EN-US">E. Derajat
Dehidrasi (Lab IKA FKUI, 1988)</span></div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;"><span lang="EN-US">Kehilangan berat badan</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; mso-list: l2 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">2,5 % tidak ada dehidrasi</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; mso-list: l2 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">2,5-5% Dehidrasi ringan</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; mso-list: l2 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">5-10 % dehidrasi sedang</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; mso-list: l2 level2 lfo2; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">> 10% dehidrasi berat</span></div>
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
<ol start="2" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l2 level1 lfo2; tab-stops: list 36.0pt;"><span lang="EN-US">Skor Maurice King</span></li>
</ol>
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 41.4pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; page-break-inside: avoid;">
<td style="border-bottom: none; border: solid windowtext 1.0pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 108.0pt;" valign="top" width="144">
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Bagian Tubuh</span></div>
</td>
<td colspan="3" style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 329.15pt;" valign="top" width="439">
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">N I L A I</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 108.0pt;" valign="top" width="144">
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Yang Diperiksa</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: 0cm 5.4pt 0cm 5.4pt; width: 89.85pt;" valign="top" width="120">
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">0</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: 0cm 5.4pt 0cm 5.4pt; width: 119.65pt;" valign="top" width="160">
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">1</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: 0cm 5.4pt 0cm 5.4pt; width: 119.65pt;" valign="top" width="160">
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">2</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 108.0pt;" valign="top" width="144">
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Keadaan Umum</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Turgor</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Mata</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">UUB</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Mulut</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Denyut Nadi</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: 0cm 5.4pt 0cm 5.4pt; width: 89.85pt;" valign="top" width="120">
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Sehat</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Normal</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Nomral</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Normal</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Normal</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Kuat</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">< 120</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: 0cm 5.4pt 0cm 5.4pt; width: 119.65pt;" valign="top" width="160">
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Gelisah cengeng, apatis, ngantuk</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Sedikit, kurang</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Sedikit cekung</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Sedikit cekung</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Kering</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Sedang</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">(120-140)</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: 0cm 5.4pt 0cm 5.4pt; width: 119.65pt;" valign="top" width="160">
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Mengigau, koma/syok</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Sangat kurang</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Sangat cekung</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Sangat cekung</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Kering, sianosis</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">Lemah</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<span lang="EN-US">> 140</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; text-indent: 36.0pt;">
<span lang="EN-US">KETERANGAN :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 72.0pt; mso-list: l0 level1 lfo3; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Skor : </span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 108.0pt; mso-list: l0 level2 lfo3; tab-stops: list 90.0pt; text-indent: -36.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">0-2 dehidrasi ringan</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 108.0pt; mso-list: l0 level2 lfo3; tab-stops: list 90.0pt; text-indent: -36.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">3-6 dehidrasi sedang</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 108.0pt; mso-list: l0 level2 lfo3; tab-stops: list 90.0pt; text-indent: -36.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">7-12 Dehidrasi berat</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 72.0pt; mso-list: l0 level1 lfo3; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Pada anak-anak Ubun Ubun Besar sudah menutup</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 72.0pt; mso-list: l0 level1 lfo3; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Untu k kekenyalan kulit :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; text-indent: 18.0pt;">
<span lang="EN-US">-<span style="mso-spacerun: yes;"> </span>1 detik <span style="mso-tab-count: 1;"> </span>: dehidrasi ringan</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; text-indent: 18.0pt;">
<span lang="EN-US">-<span style="mso-spacerun: yes;"> </span>1-2 detik<span style="mso-tab-count: 1;"> </span>: dehidrasi sedang</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; text-indent: 18.0pt;">
<span lang="EN-US">-<span style="mso-spacerun: yes;"> </span>> 2 detik
<span style="mso-tab-count: 1;"> </span>: dehidrasi berat</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; text-indent: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; text-indent: 18.0pt;">
<br /></div>
</div>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; mso-list: l1 level1 lfo1; text-indent: -36.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">PENGKAJIAN</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Identitas</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<span lang="EN-US">Diare akut lebih sering terjadi pada bayi dari pada anak, frekuensi
diare untuk neonatus > 4 kali/hari sedangkan untuk anak > 3 kali/hari
dalam sehari. Status ekonomi yang rendah merupakan salah satu faktor yang dapat
mempengaruhi terjadinya diare pada nak ditinjau dari pola makan, kebersihan dan
perawatan. Tingkat pengetahuan perlu dikaji untuk mengetahui tingkat perlaku
kesehatan dan komunikasi dalam pengumpulan data melalui wawancara atau
interview. Alamat berhubungan dengan epidemiologi (tempat, waktu dan orang) (
Lab. FKUI, 1988).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Keluhan utama</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<span lang="EN-US">Keluhan yang membuat klien dibawa ke rumah sakit. Manifestasi klnis
berupa BAB yang tidaknomral/cair lebih banyak dari biasanya (LAN IKA, FKUA,
1984)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Riwayat Penyakit Sekarang</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<span lang="EN-US">Paliatif, apakah yang menyebabkan gejala diare dan apa yang telah
dilakukan. Diare dapat disebabkan oleh karena infeksi, malabsorbsi, faktor
makanan dan faktor psikologis.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<span lang="EN-US">Kuatitatif, gejala yang dirasakan akibat diare bisanya berak lebih
dari 3 kali dalam sehari dengan atau tanpa darah atau lendir, mules, muntak.
Kualitas, Bab konsistensi, awitan, badan terasa lemah, sehingga mengganggu
aktivitas sehari-hari .</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<span lang="EN-US">Regonal,perut teras mules, anus terasa basah.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<span lang="EN-US">Skala/keparahan, kondisi lemah dapat menurunkan daya tahan tubuh dan
aktivitas sehari-hari.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<span lang="EN-US">Timing, gejala diare ini dapat terjadi secara mendadak yang terjadi
karena<span style="mso-spacerun: yes;"> </span>infeksi atau faktor lain, lamanya
untuk diare akut 3-5 hari, diare berkepanjangan > 7 hari dan Diare kronis
> 14 hari (Lab IKA FKUA, 1984)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Riwayat Penyakit sebelumnya</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<span lang="EN-US">Infeksi parenteral seperti ISPA, Infeksi Saluran kemih, OMA (Otitis
Media Acut) merupakan faktor predisposisi terjadinya diare (Lab IKA FKUA, 1984)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Riwayat Prenatal, Natal dan
Postnatal</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; mso-list: l1 level3 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Prenatal</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt;">
<span lang="EN-US">Pengaruh konsumsi jamu-jamuan terutamma pada kehamilan semester
pertama, penyakti selama kehamilan yang menyertai seperti TORCH, DM,
Hipertiroid yang dapat mempengaruhi pertunbuhan dan perkembangan janin di dalam
rahim.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; mso-list: l1 level3 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Natal</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt;">
<span lang="EN-US">Umur kehamilan, persalinan dengan bantuan alat yangdapat
mempengaruhi fungsi dan maturitas organ vital .</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; mso-list: l1 level3 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Post Natal</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt;">
<span lang="EN-US">Apgar skor < 6 berhubungan dengan asfiksia, resusitasi atau
hiperbilirubinemia. BErat badan dan panjang badan untuk mengikuti pertumbuhan
dan perkembangan anak pada usia sekelompoknya. Pemberian ASI dan PASI terhadap
perkembangan daya tahan tubuh alami dan imunisasi buatan yang dapat mengurangi
pengaruh infeksi pada tubuh.</span></div>
<div class="MsoNormal" style="line-height: normal;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 36.0pt; mso-list: l1 level2 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Riwayat Pertumbuhan dan
Perkembangan</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt;">
<span lang="EN-US">Pertumbuhan dan perkembangan menjadi bahan pertimbangan yang penting
karena setiap individu mempunyai ciri-ciri<span style="mso-spacerun: yes;">
</span>struktur dan fungsi yang berbeda, sehingga pendekatan pengkajian fisik
dan tindakan haruys disesuaikan dengan pertumbuhan dan perkembangan (Robert
Priharjo, 1995)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US"> </span><span lang="EN-US"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-left: 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><b>DOWNLOAD FILE WORD LENGKAP <a href="http://sprysphere.com/9TvA" target="_blank">KLIK DISINI !</a></b> </span></div>
Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-11377887350062298332018-04-05T06:35:00.000+07:002018-04-05T16:06:23.763+07:00ASUHAN KEPERAWATAN GAGAL NAFAS<div style="text-align: justify;">
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<h2 style="line-height: 150%;">
<span style="font-size: small;"><span lang="EN-US">A.<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span lang="EN-US">Pengertian</span></span></h2>
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<span style="font-size: small;">Kegagalan pernafasan adalah pertukaran gas yang tidak adekuat sehingga
terjadi hipoksia, hiperkapnia (peningkatan konsentrasi karbon dioksida arteri),
dan asidosis.</span></div>
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<span style="font-size: small;">Ventilator adalah suatu alat yang digunakan untuk membantu sebagian atau
seluruh proses ventilasi untuk mempetahankan oksigenasi.</span></div>
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<br /></div>
<h2 style="line-height: 150%;">
<span style="font-size: small;"><span lang="EN-US">B.<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span lang="EN-US">Penyebab gagal nafas</span></span></h2>
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<li class="MsoNormal" style="line-height: 150%;"><span style="font-size: small;">Trauma kepala :
contusio cerebri</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span style="font-size: small;">Radang otak :
encephalitis</span></li>
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narkotika, anestesi</span></li>
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iga/thoraks: fraktur costae, pneumo thorax, haematothoraks</span></li>
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jantung : kegagalan jantung kiri</span></li>
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<span style="font-size: small;"><span lang="EN-US">C.<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span lang="EN-US">Patofisiologi</span></span></h2>
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<span style="font-size: small;">Pada pernafasan spontan inspirasi terjadi karena
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terjadi tekanan negatif sehingga aliran udara masuk ke paru, sedangkan fase
ekspirasi berjalan secara pasif .</span></div>
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<span style="font-size: small;">Pada pernafasan dengan ventilasi mekanik, ventilator mengirimkan udara
dengan memompakan ke paru pasien, sehingga tekanan selama inspirasi adalah
positif dan menyebabkan tekanan intra thorakal meningkat. Pada akhir inspirasi
tekanan dalam rongga thoraks paling positif. </span></div>
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="0" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="35" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="0" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="0" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
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<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
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<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
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<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
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<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
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<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
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<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
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<w:LsdException Locked="false" Priority="19" QFormat="true"
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<w:LsdException Locked="false" Priority="21" QFormat="true"
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<w:LsdException Locked="false" Priority="31" QFormat="true"
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<w:LsdException Locked="false" Priority="32" QFormat="true"
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<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
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<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
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<span style="font-size: small;"><span lang="EN-US" style="font-weight: normal;">A.<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span lang="EN-US">Pemeriksaan Fisik</span><span lang="EN-US" style="font-weight: normal;"></span></span></h2>
<span style="font-size: small;">
</span><br />
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<span style="font-size: small;">( Menurut pengumpulan data dasar oleh Doengoes)</span></div>
<span style="font-size: small;">
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-indent: -36pt;">
1.<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span>Sirkulasi</div>
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Tanda : Takikardia, irama ireguler</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
S3S4/Irama gallop </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt;">
Daerah PMI bergeser ke daerah mediastinal</div>
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Hamman’s sign (bynui udara beriringan dengan
denyut jantung menandakan udara di mediastinum)</div>
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TD : hipertensi/hipotensi</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-indent: -18pt;">
2.<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span>Nyeri/Kenyamanan</div>
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Tanda :
Melindungi bagian nyeri, perilaku distraksi, ekspresi meringis</div>
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3.<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span>Pernapasan</div>
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Gejala
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paru kronis, inflamasi paru , keganasan, “lapar udara”, batuk</div>
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Tanda : takipnea, peningkatan kerja pernapasan,
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perkusi : hiperesonan di atas area berisi udara (pneumotorak), dullnes di area
berisi cairan (hemotorak); perkusi : pergerakan dada tidak seimbang, reduksi
ekskursi thorak. Kulit : cyanosis, pucat, krepitasi sub kutan; mental: cemas,
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5. Penyuluhan/pembelajaran</div>
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Gejala : riwayat faktor resiko
keluarga dengan tuberkulosis, kanker </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 63pt; text-indent: -45pt;">
</div>
<h2 style="line-height: 150%;">
<span lang="EN-US">B.<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span lang="EN-US">Pemeriksaan Diagnostik</span></h2>
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- Hb : dibawah 12 gr %</div>
<div class="MsoNormal" style="line-height: 150%;">
- Analisa gas darah : </div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 117pt; text-indent: -81pt;">
<span style="font-family: "wingdings";">Ø<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span>pH dibawah 7,35 atau di atas 7,45</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 117pt; text-indent: -81pt;">
<span style="font-family: "wingdings";">Ø<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span>paO2 di bawah 80 atau di atas 100 mmHg</div>
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<span style="font-family: "wingdings";">Ø<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span>pCO2 di bawah 35 atau di atas 45 mmHg</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 117pt; text-indent: -81pt;">
<span style="font-family: "wingdings";">Ø<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span>BE di bawah -2 atau di atas +2</div>
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-<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span>Saturasi O2
kurang dari 90 %</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72pt; text-indent: -72pt;">
-<span style="font-family: "times new roman"; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span>Ro” :
terdapat gambaran akumulasi udara/cairan , dapat terlihat perpindahan letak
mediastinum</div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72pt; text-indent: -72pt;">
<b>DOWNLOAD FILE WORD LENGKAP <a href="http://sprysphere.com/8WVw" target="_blank">KLIK DISINI!</a></b> </div>
</span><br />
<div style="text-align: justify;">
</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-75726846679560321232018-04-05T06:31:00.000+07:002018-04-05T06:31:02.466+07:00ASUHAN KEPERAWATAN EMPIEMA <div style="text-align: justify;">
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<div class="WordSection1" style="text-align: justify;">
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt; text-indent: -27pt;">
<b><span lang="EN-US"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US">Pengertian.</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;"><span style="font: 7.0pt "Times New Roman";"></span></span></span><span lang="EN-US">Empiema adalah keadaan terkumpulnya nanah ( pus ) didalam ronggga
pleura dapat setempat atau mengisi seluruh rongga pleura( Ngastiyah,1997).</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;"><span style="font: 7.0pt "Times New Roman";"></span></span></span><span lang="EN-US">Empiema adalah<span style="mso-spacerun: yes;"> </span>penumpukan
cairan terinfeksi atau pus pada cavitas pleura ( Diane C. Baughman, 2000 ).</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;"><span style="font: 7.0pt "Times New Roman";"></span></span></span><span lang="EN-US">Empiema adalah penumpukan materi purulen pada areal pleural (
Hudak<span style="mso-spacerun: yes;"> </span>& Gallo, 1997 )</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45pt; text-indent: -18pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt; text-indent: -27pt;">
<b><span lang="EN-US"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US">Penyebab.</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;"><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Stapilococcus</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;"><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Pnemococcus</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45pt; text-indent: -18pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;"><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Streptococcus.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 45pt; text-indent: -18pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt; text-indent: -27pt;">
<b><span lang="EN-US"><span style="mso-list: Ignore;">III.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US">Patogenesis.</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -27pt;">
<span lang="EN-US">Terjadinya empiema dapat melalui tiga jalur:</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Sebagai komplikasi
pneumoni<span style="mso-spacerun: yes;"> </span>dan abses paru. Karena kuman
menjalar perkontiniutatum dan menembus pleura visceral .</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Secara hematogen, kuman dari
focus lain sampai pada pleura visceral</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Infeksi darti luar dinding
thoraks yang menjalar kedalam pleura misalnya pada trauma thoraks, abses
dinding thoraks.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt; text-indent: -27pt;">
<b><span lang="EN-US"><span style="mso-list: Ignore;">IV.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US">Manisfestasi Klinik.</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt;">
<span lang="EN-US">Demam, berkeringat malam, nyeri pleural, dispneu, arokreksia ,dan
penurunan berat badan.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt;">
<span lang="EN-US">Tidak terdapatnya bunyi nafas; pendataran pada perkusi dada,<span style="mso-spacerun: yes;"> </span>penurunan premitus</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt; text-indent: -27pt;">
<b><span lang="EN-US"><span style="mso-list: Ignore;">V.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US">Evaluasi Diagnosis </span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -27pt;">
<span lang="EN-US">Foto dada dan thoraksintesis.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54pt; text-indent: -27pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt; text-indent: -27pt;">
<b><span lang="EN-US"><span style="mso-list: Ignore;">VI.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US">Komplikasi.</span></b></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<span lang="EN-US">Perubahan
Fibrotik yang tidak dapat sembuh yang menggangu ventilasi paru yang disebabkan
terjebaknya paru pada sisi yang terkena.</span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt; text-indent: -27pt;">
<b><span lang="EN-US"><span style="mso-list: Ignore;">VII.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US">Penatalaksanaan (Medik).</span></b></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%;">
<span lang="EN-US">Sasaran
penetalaksanaan adalah mengaliran cavitas pleura hingga mencapai ekspansi paru
yang optimal. Dicapai dengan drainase yang adekuat, anti biaotika<span style="mso-spacerun: yes;"></span>(dosis besar )
dan atau streptokinase. Drainase cairan pleura atau pus tergantung pada tahapan
penyakit dengan :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Aspirasi jarum ( Thorasintesis
),jika cairan tidak terlalu kental</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Drainase tertutup dengan WSD,
indikasi bila nanah sangat kental, pnemothoraks</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Drainase dada terbuka untuk
mengeluarkan pus pleural yang mengental dan debris serta mesekresi jaringan
pulmonal yang mendasari penyakit.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Dekortikasi, jika imflamasi
telah bertahan lama.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27pt; text-indent: -27pt;">
<b><span lang="EN-US"><span style="mso-list: Ignore;">VIII.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="EN-US">Intervensi Keperawatan. </span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Perawatan pada umumnya sama dengan<span style="mso-spacerun: yes;"> </span>pasien pleuritis,<span style="mso-spacerun: yes;"> </span>bila dilakukan fungsi plera atau dipasang WSD
cara menolong tidak berbeda. Bila penyebab adalah kuman TBC maka, setelah
empiema sembuh pasien perlu pengobatan TB.<span style="mso-spacerun: yes;">
</span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Bantu pasien mengatasi kondisi,
instruksi dalam latihan pernafasan (pernafasan bibir dan pernafasan
diagpragmatik )</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.85pt; text-indent: -19.85pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Berikan perawatan spesifik
terhadap metoda drainase pleural.<span style="mso-tab-count: 1;"> </span></span></div>
</div>
<div style="text-align: justify;">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"></span><br clear="all" style="mso-break-type: section-break; page-break-before: always;" /><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">
</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<b><span lang="EN-US">ASUHAN KEPERAWATAN
PADA PASIEN DENGAN EMPIEMA .</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<b><i><span lang="EN-US">Dasar data pengkajian.</span></i></b></div>
<ul style="margin-top: 0cm; text-align: justify;" type="circle">
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Aktivitas<span style="mso-spacerun: yes;"> </span>/ istirahat.</span><span lang="EN-US"> </span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Gejala ; keletihan, kelemahan, malaise.</span>
</li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify;">
<span lang="EN-US"><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>Ketidakmampuan melakukan<span style="mso-spacerun: yes;">
</span>ADL karena sulit bernapas.<span style="mso-tab-count: 1;"> </span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify;">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span>Ketidakmampuan
untuk tidur.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify;">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span>Dispneu pada saat
istirahat.</span></div>
<ul style="margin-top: 0cm; text-align: justify;" type="circle">
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Sirkulasi ;<span style="mso-spacerun: yes;"> </span>pembengkakan pada ekstremitas bawah.</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US"><span style="mso-spacerun: yes;"> </span>Integritas ego;<span style="mso-spacerun: yes;"> </span>peningkatan factor resiko, perubahan
pola hidup.</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Makanan/cairan ;<span style="mso-spacerun: yes;"> </span>mual muntah<span style="mso-spacerun: yes;"> </span>nafsu makan menurun .</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Higiene ;<span style="mso-spacerun: yes;"> </span>penurunan kemampuan melakukan ADL.</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Pernafasan ;<span style="mso-spacerun: yes;"> </span>nafas pendek batuk menetap dengan
produksi sputum, riwayat pneumoni berulang ,<span style="mso-spacerun: yes;"> </span>episode batuk hilang timbul.</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Keamanan. ;<span style="mso-spacerun: yes;"> </span>riwayat reaksi alergi atau sensitive
terhadap zat / factor lingkungan.</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Seksualitas. ; penurunan libido.</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Interaksi social ; hubungan
ketergantungan,<span style="mso-spacerun: yes;"> </span>kurang sistem
pendukung,<span style="mso-spacerun: yes;"> </span>penyakit lama.</span></li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<b><i><span lang="EN-US">Prioritas Keperawatan.</span></i></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 99pt; text-align: justify; text-indent: -81pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font-family: "Times New Roman", "serif";"> </span></span></span><span lang="EN-US">Mempertahankan patensi jalan
nafas</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 99pt; text-align: justify; text-indent: -81pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Membantu tindakan untuk
mempermudah pertukaran gas.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 99pt; text-align: justify; text-indent: -81pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Meningkatkan masukan nutrisi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 99pt; text-align: justify; text-indent: -81pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Mencegah komplikasi,
memperlambat memburuknya kondisi</span><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 99pt; text-align: justify; text-indent: -81pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">5. Memberikan informasi tentang proses penyakit /
prognosis dan program pengobatan.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 99pt; text-align: justify; text-indent: -81pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 99pt; text-align: justify; text-indent: -81pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><b>DOWNLOAD FILE WORD LENGKAP <a href="http://sprysphere.com/8WHk" target="_blank">KLIK DISINI!</a></b> </span></div>
<div style="text-align: justify;">
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-53537236485936021892018-04-05T06:26:00.000+07:002018-04-05T06:26:09.304+07:00ASUHAN KEPERAWATAN EFFUSI PLEURA AKIBAT MALIGNANCY <div style="text-align: justify;">
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<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pengertian </span>
<div class="MsoNormal" style="text-align: justify; text-indent: 18pt;">
<span lang="EN-US">Effusi Pleura
adalah : Kumpulan cairan dalam rongga pleura yaitu anatara pleura parietalis
dan pleura viceralis yang berupa cairan transudat atau eksudat (Lab UPF Ilmu
Penyakit Paru FK Unair RSUD Dr. Soetomo Surabaya, 1994 : 3). </span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 18pt;">
<br /></div>
<h4 style="margin-left: 0cm; text-align: justify;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Faktor Penyebab</span></h4>
<div class="MsoNormal" style="text-align: justify; text-indent: 18pt;">
<span lang="EN-US">Menurut asalnya
cairan yang terkumpul dalam rongga pleura ada dua yaitu : berasal dari paru
sendiri yang disebut eksudat dan cairan yang berasal dari luar paru yang
disebut transudat. Adapun penyebab<span style="mso-spacerun: yes;">
</span>adanya cairan eksudat antara lain :</span></div>
<div class="MsoNormal" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Infeksi : Tuberkolosa Pneumonia</span></div>
<div class="MsoNormal" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Tumor</span></div>
<div class="MsoNormal" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Infark Paru</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Sedangkan penyebab adanya cairan transudat
antara lain : </span></div>
<div class="MsoNormal" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kegagalan jantung kognetif</span></div>
<div class="MsoNormal" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Asites</span></div>
<div class="MsoNormal" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Vena kava superior Syndrom</span></div>
<div class="MsoNormal" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Tumor</span></div>
<h4 style="margin-left: 0cm; text-align: justify;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Patofisiologi </span></h4>
<div class="MsoNormal" style="text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Dalam
keadaan<span style="mso-spacerun: yes;"> </span>normal tidak ada rongga kosong
antara pleura parietalis dan pleura vicelaris, karena di antara<span style="mso-spacerun: yes;"> </span>pleura tersebut terdapat cairan antara 1 – 20
cc yang<span style="mso-spacerun: yes;"> </span>merupakan lapisan tipis serosa
dan selalu bergerak teratur.Cairan yang sedikit ini merupakan pelumas antara
kedua pleura, sehingga pleura tersebut mudah bergeser satu sama lain. Di
ketahui bahwa cairan di produksi oleh pleura parietalis dan selanjutnya di
absorbsi tersebut dapat terjadi karena adanya tekanan hidrostatik pada pleura
parietalis dan tekanan osmotic koloid<span style="mso-spacerun: yes;">
</span>pada pleura viceralis. Cairan kebanyakan diabsorbsi oleh system limfatik
dan hanya sebagian kecil diabsorbsi oleh system kapiler pulmonal. Hal yang
memudahkan penyerapan cairan yang pada pleura viscelaris adalah terdapatnya
banyak mikrovili disekitar sel – sel mesofelial. Jumlah cairan dalam rongga
pleura tetap. Karena adanya keseimbangan antara produksi dan absorbsi. Keadan
ini bisa terjadi karena adanya tekanan hidrostatik sebesar 9 cm H<sub>2</sub>o
dan tekanan osmotic koloid sebesar 10 cm H<sub>2</sub>o. Keseimbangan tersebut
dapat terganggu oleh beberapa hal, salah satunya adalah infeksi tuberkulosa
paru. </span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Terjadi infeksi
tuberkulosa paru, yang pertama basil Mikobakterium tuberkulosa masuk melalui
saluran nafas menuju alveoli,terjadilah infeksi primer. Dari infeksi primer ini
akan timbul peradangan saluran getah bening menuju hilus (Limfangitis local)
dan juga diikuti dengan pembesaran kelenjar getah bening hilus (limphadinitis
regional). Peradangan pada saluran getah bening akan mempengaruhi permebilitas
membran. Permebilitas membran akan meningkat yang akhirnya dapat menimbulkan
akumulasi cairan dalam rongga pleura. Kebanyakan terjadinya effusi<span style="mso-spacerun: yes;"> </span>pleura akibat dari tuberkulosa paru melalui
focus subpleura yang robek atau melalui aliran getah bening. Sebab lain<span style="mso-spacerun: yes;"> </span>dapat juga dari robeknya pengkejuan kearah
saluran getah bening yang menuju<span style="mso-spacerun: yes;"> </span>rongga
pleura, iga<span style="mso-spacerun: yes;"> </span>atau columna vetebralis.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Adapun bentuk<span style="mso-spacerun: yes;"> </span>cairan effusi akibat tuberkolusa paru adalah
merupakan eksudat, yaitu<span style="mso-spacerun: yes;"> </span>berisi protein
yang terdapat pada cairan pleura tersebut karena kegagalan aliran protein getah
bening. Cairan ini biasanya serous, kadang – kadang bisa juga hemarogik. Dalam
setiap ml cairan pleura bias<span style="mso-spacerun: yes;"> </span>mengandung
leukosit antara 500 – 2000. Mula – mula yang dominan adalah sel – sel
polimorfonuklear, tapi kemudian sel limfosit, Cairan effusi sangat sedikit
mengandung kuman tubukolusa. Timbulnya cairan effusi bukanlah karena adanya
bakteri tubukolosis, tapi karena akibat adanya effusi pleura dapat menimbulkan
beberapa perubahan fisik antara lain : Irama pernapasan tidak teratur, frekwensi
pernapasan meningkat , pergerakan dada asimetris, dada yanbg lebih cembung,
fremitus raba melemah, perkusi redup. Selain hal – hal diatas ada perubahan
lain yang ditimbulkan oleh effusi pleura yang diakibatkan infeksi tuberkolosa
paru yaitu peningkatan suhu, batuk dan berat badan menurun.</span></div>
<h4 style="margin-left: 0cm; text-align: justify;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Diagnosis</span></h4>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Klinis.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Cairan pleura
yang kurang dari 300 cc tidak meberi tanda – tanda fisik yang nyata. Bila lebih
dari 500 cc akan memberikan kelainan pada pemeriksaan fisik seperti penurunan
pergerakan hemithoraks yang sakit, fremitus suara dan suara napas melemah..
Cairan pleura yang lebih dari 1000 cc dapat menyebabkan dada cembung dan
egofoni (dengan syarat cairan tidak memenuhi seluruh rongga pleura). Cairan
yang lebih dari 2000 cc : Suara napas melemah atau menurun (mungkin menghilang
sama sekali) dan mediastinum terdorong ke arah paru yang sehat.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Radiologi</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Cairan yang
kurang dari 300 cc, pada fluoskopi maupun foto thoraks PA tidak tampak. Mungkin
kelainan yang nampak hanya berupa penumpukan sinus kontofrenikus. Pada effusi
pleura subpulmonal , meskipun cairan pleura lebih dari 300 cc, sinus
kontofrenikus tidak tampat tumpul tetapi diafragma kelihatan meninggi. Untuk
memastikan dapat dilakukan dengan membuat foto dada lateral dari sisi dada yang
sakit.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Foto thoraks PA
dan possi lateral dekubitus pada sisi yang sakit sering memberikan hasil yang
memuaskan<span style="mso-spacerun: yes;"> </span>bila cairan pleura sedikit,
atau cairan subpulmonal yaitu nampak garis batas cairan yang sejajar dengan
kolumna vertebralis atau berupa garis horisontal.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<br /></div>
<h4 style="margin-left: 0cm; text-align: justify;">
<span lang="EN-US"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pengelolaan </span></h4>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Pengelolaan efusi pleuran ditujuhkan pada
pengobatan penyakit dasar dan pengosongan cairan (Torasentesis)</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Indikasi untuk melakukan torasentesis
adalah :</span></div>
<ol start="1" style="margin-top: 0cm; text-align: justify;" type="a">
<li class="MsoNormal"><span lang="EN-US">Menghilangkan sesak napas yang disebabkan oleh akumulasi cairan
dalam rongga plera.</span></li>
<li class="MsoNormal"><span lang="EN-US">Bila therapi spesifik pada penyakit prmer tidak efektif atau
gagal.</span></li>
<li class="MsoNormal"><span lang="EN-US">Bila terjadi reakumulasi cairan.</span></li>
</ol>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Pengambilan pertama cairan pleura jangan
lebih dari 1000 cc, karena pengambilan cairan pleura dalam waktu singkat dan
dalam jumlah yang banyak dapat menimbulkan oedema paru yang ditandai dengan
batuk dan sesak.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Kerugian :</span></div>
<ol start="1" style="margin-top: 0cm; text-align: justify;" type="a">
<li class="MsoNormal"><span lang="EN-US">Tindakan thoraksentesis menyebabkan kehilangan protein yang
berada dalam cairan pleura.</span></li>
<li class="MsoNormal"><span lang="EN-US">Dapat menimbulkan infeksi di rongga pleura.</span></li>
<li class="MsoNormal"><span lang="EN-US">Dapat terjadi pneumothoraks. </span></li>
</ol>
<span lang="EN-US"><b>ASUHAN KEPERAWATAN</b></span>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">I. Pengkajian </span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Riwayat<span style="mso-spacerun: yes;"> </span>Keperawatan</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Keluhan utama :
Adanya sesak napas yang dirasakan semakin berat disamping itu disertai nyeri
dada yang semakin berat saat inspirasi dan saat miring ke sisi yang sakit.</span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US"><b>DOWNLOAD FILE WORD LENGKAP <a href="http://sprysphere.com/8Vxs" target="_blank">KLIK DISINI !</a></b> </span></div>
<div style="text-align: justify;">
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-79651970215399327742018-04-05T06:23:00.002+07:002018-04-05T06:23:24.587+07:00ASUHAN KEPERAWATAN DIARE<div style="text-align: justify;">
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="19" QFormat="true"
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<w:LsdException Locked="false" Priority="31" QFormat="true"
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<w:LsdException Locked="false" Priority="32" QFormat="true"
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<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
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<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
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<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
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<w:LsdException Locked="false" Priority="52"
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<w:LsdException Locked="false" Priority="46"
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<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
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<div class="MsoNormal" style="margin-left: 27pt; text-align: justify;">
<b><span lang="EN-US">KONSEP MEDIS</span></b></div>
<div class="MsoNormal" style="margin-left: 27pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 27pt; text-align: justify;">
<b><span lang="EN-US">Pengertian</span></b></div>
<div class="MsoNormal" style="margin-left: 26.95pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Diare adalah buang air besar (defekasi) dengan tinja berbentuk
cairan atau setengah cairan, dengan demikian kandungan air pada tinja lebih
banyak dari keadaan normal yakni 100-200 ml/sekali defekasi (Hendarwanto,
1999).</span></div>
<div class="MsoNormal" style="margin-left: 27pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Menurut WHO (1980) diare adalah buang air besar encer atau cair
lebih dari tiga kali sehari. Diare akut adalah diare yang awalnya mendadak dan
berlangsung singkat dalam beberapa jam atau beberapa hari. </span></div>
<div class="MsoNormal" style="margin-left: 27pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 27pt; text-align: justify;">
<b><span lang="EN-US">Penyebab</span></b></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Diare akut
karena infeksi (gastroenteritis) dapat ditimbulkan oleh:</span></div>
<div class="MsoNormal" style="margin-left: 99pt; text-align: justify; text-indent: -72.05pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Bakteri <span style="mso-tab-count: 1;"> </span>:<span style="mso-tab-count: 1;"> </span>Escherichia coli,
Salmonella typhi, Salmonella para typhi A/B/C, Shigella dysentriae, Shigella
flexneri, Vivrio cholera, Vibrio eltor, Vibrio parahemolyticus, Clostridium perfrigens,
Campilobacter (Helicobacter) jejuni, Staphylococcus sp, Streptococcus sp,
Yersinia intestinalis, Coccidiosis.</span></div>
<div class="MsoNormal" style="margin-left: 99pt; text-align: justify; text-indent: -72.05pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Parasit<span style="mso-tab-count: 1;"> </span>:<span style="mso-tab-count: 1;"> </span>Protozoa (Entamoeba
hystolitica, Giardia lamblia, Trichomonas hominis, Isospora sp) dan Cacing ( A.
lumbricodes, A. duodenale, N. americanus, T. trichiura, O. velmicularis, S.
stercoralis, T. saginata dan T. solium)</span></div>
<div class="MsoNormal" style="margin-left: 99pt; text-align: justify; text-indent: -72.05pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Virus<span style="mso-tab-count: 1;"> </span>:<span style="mso-tab-count: 1;"> </span>Rotavirus, Adenovirus
dan Norwalk.</span></div>
<div class="MsoNormal" style="margin-left: 26.95pt; text-align: justify;">
<span lang="EN-US">Penelitian di RS Persahabatan Jakarta Timur (1993-1994) pada 123
pasien dewasa yang dirawat di bangsal diare akut didapatkan hasil isolasi
penyebab diare akut terbanyak adalah E. coli (38 %), V. cholera Ogawa (18 %)
dan Aeromonas sp. 14 %).</span></div>
<div class="MsoNormal" style="margin-left: 27pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 27pt; text-align: justify;">
<br /></div>
<b><span lang="EN-US">Patofisiologi</span></b>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Sebanyak kira-kira 9-10 liter cairan
memasuki saluran cerna setiap hari yang berasal dari luar (asupan diet) dan
dari dalam tubuh sendiri (sekresi cairan lambung, empedu dan sebagainya).
Sebagian besar jumlah tersebt diresorbsi di usus halus dan sisanya sebanyak
1500 ml memasuki usus besar. Sejumlah 90% dari cairan usus besar akan
diresorbsi sehingga tersisa sejumlah 150-250 ml cairan ikut membentuk tinja.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Faktor-faktor fisiologis yang menyebabkan
diare sangat erat hubungannya satu sama lain. Misalnya, cairan dalam lumen usus
yang mengkat akan menyebabkan terangsangnya usus secara mekanis karena
meningkatnya volume sehingga motilitas usus meningkat. Sebaliknya bila waktu
henti makanan di usus terlalu cepat akan menyebabkan gangguan waktu penyentuhan
makanan dengan mukosa usus sehingga penyerapan elektrolit, air dan zat-zat lain
terganggu. Bagan patofisiologi diare dan mekanisme kompensasi dengan larutan
gula garam secara sederhana dapat dilihat pada gambar berikut:</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US"><span style="font-size: small;"> </span><b><span style="font-size: small;">DOWNLOAD FILE WORD LENGKAP <a href="http://sprysphere.com/8VlE" target="_blank">KLIK DISINI!</a></span></b></span></div>
Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-76260316995249634472018-04-05T06:19:00.000+07:002018-04-05T06:19:26.841+07:00ASUHAN KEPERAWATAN DIABETES MELLITUS (DM)<span style="font-size: small;">
</span><div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><b><span lang="EN-US">LAPORAN
PENDAHULUAN</span></b></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<h2 style="margin-left: 17.85pt; text-align: justify; text-indent: -17.85pt;">
<span style="font-size: small;"><span lang="EN-US"><span>A.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Konsep Dasar</span></span></h2>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 39.3pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Definisi</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Diabetes Mellitus ( DM ) adalah penyakit metabolik yang kebanyakan
herediter, demham tanda – tanda hiperglikemia dan glukosuria, disertai dengan
atau tidak adanya gejala klinik akut ataupun kronik, sebagai akibat dari
kuranganya insulin efektif di dalam tubuh, gangguan primer terletak pada
metabolisme karbohidrat yang biasanya disertai juga gangguan metabolisme lemak
dan protein. ( Askandar, 2000 ).</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Gangren adalah proses atau keadaan<span>
</span>yang ditandai dengan adanya jaringan mati atau nekrosis, namun secara
mikrobiologis adalah proses nekrosis yang disebabkan oleh infeksi. ( Askandar,
2001 ).</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Gangren Kaki Diabetik adalah luka pada kaki yang merah
kehitam-hitaman dan berbau busuk akibat sumbatan yang terjadi di pembuluh darah
sedang atau besar di tungkai. ( Askandar, 2001).</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 39.3pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Anatomi Fisiologi</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Pankreas merupakan sekumpulan kelenjar yang panjangnya kira – kira
15 cm, lebar<span> </span>5 cm, mulai dari duodenum
sampai ke limpa<span> </span>dan beratnya rata – rata
60 – 90 gram. Terbentang pada vertebrata lumbalis 1 dan 2 di belakang lambung.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Pankreas merupakan kelenjar endokrin terbesar yang terdapat di dalam
tubuh baik hewan maupun manusia. Bagian depan ( kepala ) kelenjar pankreas
terletak pada lekukan yang dibentuk oleh duodenum dan bagian pilorus dari
lambung. Bagian badan yang merupakan bagian utama dari organ ini merentang ke
arah limpa dengan bagian ekornya menyentuh atau terletak pada alat ini. Dari segi
perkembangan<span> </span>embriologis, kelenjar
pankreas terbentuk dari epitel yang berasal dari lapisan epitel yang membentuk
usus.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Pankreas terdiri dari dua jaringan utama, yaitu : </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US">(1). Asini
sekresi getah pencernaan ke dalam duodenum. </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 42.55pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US">(2). Pulau
Langerhans yang tidak tidak mengeluarkan sekretnya keluar, tetapi menyekresi
insulin dan glukagon langsung ke darah.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US">Pulau – pulau Langerhans yang menjadi
sistem endokrinologis dari pamkreas tersebar di seluruh pankreas dengan berat
hanya 1 – 3 % dari berat total pankreas. Pulau langerhans berbentuk ovoid
dengan besar masing-masing pulau berbeda. Besar pulau langerhans yang terkecil
adalah 50 </span><span lang="EN-US" style="font-family: Symbol;"><span>m</span></span><span lang="EN-US">, sedangkan yang terbesar 300 </span><span lang="EN-US" style="font-family: Symbol;"><span>m</span></span><span lang="EN-US">, terbanyak adalah yang besarnya 100 – 225 </span><span lang="EN-US" style="font-family: Symbol;"><span>m</span></span><span lang="EN-US">. Jumlah semua pulau langerhans di pankreas diperkirakan antara 1 –
2 juta. </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Pulau
langerhans manusia, mengandung tiga jenis sel utama, yaitu :</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: -21.25pt;">
<span style="font-size: small;"><span lang="EN-US">(1). Sel – sel A ( alpha ), jumlahnya sekitar 20 – 40 % ;
memproduksi glikagon yang manjadi faktor hiperglikemik, suatu hormon yang
mempunyai “ anti insulin like activity “.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: -21.25pt;">
<span style="font-size: small;"><span lang="EN-US">(2). Sel – sel B ( betha ), jumlahnya sekitar 60 – 80 % , membuat
insulin.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: -21.25pt;">
<span style="font-size: small;"><span lang="EN-US">(3). Sel – sel D ( delta ), jumlahnya sekitar 5 – 15 %, membuat
somatostatin. </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Masing – masing sel tersebut, dapat dibedakan
berdasarkan struktur dan sifat pewarnaan. Di bawah mikroskop pulau-pulau
langerhans ini nampak berwarna pucat dan banyak mengandung pembuluh darah
kapiler. Pada penderita DM, sel beha sering ada tetapi berbeda dengan sel beta
yang<span> </span>normal dimana sel beta tidak
menunjukkan reaksi pewarnaan untuk insulin sehingga dianggap tidak berfungsi.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Insulin merupakan protein kecil dengan berat
molekul 5808 untuk insulin manusia. Molekul insulin terdiri dari dua rantai
polipeptida yang tidak sama, yaitu rantai A dan B. Kedua rantai ini dihubungkan
oleh<span> </span>dua jembatan ( perangkai ), yang
terdiri dari disulfida. Rantai A terdiri dari 21 asam amino dan rantai B
terdiri dari 30 asam amino. Insulin dapat larut pada pH 4 – 7 dengan titik isoelektrik
pada 5,3. Sebelum insulin dapat berfungsi, ia harus berikatan dengan protein
reseptor yang besar di dalam membrana sel.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Insulin di sintesis sel beta pankreas dari
proinsulin dan di simpan dalam butiran berselaput yang berasal dari kompleks
Golgi. Pengaturan sekresi insulin dipengaruhi efek umpan balik kadar glukosa
darah pada pankreas. Bila kadar glukosa darah meningkat diatas 100 mg/100ml
darah, sekresi insulin meningkat cepat. Bila kadar glukosa normal atau rendah,
produksi insulin akan menurun.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Selain kadar glukosa darah, faktor lain
seperti asam amino, asam lemak, dan hormon gastrointestina merangsang sekresi
insulin dalam derajat berbeda-beda. Fungsi metabolisme utama insulin untuk
meningkatkan kecepatan transport glukosa melalui membran sel ke jaringan
terutama sel – sel otot, fibroblas dan sel lemak.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 21.25pt;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 21.25pt;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 21.25pt;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US"><span> </span>Etiologi</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 60.55pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>a.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Diabetes Melitus </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">DM mempunyai etiologi yang heterogen, dimana
berbagai lesi dapat menyebabkan insufisiensi insulin, tetapi determinan genetik
biasanya memegang peranan penting pada mayoritas DM. Faktor lain yang dianggap
sebagai kemungkinan etiologi DM yaitu :</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 81.8pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Kelainan sel beta pankreas,
berkisar dari hilangnya sel beta sampai kegagalan sel beta melepas insulin.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 81.8pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Faktor – faktor lingkungan yang
mengubah fungsi sel beta, antara lain agen yang dapat menimbulkan infeksi, diet
dimana pemasukan karbohidrat dan gula yang diproses secara berlebihan, obesitas
dan kehamilan. </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 81.8pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>3.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Gangguan sistem imunitas. Sistem
ini dapat dilakukan oleh autoimunitas yang disertai pembentukan sel – sel
antibodi antipankreatik dan mengakibatkan kerusakan sel - sel penyekresi
insulin, kemudian peningkatan kepekaan sel beta oleh virus.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 81.8pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>4.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Kelainan insulin. Pada pasien
obesitas, terjadi gangguan kepekaan jaringan terhadap insulin akibat kurangnya
reseptor insulin yang terdapat pada membran sel yang responsir terhadap
insulin.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 60.55pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>b.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Gangren Kaki Diabetik </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: 21.25pt;">
<span style="font-size: small;"><span lang="EN-US">Faktor – faktor yang berpengaruh atas terjadinya
gangren kaki diabetik dibagi menjadi endogen dan faktor eksogen. </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US">Faktor endogen : a. Genetik, metabolik</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: 3cm;">
<span style="font-size: small;"><span lang="EN-US">b. Angiopati diabetik</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: 3cm;">
<span style="font-size: small;"><span lang="EN-US">c. Neuropati diabetik</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US">Faktor eksogen :<span> </span>a. Trauma</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: 3cm;">
<span style="font-size: small;"><span lang="EN-US">b. Infeksi</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: 3cm;">
<span style="font-size: small;"><span lang="EN-US">c. Obat</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: -35.45pt;">
<span style="font-size: small;"><span lang="EN-US">4. Patofisiologis</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 63.8pt; text-align: justify; text-indent: -21.25pt;">
<span style="font-size: small;"><span lang="EN-US">a. Diabetes Melitus</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 2cm; text-align: justify; text-indent: 1cm;">
<span style="font-size: small;"><span lang="EN-US">Sebagian besar gambaran patologik dari DM dapat dihubungkan dengan
salah satu efek utama akibat kurangnya insulin berikut:</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 74.7pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Berkurangnya pemakaian glukosa
oleh sel – sel tubuh yang mengakibatkan naiknya konsentrasi glukosa darah
setinggi 300 – 1200 mg/dl.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 74.7pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Peningkatan mobilisasi lemak
dari daerah penyimpanan lemak yang menyebabkan terjadinya metabolisme lemak
yang abnormal disertai dengan endapan kolestrol pada dinding pembuluh darah.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 74.7pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>3.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Berkurangnya protein dalam
jaringan tubuh.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 2cm; text-align: justify; text-indent: 1cm;">
<span style="font-size: small;"><span lang="EN-US">Pasien – pasien yang mengalami defisiensi insulin tidak dapat
mempertahankan kadar glukosa plasma puasa yang normal atau toleransi sesudah
makan. Pada hiperglikemia yng parah yang melebihi ambang ginjal normal (
konsentrasi glukosa darah sebesar 160 – 180 mg/100 ml ), akan timbul glikosuria
karena tubulus – tubulus renalis tidak dapat<span>
</span>menyerap kembali semua glukosa. Glukosuria ini akan mengakibatkan
diuresis osmotik yang menyebabkan poliuri disertai kehilangan sodium, klorida,
potasium, dan pospat. Adanya poliuri menyebabkan dehidrasi dan timbul
polidipsi. Akibat glukosa yang keluar bersama urine maka pasien akan mengalami
keseimbangan protein negatif dan berat badan menurun serta cenderung terjadi
polifagi. Akibat yang lain adalah astenia atau kekurangan energi sehingga pasien
menjadi cepat telah dan mengantuk yang disebabkan oleh berkurangnya atau
hilangnya protein tubuh dan juga berkurangnya penggunaan karbohidrat untuk
energi. </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 2cm; text-align: justify; text-indent: 1cm;">
<span style="font-size: small;"><span lang="EN-US">Hiperglikemia yang lama<span> </span>akan
menyebabkan arterosklerosis, penebalan membran basalis dan perubahan pada saraf
perifer. Ini akan memudahkan terjadinya gangren.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 2cm; text-align: justify; text-indent: -14.15pt;">
<span style="font-size: small;"><span lang="EN-US">b. Gangren Kaki Diabetik</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 2cm; text-align: justify; text-indent: 1cm;">
<span style="font-size: small;"><span lang="EN-US">Ada dua teori utama mengenai terjadinya komplikasi kronik DM akibat
hiperglikemia, yaitu teori sorbitol dan teori glikosilasi. </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 74.7pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><span lang="EN-US"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Teori Sorbitol</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-align: justify; text-indent: 1cm;">
<span style="font-size: small;"><span lang="EN-US">Hiperglikemia akan menyebabkan penumpukan kadar glukosa pada sel dan
jaringan tertentu dan dapat mentransport glukosa tanpa insulin. Glukosa yang
berlebihan ini tidak akan termetabolisasi habis secara normal<span> </span>melalui glikolisis, tetapi sebagian dengan
perantaraan enzim aldose reduktase akan diubah menjadi sorbitol. Sorbitol akan
tertumpuk dalam sel / jaringan tersebut dan menyebabkan kerusakan dan perubahan
fungsi. </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-align: justify; text-indent: -14.2pt;">
<span style="font-size: small;"><span lang="EN-US">2. Teori Glikosilasi</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-align: justify; text-indent: 1cm;">
<span style="font-size: small;"><span lang="EN-US">Akibat hiperglikemia akan menyebabkan terjadinya glikosilasi pada
semua protein, terutama yang mengandung senyawa lisin. Terjadinya proses
glikosilasi pada protein membran basal dapat menjelaskan semua komplikasi baik
makro maupun mikro vaskular.</span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-align: justify; text-indent: 1cm;">
<span style="font-size: small;"><span lang="EN-US">Terjadinya Kaki Diabetik (KD) sendiri disebabkan oleh faktor –
faktor disebutkan dalam etiologi. Faktor utama yang berperan timbulnya KD
adalah angiopati, neuropati dan infeksi. Neuropati merupakan faktor penting
untuk terjadinya KD. Adanya neuropati perifer akan menyebabkan terjadinya
gangguan sensorik maupun motorik. Gangguan sensorik akan menyebabkan hilang
atau menurunnya sensasi nyeri pada kaki, sehingga akan mengalami trauma tanpa
terasa yang mengakibatkan terjadinya ulkus pada kaki gangguan motorik juga akan
mengakibatkan terjadinya atrofi otot kaki, sehingga merubah titik tumpu yang
menyebabkan ulsetrasi pada kaki pasien. Angiopati akan menyebabkan
terganggunya<span> </span>aliran darah<span> </span>ke kaki. Apabila sumbatan darah terjadi pada
pembuluh darah yang lebih besar maka<span> </span>penderita
akan merasa sakit tungkainya sesudah ia berjalan pada jarak tertentu.
Manifestasi gangguan pembuluh darah yang lain dapat berupa : ujung kaki terasa
dingin, nyeri kaki di malam hari, denyut arteri hilang, kaki menjadi pucat bila
dinaikkan. Adanya angiopati tersebut akan menyebabkan terjadinya penurunan
asupan nutrisi, oksigen ( zat asam ) serta antibiotika sehingga menyebabkan
luka sulit sembuh ( Levin,1993). Infeksi sering merupakan komplikasi yang
menyertai KD akibat berkurangnya aliran darah atau neuropati, sehingga faktor
angiopati dan infeksi berpengaruh terhdap penyembuhan atau pengobatan dari KD. </span></span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-align: justify; text-indent: 1cm;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: small;">
</span></div>
<div class="MsoNormal" style="margin-left: 70.9pt; text-align: justify; text-indent: -42.55pt;">
<span style="font-size: small;"><span lang="EN-US">5. Klasifikasi </span></span></div>
<div style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: "Times New Roman", "serif"; line-height: 150%;">Wagner ( 1983 ) membagi gangren kaki diabetik
menjadi enam tingkatan , yaitu :</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: small;"><span lang="EN-US" style="font-family: "Times New Roman", "serif"; line-height: 150%;"><b>DOWNLOAD FILE WORD LENGKAP <a href="http://sprysphere.com/8VWz" target="_blank">KLIK DISINI!</a></b> </span></span><!--[if gte mso 9]><xml>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="header"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="35" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="envelope address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="endnote reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="endnote text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="table of authorities"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
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<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
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<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
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<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
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<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
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<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
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<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
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<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
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<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
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<w:LsdException Locked="false" Priority="21" QFormat="true"
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<w:LsdException Locked="false" Priority="31" QFormat="true"
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<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-67394007981747893672018-03-16T08:53:00.001+07:002018-03-16T08:53:17.480+07:00ASUHAN KEPERAWATAN PADA ANAK DENGAN THALASEMIA<!--[if !mso]>
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<div class="MsoNormal">
<span lang="EN-US"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level1 lfo1; tab-stops: list 54.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">PENDAHULUAN.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l0 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Latar Belakang</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Thalasemia merupakan penyakit kelainan darah yang
bersifat herediter, dan diturunkan secara resesif. Pada tahun 1925, diagnosa
penyakit ini pertama kali diumumkan oleh Thoomas Cooley<span style="mso-spacerun: yes;"> </span>( Cooleys Anemia ) yang didapat diantara
keluarga keturunan Italia yang bermukim di Amerika Serikat. Kata Thalassemia
berasal dari bahasa Yunani yang berarti Laut dan digunakan pertama kali oleh
Whipple dan Bradford pada tahun 1932.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Prevalensi terjadinya thalasemia berbeda – beda untuk
tiap ras, ras yang dominan terjadi thalasemia adalah penduduk China, Malaysia,
Indocina, Afrika, Mediterania, Timur Tengah dan Asia. Dalam perkembangannya
ditemukan bahwa thalasemia bukan hanya disebabkan faktor herediter, tetapi juga
disebabkan karena terjadinya mutasi, terutama pada penduduk Timut Tengah,
Afrika dan<span style="mso-spacerun: yes;"> </span>Asia. Thalasemia terdiri dari
dua jenis yaitu thalasemia alfa dan thalasmia beta.<span style="mso-spacerun: yes;"> </span>Thalasemia Alfa pertama kali dilaporkan
secara independen di Amerika Serikat danYunani pada tahun 1955, dan dikenal
sebagai penyakit Hemoglobin<span style="mso-spacerun: yes;"> </span>H. Penyakit
ini disebabkan keadaan heterozigot Thalasemia alfa nol ( Alfa 1 ) dan
Thalasemia Alfa Plus ( Alfa 2 ). Pada tahun 1958 Jenis kedua dijumpai di RS
Bartolomew di London dan disebut Hemoglobin Bart yang merupakan keadaan
homozigot dari thalassemia nol ( Alfa 1 )</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Insiden terjadinya penyakit ini cukup tinggi, pada
individu kulit hitam, diperkirakan<span style="mso-spacerun: yes;"> </span>satun
dari empat ratus orang memderita penyakit ini. Dahulu 25 % kematian penderita
terjadi sebelum berusia 5 tahun, namundengan pengobatan baru, 85 % orang dengan
ganggian ini dapat hidup sampai usia 20 tahun dan 60 % penderita dapat hidup
sampai usia diatas 50 tahun.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US"><span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l0 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Tujuan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Tujuan dari pemberian Asuhan keperawatan pada penderita
Thalassemia adalah:</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; tab-stops: list 108.0pt; text-align: justify;">
<span lang="EN-US"><img alt="*" height="15" src="file:///C:\Users\User\AppData\Local\Temp\msohtmlclip1\01\clip_image001.png" width="15" /><span style="mso-tab-count: 1;"> </span>Meningkatkan
perfusi jaringan.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; tab-stops: list 108.0pt; text-align: justify;">
<span lang="EN-US"><img alt="*" height="15" src="file:///C:\Users\User\AppData\Local\Temp\msohtmlclip1\01\clip_image001.png" width="15" /><span style="mso-tab-count: 1;"> </span>Memberikan
kebutuhan nutrisi, cairan.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; tab-stops: list 108.0pt; text-align: justify;">
<span lang="EN-US"><img alt="*" height="15" src="file:///C:\Users\User\AppData\Local\Temp\msohtmlclip1\01\clip_image001.png" width="15" /><span style="mso-tab-count: 1;"> </span>mencegah
komplikasi</span></div>
<div class="MsoBodyTextIndent">
<span lang="EN-US"><img alt="*" height="15" src="file:///C:\Users\User\AppData\Local\Temp\msohtmlclip1\01\clip_image001.png" width="15" /><span style="mso-tab-count: 1;"> </span>memberikan
informasi tentang proses penyakit, prognosis dan program pengobatan.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; tab-stops: list 108.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level1 lfo1; tab-stops: list 54.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">TINJAUAN TEORI</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l0 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Definisi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Thalasemia merupakan penyakit anemia hemolitikdimana
terjadi kerusakan sel darah merah didalam pembluh darah sehingga umur erirosit
menjadi pendek ( kurang dari 100 hari ). ( Ngastiyah, 1997 : 377 )</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Thalasemia merupakan penyakit anemua hemolitik herediter
yang diturunkan secara resesif, secara molekuler dibedakan menjadi thalasemia
alfa dan beta, sedangkan secara klinis dibedakan menjadi thalasemia mayor dan
minor ( Mansjoer, Kapita Selekta Kedokteran, 2000 : 497 )</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l0 level2 lfo1; tab-stops: list 72.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Proses patologi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; tab-stops: 81.0pt; text-align: justify;">
<span lang="EN-US">Hemoglobin pasca kelahiran yang normal
terdiri dari dua rantai alfa dan beta polipeptide. Dalam beta thalasemia, ada
penurunan sebagian atau keseluruhan dalam proses sintesis molekul hemoglobin
rantai beta, Konsekuensi adanya peningkatan compensatory dalam proses
pensintesisan rantai alfa dan produksi rantai gamma tetap aktif, dan
menyebabkan ketidaksempurnaan formasi hemoglobin. Polipeptida yang tidak
seimbang ini sangat tidak stabil, mubah terpisah dan merusak sel darah merah
yang dapat menyebabkan anemia yang parah. Untuk menanggulangi proses hemolitik,
sel darah merah dibentuk dalam jmlah yang banyak, atau setidaknya sumsum tulang
ditekan dengan proses trannfusi. Kelebihan Fe dari penambahan RBCs dalam
transfusi serta kerusakan yang cepat dari sel defectif disimpan dalam berbagai
organ (hemosiderosis )</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; tab-stops: 81.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; tab-stops: 81.0pt; text-align: justify;">
<span lang="EN-US"><span style="font-size: small;"><b>DOWNLOAD FILE WORD LENGKAP <a href="http://dashsphere.com/BNyw" target="_blank">KLIK DISINI !</a></b></span> </span></div>
Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-48813525639153017662018-03-15T17:42:00.003+07:002018-03-15T17:42:54.874+07:00Asuhan Keperawatan Pada Anak “A” dengan Kejang Demam di Ruang Anak RSUD Dr. Soetomo Surabaya<div style="text-align: justify;">
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<h1 style="margin-left: 0cm; text-align: justify; text-indent: 0cm;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">BAB<span> </span>1</span></span></h1>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: small;"><b><span lang="EN-US" style="color: black; line-height: 150%;">PENDAHULUAN</span></b></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span style="font-size: small;"><b><span lang="EN-US" style="color: black;"><span>1.1<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></b><b><span lang="EN-US" style="color: black;">Latar Belakang</span></b><span lang="EN-US" style="color: black;"></span></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify; text-indent: 42.5pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Anak
merupakan hal yang penting artinya bagi sebuah keluarga. Selain sebagai penerus
keturunan, anak pada akhirnya juga sebagai generasi penerus bangsa. Oleh karena
itu tidak satupun orang tua yang menginginkan anaknya jatuh sakit, lebih-lebih
bila anaknya mengalami kejang demam.</span></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify; text-indent: 42.5pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Kejang demam
merupakan kelainan neurologis akut yang paling sering dijumpai pada anak.
Bangkitan kejang ini terjadi karena adanya kenaikan suhu tubuh (suhu rektal di
atas 38<sup>o</sup>C) yang disebabkan oleh proses ekstrakranium. Penyebab demam
terbanyak adalah infeksi saluran pernapasan bagian atas disusul infeksi saluran
pencernaan. (Ngastiyah, 1997; 229).</span></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify; text-indent: 42.5pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Insiden
terjadinya kejang demam terutama pada golongan anak umur 6 bulan sampai 4
tahun. Hampir 3 % dari anak yang berumur di bawah 5 tahun pernah menderita
kejang demam. Kejang demam lebih sering didapatkan pada laki-laki daripada
perempuan. Hal tersebut disebabkan karena pada wanita didapatkan maturasi
serebral yang lebih cepat dibandingkan laki-laki. (ME. Sumijati, 2000;72-73)</span></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify; text-indent: 42.5pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Berdasarkan
laporan dari daftar diagnosa dari lab./SMF Ilmu Kesehatan Anak RSUD Dr. Soetomo
Surabaya didapatkan data adanya peningkatan insiden kejang demam. Pada tahun
1999 ditemukan pasien kejang demam sebanyak 83 orang dan tidak didapatkan angka
kematian (0 %). Pada tahun 2000 ditemukan pasien kejang demam 132 orang dan
tidak didapatkan angka kematian (0 %). Dari data di atas menunjukkan adanya
peningkatan insiden kejadian sebesar 37%.</span></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify; text-indent: 42.5pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Bangkitan
kejang berulang atau kejang yang lama akan mengakibatkan kerusakan sel-sel otak
kurang menyenangkan di kemudian hari, terutama adanya cacat baik secara fisik,
mental atau sosial yang mengganggu pertumbuhan dan perkembangan anak. (Iskandar
Wahidiyah, 1985 : 858) .</span></span></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify; text-indent: 42.5pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Kejang demam
merupakan kedaruratan medis yang memerlukan pertolongan segera. Diagnosa secara
dini serta pengelolaan yang tepat sangat diperlukan untuk menghindari cacat
yang lebih parah, yang diakibatkan bangkitan kejang yang sering. Untuk itu
tenaga perawat/paramedis dituntut untuk berperan aktif dalam mengatasi keadaan
tersebut serta mampu memberikan asuhan keperawatan kepada keluarga dan
penderita, yang meliputi aspek promotif, preventif, kuratif dan rehabilitatif
secara terpadu dan berkesinambungan serta memandang klien sebagai satu kesatuan
yang utuh secara bio-psiko-sosial-spiritual. Prioritas asuhan keperawatan pada
kejang demam adalah : Mencegah/mengendalikan aktivitas kejang, melindungi
pasien dari trauma, mempertahankan jalan napas, meningkatkan harga diri yang
positif, memberikan informasi kepada keluarga tentang proses penyakit,
prognosis dan kebutuhan penanganannya. (I Made Kariasa, 1999; 262).</span></span></div>
<div class="MsoNormal" style="margin-left: 36pt; text-align: justify; text-indent: 42.5pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Berdasarkan
hal-hal tersebut di atas, penulis tertarik membuat karya tulis dengan judul
“Asuhan Keperawatan Pada Anak “A” dengan Kejang Demam di Ruang Anak RSUD Dr.
Soetomo Surabaya”.</span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: small;"><b><span lang="EN-US" style="color: black; line-height: 150%;">A. TINJAUAN TEORI<span> </span></span></b></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 45.35pt; text-indent: -45.35pt;">
<span style="font-size: small;"><b><span lang="EN-US" style="color: black;">I.<span> </span>Pengertian</span></b></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Tetanus adalah penyakit infeksi yang ditandai oleh kekakuan
dan kejang otot, tanpa disertai gangguan kesadaran, sebagai akibat dari toksin
kuman closteridium tetani</span><span lang="EN-US" style="color: black;"> </span></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 45.35pt; text-indent: -45.35pt;">
<span style="font-size: small;"><b><span lang="EN-US" style="color: black;">II. Etiologi</span></b></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Sering kali tempat
masuk kuman sukar dikteahui teteapi suasana anaerob seperti pada luka tusuk,
lukakotor, adanya benda asing dalam luka yang menyembuh , otitis media, dan
cairies gigi, menunjang berkembang biaknya kuman yang menghasilkan endotoksin.</span></span></div>
<div class="MsoNormal" style="margin-left: 45.35pt; text-indent: -45.35pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 45.35pt; text-indent: -45.35pt;">
<span style="font-size: small;"><b><span lang="EN-US" style="color: black;">III. Patofisiologi</span></b></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Bentuk spora dalam
suasana anaerob dapat berubah menjadi kuman vegetatif yang menghasilkan
eksotoksin. Toksin ini menjalar intrakasonal sampai ganglin/simpul saraf dan
menyebabkan hilangnya keseimbanngan tonus otot sehingga terjadi kekakuan otot
baik lokal maupun mnyeluruh. Bila toksin banyak, selain otot bergaris, otot
polos dan saraf otak juga terpengaruh.</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Sumber energi otak
adalah glukosa yang melalui proses oksidasi dipecah menjadi CO<sub>2</sub> dan
air. Sel dikelilingi oleh membran yang terdiri dari permukaan dalam yaitu
lipoid dan permukaan luar yaitu ionik. Dalam keadaan normal membran sel neuron
dapat dilalui dengan mudah oleh ion kalium (K<sup>+</sup>) dan sangat sulit
dilalui oleh ion natrium (Na<sup>+</sup>) dan elektrolit lainnya, kecuali ion
klorida (Cl<sup>-</sup>). Akibatnya konsentrasi ion K<sup>+ </sup>dalam sel
neuron tinggi dan konsentrasi Na<sup>+</sup> rendah, sedang di luar sel neuron
terdapat keadaan sebalikya. Karena perbedaan jenis dan konsentrasi ion di dalam
dan di luar sel, maka terdapat perbedaan potensial membran yang disebut
potensial membran dari neuron. Untuk menjaga keseimbangan potensial membran
diperlukan energi dan bantuan enzim Na-K ATP-ase yang terdapat pada permukaan
sel.</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Keseimbangan potensial
membran ini dapat diubah oleh :</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Perubahan konsentrasi
ion di ruang ekstraselular</span></span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<span style="font-size: small;"><span lang="EN-US" style="color: black;">Rangsangan yang datang
mendadak misalnya mekanisme, kimiawi atau aliran listrik dari sekitarnya</span></span></div>
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-72086568074068445542018-03-15T17:38:00.000+07:002018-03-15T17:38:01.633+07:00POLA ASUH KELUARGA TERHADAP ANAK PENYANDANG AUTISME <div style="text-align: justify;">
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<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">PENDAHULUAN</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.1<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Latar Belakang</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; text-align: justify; text-indent: 0cm;">
<span lang="EN-US">Di dalam kurun waktu 10 tahun trakhir ini terjadi peningkatan yang
luar biasa dari jumlah penyandang autisme infatil. Hal ini terjadi di seluruh
belahan dunia, termasuk di Indonesia. Peningkatan jumlah penyandang autisme
diperkiralan 1 per 5000 anak dan sekarang sudah meningkat menjadi 1 per 5000
anak (Melly Budhiman, 1999). Autisme dapat terjadi pada semua kalangan bai kaya
atau miskin, kelas bawah, kelas atas, pedesaan, kota dan dapat terjadi pada
anak-anak dari semua kelompok etnik dan budaya di seluruh dunia (Rudy Sutadi,
1997; Whally dan Wong, 1999). Autisme merupakan gangguan proses perkembangan
yang terjadi dalam tiga tahun pertama kehidupan yang menyebabkan gangguan pada
bahasa, kognitif, sosial dan fungsi adaptif (Rudy Sutadi, 1999; S. Shirataki, 1998).</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 lang="EN-US">Dalam keadaan yang lebih normal, orang tua cenderung menganggap
anak-anak sebagai perluasan diri mereka sendiri dan melihat di dalam diri anak.
Anak mereka merupakan warisan genetik dan aspek-aspek tertentu kepribadian
mereka (Soetjiningsih, 1995). Pandangan seperti ini dapat menjadi patologis
jika anak ternyata tidak sesuai dengan yang diharapkan (Nelson, 1988). Orang
tua dari anak-anak yang sakit kronis yang menderita gangguan emosional
mempunyai risiko untuk mengembangkan sikap tidak sehat dan destruktif terhadap
anak mereka (Adriana, 1999; Nelson 1988). Kondisi seperti ini akan mempengaruhi
pola asuh orang tua terhadap anak penyandang autisme.</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 lang="EN-US">Masalah autisme masih merupakan fenomena baru yang mengalami
peningkatan di akhir dekade ini. Pengetahuan masyarakatpun masih sangat
terbatas. Sedangkan penangan anak penyandang autisma memerlukan perlakuan yang
khusus (Adriana, 1999). Sikap orang tua yang diwujudkan dalam pola asuh sangat
dominan berpengaruh terhadap perkembangan anak selanjutnya. Pola asih tersebut
adalah otoriter, serba membolehkan, anak tak acuh dan timbal balik (Rutter,
1997). Pola asuh yang sesuai sangat diperlukan untukj menangani anak penyandang
autisma secara lebih efektif. Dala pengembangan perspektif yang lebih
realistis, perlu digali kecenderungan pola asuh keluarga pada anak autisma
dalam usaha mengembangkan metode-metode yang lebih efektif dan efisien untuk
menangani anak penyandang autisma.</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 lang="EN-US">Keterlibatan orang tua sebagai orang yang terdekat di dalam keluarga
dan orang yang pertama-tama menerima bahwa anak mereka adalah penyandang
autisme sangat diperlukan. Hal ini perlu, karena dengan demikian diharapkan
dapat secara serius menangani tata laksana anak penyandang autisma. Salah
satunya dengan menggali kecenderungan pola asuh keluarga, sehingga bisa dikaji
hal-hal yang perlu dilakukan untuk penatalaksanaan dan pola suh yang paling
sesuai dengan yang mempunyai prinsip-prinsip tatalaksana perilaku yang berbeda
dengan pola pengasuhan umumnya.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.2<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Rumusan Masalah</span></div>
<div class="MsoBodyTextIndent2" style="line-height: 150%; margin-left: 35.45pt; text-align: justify; text-indent: -17.45pt;">
<span lang="EN-US">1.<span style="mso-spacerun: yes;">
</span>Apakah keluarga cenderung menggunakan pola asuh otoriter terhdapa anak
penyandang autisma ?</span></div>
<ol start="2" style="margin-top: 0cm; text-align: justify;" type="1">
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Apakah keluarga cenderung
menggunakan pola asuh serba membolehkan terhadapa anak penyandang autisma
?</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Apakah keluiarga cenderung
menggunakan pola asuh acuh tak acuh terhdapa anak penyandang autisma ?</span></li>
<li class="MsoNormal" style="line-height: 150%;"><span lang="EN-US">Apakah keluarga cenderung
menggunakan pola asuh timbal balik terhdapa anak penyandang autisma ?</span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">1.3 Tujuan Penelitian</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">1.3.1 Tujuan Umum</span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 1cm; text-align: justify; text-indent: 0cm;">
<span lang="EN-US">Mengetahui kecenderungan pola asuh yang
digunakan keluarga terhadap anak penyandang autisma.</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: 1cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">1.3.2 Tujuan Khusus</span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 42.55pt; text-align: justify; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Mendidentifikasi sejauh mana
kecenderungan keluarga menggunakan pola asuh otoriter terhdapa anak penyandang
autisma.</span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 42.55pt; text-align: justify; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Menidentifikasi seberapa jauh
kecenderungan keluarga menggunakan pola asuh serba membolehkan terhadap anak
penyandang autisma.</span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 42.55pt; text-align: justify; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Menidentifikasi seberapa jauh
kecenderungan keluarga menggunakan pola asuh acuh tak acuh<span style="mso-spacerun: yes;"> </span>terhadap anak penyandang autisma.</span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 42.55pt; text-align: justify; text-indent: -14.2pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Menidentifikasi seberapa jauh
kecenderungan keluarga menggunakan pola asuh timbal balik terhadap anak
penyandang autisma.</span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 1cm; text-align: justify; text-indent: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">1.4<span style="mso-spacerun: yes;"> </span>Manfaat Penelitian</span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 49.65pt; text-align: justify; text-indent: -1cm;">
<span lang="EN-US">1.4.1 Dapat digunakan sebagai panduan dalam
upaya memberikan pola asuh yang sesuai terhadap anak penyandang autisma.</span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 1cm; text-align: justify; text-indent: -7.05pt;">
<span lang="EN-US">1.4.2 Sebagai bahan informasi bagi peneliti
berikutnya.</span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 49.65pt; text-align: justify; text-indent: -1cm;">
<span lang="EN-US">1.4.3 Memberikan<span style="mso-spacerun: yes;"> </span>masukan<span style="mso-spacerun: yes;">
</span>kepada<span style="mso-spacerun: yes;"> </span>keluarga<span style="mso-spacerun: yes;"> </span>tentang pola asuh anak penyandang autisma
yang sesuai.</span></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 49.65pt; text-align: justify; text-indent: -1cm;">
<br /></div>
<div class="MsoBodyTextIndent3" style="line-height: 150%; margin-left: 49.65pt; text-align: justify; text-indent: -1cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">2. TUNJAUAN PUSTAKA</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 lang="EN-US">2.1 Pola Asuh</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span>Pola asuh adalah
serangkaian pengasuhan orang tua yang meliputi psiko, sosio, spiritual yang
dapat mempengaruhi perkembangan jiwa anak (Kaplan dan Sadock, 1997).</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 /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">2.2 Macam-Macam Pola Asuh</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span>Menurut Rutter
(1997) menggambarkan empat macam gaya pengasuhan orang tua, antara lain :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Otoriter</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="EN-US">Adalah suatu gaya pengaasuhan yang ditandai dengan
adanya aturan yang kaku dan ketat yang dapat menyebabkan depresi pada anak.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Serba membolehkan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="EN-US">Adalah suatu sikap atau gaya pengasuhan orang tua yang
ditandai dengan kesabaran dan tidak ada penentuan batas-batas yang dapat
menyebabkan kontrol impils yang buruk.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pola asuh acuh tak acuh</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="EN-US">Adalah suatu sikap atau gaya mengasuh orang tua kepada
anak yang ditandai dengan penelantaran dan tidak adanya keterlibatan yang menyebakan
perilaku agresif.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Pola asuh timbal balik</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<span lang="EN-US">Adalah suatu sikap ayau gaya pengauhan orang tua kepada
anak yang ditandai dengan pengambilan keputusan secara bersama-sama dengan
perilaku yang diarahkan dengan cara yang rasional yang dapat menyebakan rasa
percaya diri.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 14.2pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">2.3 Autisme Masa Kanak</span></div>
<div class="MsoBodyText" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">Autisma masa
kanak adalah gangguan perkembangan pervasif yang ditandai oleh adanya
abnormalitas da/atau hendaya perkembangan yang muncul sebekum usia 3 tahun, dan
dengan ciri fungsi yang abnormal dalam tiga bidang dari interaksi sosial.
komunikasi dan perilaku yang terbatas dan berulang. Gangguan ini dijumpai 3
sampai 4 kali lebih banyak pada anak laki-laki dibanding dengan anak perempuan
(PPDGJ, 1993; N.Keltner, 1991; Maramis, WF., 1995). Istilah autisma dipinjam dari
bidang schizophrenia, dimana Bleiler memakai istilah autisma ini untuk
menggambarkan perilaku pasien schizophrenia yang menarik diri dari dunia luar
dan menciptakan dunia fantasinya sendiri. Kanner ingin menggambarkan bahwa
anak-anak tersebut juga hidup dalam dunianya sendiri, terpisah dari dunia luar.</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">Namun terdapat perbedaan yang jelas antara penyebab dari autisma
pada penderita schizophrenia dan penyandang autisma masa kank. Pada
schizophrenia autisma disebabkan oleh proses regresi oleh penyakit jiwa,
sedangkan pada anak dengan autisma disebabkan karena adanya kegagalan
perkembangan (Melly Budhiman, 1998).<span style="mso-spacerun: yes;"> </span></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 lang="EN-US">Menurut Ika Widyawati (1997) ada beberapa macam teori tentang
penyebab autisma, anatara lain :</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">2.3.1 Teori Psikososial</span></div>
<div class="MsoBodyText" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">Dalam teori
psikososial, Kanner mempertimbangkan adanya pengaruh psikogenik sebagai
penyebab autisma: orang tua yang emosional, kaku dan obsesif yang mengasuh anak
yang kurang hangat bahkan cenderung dingin. Pendapat lain mengatakan adanya
trauma pada anak yang disebabkan oleh hostilisasi yang tak disadari dari ibu.
Teori ini ditentang oleh Rudy Sutadi (1997) ternyata terbukti bahwa cara orang
tua memperlakukan anak tidak ada hubungan dengan terjadinya autisma.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36pt; text-align: justify; text-indent: -36pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">2.3.2 Teori Biologis</span></div>
<div class="MsoBodyText" style="line-height: 150%; text-align: justify;">
<span lang="EN-US">Teori ini
berkembangan karena beberapa fakta seprti adanya hubungan yang erat dengan
retardasi mental (75-80%), perbandingan laki-laki : Perempuan = 4:1,
meningkatnya insidens gangguan kejang (25%). Sehingga diyakini bahwa gangguan
autisma ini merupakan suatu sindrom perilaku yang dapat siebabkan oleh berbagai
kondisi yang mempengaruhi sistem saraf pusat yaitu diduga adanya disfungsi dari
batang otak, sistem limbik dan cerebellum. Gangguan fungsi cerebellum yang
sangat khas pada penyandang autisma adalah ketidakmampuannya untuk mengalihkan
perhatian dengan cepat. Gangguan sistem limbik pada umumnya kurang dapat
mengendalikan emosinya, sering agresivitas yang ditujukan pada orang lain atau
diri-sendiri.</span></div>
<div class="MsoBodyText" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoBodyText" style="line-height: 150%; text-align: justify;">
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-59630922382917692062018-03-15T17:33:00.001+07:002018-03-15T17:33:07.832+07:00ASUHAN KEPERAWATAN PADA ANAK DENGAN MORBILI <div style="text-align: justify;">
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<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Definisi
:</span></b><span lang="EN-US"></span></div>
<div class="MsoNormal">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span>Penyakit
infeksi virus akut menular yang ditandai dengan 3 stadium, yaitu :</span></div>
<div class="MsoNormal">
<span lang="EN-US">a. Stadium Kataral</span></div>
<div class="MsoNormal">
<span lang="EN-US">b. Stadium Erupsi, dan</span></div>
<div class="MsoNormal">
<span lang="EN-US">c. Stadium Konvalesensi</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Etiologi
:</span></b><span lang="EN-US"></span></div>
<div class="MsoNormal">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span>Penyebabnya
adalah virus morbili yang terdapat dalam sekret nasofaring dan darah sealma
masa prodormal sampai 24 jam setelah timbul bercak-bercak. Virus ini berupa
virus RNA yang termasuk famili Paramiksoviridae, genus Morbilivirus.</span></div>
<div class="MsoNormal">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span>Cara
penularan dengan droplet infeksi.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Epidemiologi
:</span></b><span lang="EN-US"></span></div>
<div class="MsoNormal">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span>Biasanya
penyakit ini timbul pada masa anak dan kemudian menyebabkan kekebalan seumur
hidup. Bayi yang dilahirkan oleh ibu yang pernah menderita morbili akan
mendapat kekebalan secara pasif (melalui plasenta)<b style="mso-bidi-font-weight: normal;"> </b>sampai umur 4-6 bulan dan setelah umur tersebut kekebalan akan
mengurang sehingga si bayi dapat menderita morbili. Bila seseorang wanita
menderita morbili ketika ia hamil 1 atau 2 bulan, maka 50% kemungkinan akan
mengalami abortus, bila ia menderita morbili pada trimester I, II, atau III
maka ia akan mungkin melahirkan seorang anak dengan kelainan bawaan atau
seorang anak dengan BBLR, atau lahir mati atau anak yang kemudian meninggal
sebelum usia 1 tahun.</span></div>
</div>
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"></span></b><br clear="all" style="mso-break-type: section-break; page-break-before: always;" /><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">
</span></b>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Patofisiologi
:</span></b><span lang="EN-US"></span></div>
<div class="MsoNormal">
<span lang="EN-US">Droplet
Infection (virus masuk)</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Berkembang
biak dalam RES</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Keluar
dari RES keluar sirkulasi</span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 0px; margin-right: 0px; text-align: left;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; mso-yfti-lastrow: yes;">
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Pirogen
:</span></div>
<div align="center" class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-align: center; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">pengaruhi termostat dalam
hipotalamus</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Titik
setel termostat meningkat</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Suhu tubuh meningkat</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">pengaruhi nervus vagus </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span lang="EN-US"> pusat</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt;">
<span lang="EN-US">muntah di
medula oblongata.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">muntah</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">anorexia</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">malaise</span></b><span lang="EN-US"></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="EN-US"><span style="mso-tab-count: 1;"> </span></span></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="EN-US">Mengendap pada organ-organ yang </span></div>
<div class="MsoNormal">
<span lang="EN-US">secara embriologis berasal dari ektoderm
seperti pada :</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Mukosa mulut</span></i></b></div>
<div class="MsoNormal">
<span lang="EN-US">infiltrasi sel-sel radang mononuklear
pada kelenjar sub mukosa mulut</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Koplik`s
spot</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kulit </span></div>
<div class="MsoNormal">
<span lang="EN-US">Ploriferasi sel-sel endotel kalpiler di
dalam korium</span></div>
<div class="MsoNormal">
<span lang="EN-US">Terjadi eksudasi serum dan kadang-kadang
eritrsit dalam epidermis</span></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Rash/
ruam kulit </span></b></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Konjunctiva</span></i></b></div>
<div class="MsoNormal">
<span lang="EN-US">terjadi reaksi peradangan umum </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US"><span style="mso-spacerun: yes;"> </span></span></i><span lang="EN-US">Konjuctivitis</span></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Fotofobia</span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">mukosa nasofaring dan broncus</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">infiltrasi sel-sel sub epitel dan sel
raksasa berinti banyak</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Reaksi peradangan secara umum</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Pembentukan eksudat serosa disertai
proliferasi sel monokuler dan sejumlah kecil pori morfonuklear</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Coriza/ pilek, cough/ batuk</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Sal. Cerna</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Hiperplasi jaringan limfoid terutama pada
usus buntu </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span lang="EN-US"> mukosa usus teriritasi </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span lang="EN-US"> kecepatan sekresi bertambah </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span lang="EN-US"> pergerakan usus meningkat </span><span lang="EN-US" style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;"><span style="mso-char-type: symbol; mso-symbol-font-family: Symbol;">®</span></span><span lang="EN-US"> diare</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Manifestasi
klinis</span></b></div>
<div class="MsoNormal">
<span lang="EN-US">Masa tunas/inkubasi penyakit berlangsung
kurang lebih dari 10-20 hari dan kemidian timbul gejala-gejala yang dibagi
dalam 3 stadium</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Stadium kataral (prodormal)</span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<span lang="EN-US">Stadium
prodormal berlangsung selama 4-5 hari ditandai oleh demam ringa hingga sedang,
batuk kering ringan, coryza, fotofobia dan konjungtivitis. Menjelang akhir
stadium kataral dan 24 jam sebelum timbul enantema, timbul bercak koplik yang
patognomonik bagi morbili, tetapi sangat jarang dijumpai. Bercak koplik
berwarna putih kelabu, sebesar ujung jarum dan dikelilingi oleh eritema. Lokalisasinya
dimukosa bukalis berhadapandengan molar dibawah, tetapi dapat menyebar tidak
teratur mengenai seluruh permukaan pipi. Meski jarang, mereka dapat pula
ditemukan pada bagian tengah bibir bawah, langit-langit dan karankula
lakrimalis. Bercak tersebut muncul dan menghilang dengan cepat dalam waktu
12-18 jam. Kadang-kadang stadium prodormal bersifat berat karena diiringi demam
tinggi mendadak disertai kejang-kejang dan pneumoni. Gambaran darah tepi ialah
limfositosis dan leukopenia.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Stadium erupsi</span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<span lang="EN-US">Coryza dan
batuk-batuk bertambah. Timbul enantema / titik merah dipalatum durum dan
palatum mole. Terjadinya eritema yang berbentuk makula papula disertai dengan
menaiknya suhu tubuh. Eritema timbul dibelakang telinga dibagian atas lateral
tengkuk, sepanjang rambut dan bagian belakang bawah. Kadang-kadang terdapat
perdarahan primer pada kulit. Rasa gatal, muka bengkak. Terdapat pembesaran
kelenjar getah bening disudut mandibula dan didaerah leher belakang. Juga
terdapat sedikit splenomegali, tidak jarang disertai diare dan muntah. Variasi
dari morbili yang biasa ini adalah “Black Measles” yaitu morbili yang disertai
perdarahan pada kulit, mulut, hidung dan traktus digestivus.</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Stadium konvalesensi</span></div>
<div class="MsoNormal" style="margin-left: 18pt;">
<span lang="EN-US">Erupsi berkurang
meninggalkan bekas yang berwarna lebih tua (hiperpigmentasi) yang bisa hilang
sendiri. Selain hiperpigmentasi pada anak Indonesia sering ditemukan pula
kulit yang bersisik. Hiperpigmentasi ini merupakan gejala patognomonik untuk
morbili. Pada penyakit-penyakit lain dengan eritema atau eksantema ruam kulit
menghilang tanpa hiperpigmentasi. Suhu menurun sampai menjadi normal kecuali
bila ada komplikasi</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Diagnosa
banding</span></b></div>
<div class="MsoNormal">
<span lang="EN-US">Ruam kulit pada campak harus dibedakan dari
:</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Eksantema subitum <span style="mso-tab-count: 2;"> </span>-<span style="mso-spacerun: yes;"> </span>toxoplasmosis</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Rubela<span style="mso-tab-count: 4;"> </span>-<span style="mso-spacerun: yes;"> </span>meningokoksemia</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Infeksi virus ekho<span style="mso-tab-count: 3;"> </span>- <span style="mso-spacerun: yes;"> </span>demam skarlatina</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Virus koksaki<span style="mso-tab-count: 3;"> </span>-<span style="mso-spacerun: yes;"> </span>penyakit riketsia</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Virus adeno<span style="mso-tab-count: 3;"> </span>-<span style="mso-spacerun: yes;"> </span>penyakit serum</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Mononukleosus infeksiosa<span style="mso-tab-count: 1;"> </span>-<span style="mso-spacerun: yes;">
</span>alergi obat</span></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US"><span style="font-size: large;"><b>DOWNLOAD FILE WORD LENGKAP <a href="http://dashsphere.com/9iY7" target="_blank">KLIK DISINI !</a></b></span> </span></div>
Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-54748648454831118572018-03-15T17:30:00.001+07:002018-03-15T17:30:15.382+07:00 ASUHAN KEPERAWATAN ANAK “MARASMIK-KWASHIORKOR” <div style="text-align: justify;">
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Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/>
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<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; text-indent: -21.3pt;">
<span lang="EN-US" style="text-transform: none;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="text-transform: none;">Pendahuluan</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-tab-count: 2;"> </span>Defisiensi gizi
dapat terjadi pada anak yang kurang mendapatkan masukan makanan dalam waktu
lama. Istilah dan klasifikasi gangguan kekurangan gizi amat bervariasi dan
masih merupakan masalah yang pelik. Walaupun demikian, secara klinis digunakan
istilah malnutrisi energi dan protein (MEP) sebagai nama umum. Penentuan jenis
MEP yang tepat harus dilakukan dengan pengukuran antropometri yang lengkap
(tinggi badan, berat badan, lingkar lengan atas dan tebal lipatan kulit),
dibantu dengan pemeriksaan laboratorium (Ngastiyah, 1997).</span></div>
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<br /></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; text-indent: -21.3pt;">
<span lang="EN-US" style="text-transform: none;"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="text-transform: none;">Klasifikasi</span></div>
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<br /></div>
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<span lang="EN-US" style="font-weight: normal; text-transform: none;">Untuk
kepentingan praktis di klinik maupun di lapangan klasifikasi MEP ditetapkan
dengan patokan perbandingan berat badan terhadap umur anak sebagai berikut:</span></div>
<div class="MsoTitle" style="line-height: 150%;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">1) Berat badan 60-80% standar
tanpa edema<span style="mso-tab-count: 1;"> </span>: gizi kurang (MEP ringan)</span></div>
<div class="MsoTitle" style="line-height: 150%;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">2) Berat badan 60-80%
standar dengan edema<span style="mso-tab-count: 1;"> </span>:
kwashiorkor (MEP berat)</span></div>
<div class="MsoTitle" style="line-height: 150%;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">3) Berat badan
<60 edema="" span="" standar="" style="mso-tab-count: 1;" tanpa=""> </60></span>: marasmus
(MEP berat)</div>
<div class="MsoTitle" style="line-height: 150%;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">4) Berat badan
<60 dengan="" edema="" span="" standar="" style="mso-tab-count: 1;"> </60></span>: marasmik
kwashiorkor (MEP berat)</div>
<div class="MsoTitle" style="line-height: 150%;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">(Ngastiyah, 1997)</span></div>
<div class="MsoTitle" style="line-height: 150%; text-indent: 35.45pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">Kwashiorkor
adalah MEP berat yang disebabkan oleh defisiensi protein. Penyakit kwashiorkor
pada umumnya terjadi pada anak dari keluarga dengan status sosial ekonomi yang
rendah karena tidak mampu menyediakan makanan yang cukup mengandung protein
hewani seperti daging, telur, hati, susu dan sebagainya. Makanan sumber protein
sebenarnya dapat dipenuhi dari protein nabati dalam kacang-kacangan tetapi
karena kurangnya pengetahuan orang tua, anak dapat menderita defisiensi
protein.</span></div>
<div class="MsoTitle" style="line-height: 150%; text-indent: 35.45pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">Marasmus
adalah MEP berat yang disebabkan oleh defisiensi makanan sumber energi
(kalori), dapat terjadi bersama atau tanpa disertai defsiensi protein. Bila
kekurangan sumber kalori dan protein terjadi bersama dalam waktu yang cukup
lama maka anak dapat berlanjut ke dalam status marasmik kwashiorkor.</span></div>
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</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l1 level1 lfo1; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="text-transform: none;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="text-transform: none;">Gambaran
Klinik dan Diagnosis</span></div>
<div class="MsoTitle" style="line-height: 150%; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-tab-count: 2;"> </span>Gambaran klinik antara Marasmus dan
Kwashiorkor sebenarnya berbeda walaupun dapat terjadi bersama-sama (Ngastiyah,
1997)</span></div>
<div class="MsoTitle" style="tab-stops: 21.3pt; text-align: justify;">
<br /></div>
<div class="MsoTitle" style="line-height: 150%; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="text-transform: none;">Gambaran Klinik Kwashiorkor:</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l0 level1 lfo2; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Pertumbuhan terganggu (berat badan dan tinggi badan kurang
dari standar)</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">Tabel 1: Perkiraan
Berat Badan (Kg)</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">1. Lahir<span style="mso-tab-count: 3;"> </span>3,25</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">2. 3-12 bulan<span style="mso-tab-count: 3;"> </span>(bln + 9) / 2</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">3. 1-6 tahun<span style="mso-tab-count: 3;"> </span>(thn x 2) + 8</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">4. 6-12 tahun<span style="mso-tab-count: 3;"> </span>{(thn x 7) – 5}
/ 2</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-spacerun: yes;"> </span>(Soetjiningsih, 1998, hal. 20)</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">Tabel 2: Perkiraan
Tinggi Badan (Cm)</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">1. 1 tahun<span style="mso-tab-count: 3;"> </span>1,5 x TB lahir</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">2. 4 tahun<span style="mso-tab-count: 3;"> </span>2 x TB lahir</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">3. 6 tahun<span style="mso-tab-count: 3;"> </span>1,5 x TB 1 thn</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">4. 13 tahun<span style="mso-tab-count: 3;"> </span>3 x TB lahir</span></div>
<div class="MsoTitle" style="margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;">5. Dewasa<span style="mso-tab-count: 3;"> </span>3,5 x TB lahir = 2 x TB
2 thn</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-spacerun: yes;"> </span>(Soetjiningsih, 1998, hal. 21)</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l0 level1 lfo2; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Perubahan mental (cengeng atau apatis)</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l0 level1 lfo2; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Pada sebagian besar anak ditemukan edema ringan sampai
berat)</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l0 level1 lfo2; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Gejala gastrointestinal (anoreksia, diare)</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l0 level1 lfo2; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Gangguan pertumbuhan rambut (defigmentasi, kusam, kering,
halus, jarang dan mudah dicabut)</span></div>
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<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">6)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Kulit kering, bersisik, hiperpigmentasi dan sering<span style="mso-spacerun: yes;"> </span>ditemukan gambaran crazy pavement dermatosis.</span></div>
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<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">7)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Pembesaran hati (kadang sampai batas setinggi pusat, teraba
kenyal, licin dengan batas yang tegas)</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l0 level1 lfo2; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">8)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Anemia akibat gangguan eritropoesis.</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l0 level1 lfo2; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">9)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Pada pemeriksaan kimia darah ditemukan hipoalbuminemia
dengan kadar globulin normal, kadar kolesterol serum rendah.</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l0 level1 lfo2; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">10)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Pada biopsi hati ditemukan perlemakan, sering disertai
tanda fibrosis, nekrosis dan infiltrasi sel mononukleus.</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l0 level1 lfo2; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">11)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Hasil autopsi pasien kwashiorkor yang berat menunjukkan
terjadinya perubahan degeneratif pada semua organ (degenerasi otot jantung,
atrofi fili usus, osteoporosis dan sebagainya)</span></div>
<div class="MsoTitle" style="tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-spacerun: yes;">
</span></span></div>
<div class="MsoTitle" style="line-height: 150%; tab-stops: 21.3pt; text-align: justify;">
<span lang="EN-US" style="text-transform: none;">Gambaran Klinik Marasmus:</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l2 level1 lfo3; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Pertumbuhan berkurang atau terhenti, otot-otot atrofi</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l2 level1 lfo3; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Perubahan mental (cengeng, sering terbangun tengah malam)</span></div>
<div class="MsoTitle" style="line-height: 150%; margin-left: 21.3pt; mso-list: l2 level1 lfo3; tab-stops: 21.3pt; text-align: justify; text-indent: -21.3pt;">
<span lang="EN-US" style="font-weight: normal; text-transform: none;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-weight: normal; text-transform: none;">Sering diare, warna hijau tua, terdiri dari lendir dengan
sedikit tinja.</span></div>
<br />
<div class="MsoTitle" style="line-height: 150%; text-align: justify; text-indent: 35.45pt;">
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-56473878811994139602018-03-15T17:24:00.001+07:002018-03-15T17:24:31.046+07:00ASUHAN KEPERAWATAN ANAK DENGAN SINDROM NEFROTIK<div style="text-align: justify;">
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<div class="MsoBodyTextIndent" style="text-align: justify;">
<span style="font-size: small;"><span>Sindroma Nefrotik
adalah status klinis yang ditandai dengan peningkatan permeabilitas membran
glomerulus terhadap protein yang mengakibatkan kehilangan urinarius yang massif
(Whaley & Wong, 2003).</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 18pt; text-align: justify; text-indent: 27pt;">
<span style="font-size: small;"><span>Menurut Behrman
dalam bukunya yang berjudul <i>Ilmu Kesehatan Anak </i>(2001) bahwa “pada anak
karena mempunyai kelainan pembentukan glomerulus”.<span> </span>Menurut tinjauan dari Robson, dari 1400
kasus, beberapa jenis glomerulonefritis merupakan penyebab dari 78% sindrom
nefrotik pada orang dewasa dan 93% pada anak-anak (Price, 1995).</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 18pt; text-align: justify; text-indent: 27pt;">
<span style="font-size: small;"><span>Sampai pertengahan
abad ke-20 morbiditas sindrom nefrotik pada anak masih tinggi yaitu melebihi
50% sedangkan angka mortalitas mencapai 23%. Menurut Raja Sheh angka kejadian
kasus sindrom nefrotik di asia tercatat sebanyak 2 kasus tiap 10.000 penduduk
(Republika, 2005). Sedangkan angka kejadian di Indonesia pada sindrom nefrotik
mencapai 6 kasus pertahun dari 100.000 anak berusia kurang dari 14 tahun
(Alatas, 2002). Sindrom nefrotik pada kasus anak-anak tercatat sebanyak 4 kasus
yang mendapatkan perawatan di ruang anak C1 lantai 2 RSUP Dr. Kariadi Semarang
terhitung mulai tahun 2006 maret 7 anak .</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 18pt; text-align: justify; text-indent: 27pt;">
<span style="font-size: small;"><span>Mortalitas dan
prognosis anak dengan sindroma nefrotik bervariasi berdasarkan etiologi, berat,
luas kerusakan ginjal, usia anak, kondisi yang mendasari dan responnya terhadap
pengobatan (Betz & Sowden, 2002).</span><span lang="EN-US"></span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 18pt; text-align: justify; text-indent: 27pt;">
<span style="font-size: small;"><span>Pada An. P,
keluarga mempunyai status sosial ekonomi dan tingkat pendidikan yang rendah
sehingga resiko terjadi ketidakefektifan penatalaksanaan aturan pengobatan bisa
terjadi. Sehingga peran perawat di sini adalah memberikan informasi mengenai
segala sesuatu yang berhubungan dengan penyakit sindrom nefrotik.</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 18pt; text-align: justify; text-indent: 27pt;">
<span style="font-size: small;"><span>Pada keadaan yang
lanjut, sindroma nefrotik yang tidak ditangani secara benar bisa mengarah pada
gagal ginjal kronik stadium akhir (Republika, 2005). Oleh karena itu peran
perawatlah untuk melakukan asuhan keperawatan pada anak dengan sindrom nefrotik
secara benar dan tepat. Sebab kematian sindroma nefrotik berhubungan dengan
gagal ginjal kronik.</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 17pt; text-align: justify; text-indent: -17pt;">
<span style="font-size: small;"><b><span lang="EN-US"><span>A.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></b><b><span lang="EN-US">Pengertian </span></b></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 19.95pt; text-align: justify; text-indent: 28.5pt;">
<span style="font-size: small;"><span lang="EN-US">Sindroma Nefrotik ditandai dengan
proteinuria, hipoproteinemia, edema, dan hiperlipidemia (Behrman, 2001).
Sindroma Nefrotik adalah status klinis yang ditandai dengan peningkatan
permeabilitas membran glomerulus terhadap protein yang mengakibatkan kehilangan
urinarius yang massif (Whaley & Wong, 2003). Sindroma nefrotik adalah
kumpulan gejala klinis yang timbul dari kehilangan protein karena kerusakan
glomerulus yang difus (Luckman, 1996).</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 19.95pt; text-align: justify; text-indent: 28.5pt;">
<span style="font-size: small;"><span lang="EN-US">Sindroma nefrotik adalah suatu
keadaan klinik dan laboratorik tanpa menunjukkan penyakit yang mendasari, dimana
menunjukkan kelainan inflamasi glomerulus. Secara fungsional sindrom nefrotik
diakibatkan oleh keabnormalan pada proses filtrasi dalam glomerulus yang
biasanya menimbulkan berbagai macam masalah yang membutuhkan perawatan yang
tepat, cepat, dan akurat. (Alatas, 2002)</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 19.95pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US">Whaley and Wong (1998) membagi tipe-tipe Syndrom
Nefrotik :</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.85pt; text-align: justify; text-indent: -19.85pt;">
<span style="font-size: small;"><span lang="SV"><span>1.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="SV">Sindroma Nefrotik lesi minimal (MCNS<span> </span>: <i>Minimal Change Nefrotik Sindroma</i>)</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 37.05pt; text-align: justify;">
<span style="font-size: small;"><span lang="SV">Merupakan kondisi yang
tersering yang menyebabkan sindroma nefrotik pada anak usia sekolah.</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.85pt; text-align: justify; text-indent: -19.85pt;">
<span style="font-size: small;"><span lang="EN-US"><span>2.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Sindroma Nefrotik Sekunder</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 37.05pt; text-align: justify;">
<span style="font-size: small;"><span lang="EN-US">Terjadi selama perjalanan penyakit vaskuler kolagen,
seperti lupus eritematosus sistemik dan purpura anafilaktoid,
glomerulonefritis, infeksi sistem endokarditis, bakterialis dan neoplasma
limfoproliferatif.</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 36.85pt; text-align: justify; text-indent: -19.85pt;">
<span style="font-size: small;"><span lang="EN-US"><span>3.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span><span lang="EN-US">Sindroma Nefirotik Kongenital</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 37.05pt; text-align: justify;">
<span style="font-size: small;"><span lang="SV">Faktor herediter sindroma
nefrotik disebabkan oleh gen resesif autosomal. Bayi yang terkena sindroma
nefrotik, usia gestasinya pendek dan gejala awalnya adalah edema dan
proteinuria. </span><span lang="FI">Penyakit ini
resisten terhadap semua pengobatan dan kematian dapat terjadi pada tahun-tahun
pertama kehidupan bayi jika tidak dilakukan dialisis.</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 17pt; text-align: justify; text-indent: -17pt;">
<span style="font-size: small;"><b><span lang="EN-US"><span>B.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></b><b><span lang="EN-US">Etiologi</span></b></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 19.95pt; text-align: justify; text-indent: 28.5pt;">
<span style="font-size: small;"><span lang="EN-US">Penyebab sindroma nefrotik ini belum
diketahui, namun akhir-akhir ini dianggap sebagai penyakit autoimun, yaitu
reaksi antigen-antibodi. Dimana 80% anak dengan sindroma nefrotik yang
dilakukan biopsi ginjal menunjukkan hanya sedikit keabnormalannya, sementara
sisanya 20 % biopsi ginjal menunjukkan keabnormalan seperti glomerulonefritis
(Novak & Broom, 1999). Patogenesis mungkin karena gangguan metabolisme,
biokimia dan fisiokimia yang menyebabkan permeabilitas membran glomerulus
meningkat terhadap protein (Whalley and Wong, 1998). Sedangkan menurut Behrman
(2001), kebanyakan (90%) anak yang menderita nefrosis mempunyai beberapa bentuk
sindroma nefrotik idiopatik, penyakit lesi minimal ditemukan pada sekitar 85%.
Sindroma nefrotik sebagian besar diperantarai oleh beberapa bentuk
glomerulonefritis.</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 17pt; text-align: justify; text-indent: -17pt;">
<span style="font-size: small;"><b><span lang="EN-US"><span>C.<span style="font-family: "Times New Roman"; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span></span></b><b><span lang="EN-US">Patofisiologi</span></b></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 19.95pt; text-align: justify; text-indent: 28.5pt;">
<span style="font-size: small;"><span lang="EN-US">Kelainan yang terjadi pada sindroma
nefrotik yang paling utama adalah proteinuria sedangkan yang lain dianggap
sebagai manifestasi sekunder. Kelainan ini disebabkan oleh karena kenaikan
permeabilitas dinding kapiler glomerulus yang sebabnya belum diketahui yang
terkait dengan hilangnya muatan negatif gliko protein dalam dinding kapiler.
Pada sindroma nefrotik keluarnya protein terdiri atas campuran albumin dan
protein yang sebelumnya terjadi filtrasi protein di dalam tubulus terlalu
banyak akibat dari kebocoran glomerulus dan akhirnya dieskresikan dalam urin.</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 19.95pt; text-align: justify; text-indent: 28.5pt;">
<span style="font-size: small;"><span lang="EN-US">Pada sindroma nefrotik protein hilang
lebih dari 2 gram per-hari yang terutama terdiri dari albumin yang
mengakibatkan hipoalbuminemia, pada umumnya edema muncul bila kadar albumin
serum turun di bawah 2,5 gram/dl. Mekanisme edema belum diketahui secara fisiologi
yang memuaskan tetapi kemungkinannya adalah bahwa edema didahului oleh
timbulnya hipoalbumin akibat kehilangan protein urin. Hipoalbumin menyebabkan
penurunan tekanan osmotik plasma yang memungkinkan transudasi cairan dari
ekstravaskuler ke ruang interstisial. Penurunan volume ekstravaskuler menurunkan
tekanan perfusi ginjal, mengaktifkan system renin angiotensin aldosteron yang
merangsang reabsorbsi atrium di tubulus distal. </span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 19.95pt; text-align: justify; text-indent: 28.5pt;">
<span style="font-size: small;"><span lang="SV">Penurunan
volume intravaskuler juga merangsang pelepasan hormon antidiuretik yang
mempertinggi reabsorbsi air dalam duktus kolektivus. Karena tekanan osmotik
plasma berkurang, natrium dan air yang telah diabsorbsi masuk ke ruang
interstisial, memperberat edema. Adanya faktor-faktor lain yang juga memainkan
peran pada pembentukan edema dapat ditunjukkan melalui observasi bahwa beberapa
penderita sindroma nefrotik mempunyai volume intravaskuler yang
normal/meningkat dan kadar renin serta aldosteron plasma normal/ meningkat dan
kadar renin serta aldosteron plasma normal atau menurun Penjelasan secara
hipotesis meliputi defek intrarenal dalam ekskresi natrium dan air atau adanya
agen dalam sirkulasi yang menaikkan permeabilitas dinding kapiler di seluruh tubuh
serta dalam ginjal.</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 19.95pt; text-align: justify; text-indent: 28.5pt;">
<span style="font-size: small;"><span lang="SV">Pada status
nefrosis hampir semua kadar lemak (kolesterol, trigliserida) dan lipoprotein
serum meningkat. Hipoproteinemia merangsang sintesis protein menyeluruh dalam
hati, termasuk lipoprotein dan katabolisme lemak menurun, karena penurunan
kadar lipoprotein lipase plasma. Sistem enzim utama yang mengambil lemak dari
plasma. Apakah lipoprotein plasma keluar melalui urin belum jelas (Behrman,
2000).</span></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 19.95pt; text-align: justify; text-indent: 28.5pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 19.95pt; text-align: justify; text-indent: 28.5pt;">
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Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0tag:blogger.com,1999:blog-5571951805809298361.post-83381767817065633752018-03-15T17:21:00.000+07:002018-03-15T17:21:13.143+07:00ASUHAN KEPERAWATANA ANAK DENGAN TB PARU<br />
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<![endif]--><b><u><span lang="EN-US"></span></u></b></div>
<div class="MsoNormal">
<b><u><span lang="EN-US">Lesi Pada Tbc Paru</span></u></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Kelenjar limfe : hilus, parantrakeal, mediatinum</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Parenkhim : fokos primer, pnemonia, atelaktis, terkuloma, kavitas</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Saluran pernafasan : air traping” penyakit endobronkhial ,
trakeobronkhial, stenosis, bronkhus, fistula bronkhopleura, bronkhopl,
bronkhoektasis, fistula bronkhoesofagus.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Pleura : efusi, emfisema, pneumothorak, hemothorak, fistula
bronkhop;eura</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Pembuluh darah : milier, perdarahan paru.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><u><span lang="EN-US">Bentuk klinis TBC Pada Anak</span></u></b></div>
<div class="MsoNormal">
<i><span lang="EN-US">Penyakit TB paru :</span></i></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">TBC paru primer (pembesaran kelenjar<span style="mso-spacerun: yes;">
</span>hilus dengan atau tanpa kelainan parenkhim)</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">TC paru progresif (pneumonia, TBC endobronkhial)</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">TBC milier</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Efusi pleura</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">TBC kronik : fibrosis, tuberkuloma, kavitas</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><u><span lang="EN-US">Diluar paru :</span></u></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Kelenjar limfe</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Otak dan selaput otak</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Tulang dan sendi</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Saluran cerna termasuk usus, perineum, hepar, kandung empedu,
pankreas</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Saluran kemih termasuk ginjal</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Kulit</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Mata</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Telinga dan mastoid</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Jantung</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Membram serous perineum perikardium)</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Kelenjar endokrin (adrenal)</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Courier New"; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US">Saluran nafas (tonsil, laring)</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span lang="EN-US">Tanda Dan Gejala</span></b></div>
<div class="MsoNormal">
<span lang="EN-US">untuk itu penting memikirkan adanya TBC
pada anak kalau terdapat keadaan atau tanda-tanda yang mencurigakan :</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo3; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">pada anak harus dicurigai
adanya TBC kalau :</span></div>
<ol start="1" style="margin-top: 0cm;" type="a">
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list 36.0pt;"><span lang="EN-US">kontak erat(serumah dengan penderita TBC dengan sputum BTA (+)</span></li>
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list 36.0pt;"><span lang="EN-US">terdpat reaksi kemerahan setelah penyuntikan BCG selama 3-7
hari.</span></li>
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list 36.0pt;"><span lang="EN-US">Terdapat gejala umum</span></li>
</ol>
<br />
<br />
<br />
<b>DOWNLOAD FILE WORD LENGKAP <a href="http://dashsphere.com/9gxQ" target="_blank">KLIK DISINI !</a></b><br />
<br />Rizki Kurniadihttp://www.blogger.com/profile/12542148078905425116noreply@blogger.com0