eko prayugo saputro (14.401.11.029) laporan pendahuluan rhd

8/12/2019 Eko Prayugo Saputro (14.401.11.029) Laporan Pendahuluan Rhd

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2/18

BAB I

PENDAHULUAN

A. Latar Bea!a"#

Pe"$a!%t &a"t'"# re'at%! (PR) a*aa+ ,aa+ ,at' !-%!a,% $a"# e/a+a$a!a" *ar%

*ea re'at%!.Pe"$a!%t &a"t'"# re'at%! a*aa+ ,e/'a+ !-"*%,% *%a"a ter&a*% !er',a!a"

era"e" *ar% !at'!at' &a"t'"# $a"# *%,e/a/!a" -e+ *ea re'at%!. Kat'!at'

&a"t'"# ter,e/'t r',a! !are"a r-,e, er&aa"a" e"$a!%t $a"# *%'a% *e"#a" %"e!,%

te"##-r-!a" $a"# *%,e/a/!a" -e+ /a!ter% Stret--', 3 +e-%t%', t%e A (-"t-+:

Stret--', $-#e"e,) /a!ter% $a"# /%,a e"$e/a/!a" *ea re'at%!.

Se/a"$a! !'ra"# e/%+ 59 6 a,%e" *e"#a" *ea re'at%! a!'t /%,a ter&a*% !ea%"a"

a*a &a"t'"# 'a% *ar% #a"##'a" !at' #a#a &a"t'"# er%!ar*%t%, (ra*a"# ,ea't &a"t'"#)

/a+!a" !eat%a".De"#a" e"$a!%t &a"t'"# re'at%! $a"# !r-"%! a*a a,%e" /%,a ter&a*%,te"-,%, !at' (#a"##'a" !at') e/e,ara" atr%' (r'a"# &a"t'"#) ar%t%a (#a"##'a"

%raa &a"t'"#) *a" #a"##'a" '"#,% 7e"tr%!e (r'a"# &a"t'"#).Pe"$a!%t &a"t'# re'at%!

a,%+ e"&a*% e"$e/a/ ,te"-,%, !at' %tra *a" e"##a"t%a" !at' a*a -ra"# *e8a,a *%

Aer%!a Ser%!at.

RHD ter*aat *%,e'r'+ *'"%a. Le/%+ *ar% 100.000 !a,', /ar' *ea reat%! *%*%a#"-,a

,et%a ta+'""$a !+',',"$a a*a !e--! a"a! ',%a 1 ta+'". ;e"*er'"# ter&a"#!%t a*a

*aera+ *e"#a" '*ara *%"#%" e/a/ %"#!'"#a" $a"# !-"*%,% !e/er,%+a" *a" #%


3/18

C. T'&'a"

1. T'&'a" U'

D%+ara!a" a+a,%,8a *aat e"#eta+'% *a" ea+a% /a%! !-",e e"$a!%t RHD

a''" !-",e !eera8ata" a*a !%e" *e"#a" Re'at-%* Heart D%,ea,e( RHD ).

2. T'&'a" K+',',

A#ar e/aa e"#eta+'%:

1) De%"%,% R+e'at% Heart D%,ea,e

2) Et%--#% R+e'at% Heart D%,ea,e

3) Peer%!,aa" D%a#"-,t%! Pe"'"&a"#R+e'at% Heart D%,ea,e

4) K-%!a,% R+e'at% Heart D%,ea,e

5) Pr-#"-,%, R+e'at% Heart D%,ea,e

6) Ka,%%!a,% R+e'at% Heart D%,ea,e

7) ?a"%e,ta,% !%"%! R+e'at% Heart D%,ea,e

8) Pe"ataa!,a"aa" R+e'at% Heart D%,ea,e

9) Pat-%,%--#% ,e!a%#', a,!e a*a a,%e" R+e'at% Heart D%,ea,e.


4/18

BAB II

PE?BAHASAN

A. DEENISI

Pe"$a!%t &a"t'"# reat%! (PR) ata' *aa /a+a,a e*%,"$a r+e'at% +eart *%,ea,e

(RHD) a*aa+ ,'at' !-"*%,% *%a"a ter&a*% !er',a!a" a*a !at' &a"t'"# $a"# /%,a /er'a

e"$e%ta" ata' !e/--ra" ter'taa !at' %tra ,e/a#a% a!%/at a*a"$a #e&aa ,%,a *ar%

*ea reat%!. Dea reat%! er'a!a" ,'at' e"$a!%t ,%,te%! $a"# *aat /er,%at

a!'t ,'/a!'t !r-"%! ata' '%"a" *a" *aat ter&a*% ,etea+ %"e!,% Stret--', /eta

+e-$t%', #r-' A a*a ,a'ra" er"aa,a" /a#%a" ata,. Dea re'at%! a!'t *%ta"*a%

-e+ *ea /er!ea"&a"#a" &a"t'"# /er*e/ar !era, !a*a"# eat ea+. P'"a! %",%*e"

*ea reat%! ter*aat a*a !e--! ',%a 1 ta+'" e"$a!%t %"% &ara"# *%&'a% a*a

a"a! *%/a8a+ ',%a 4 ta+'" *a" e"*'*'! *% ata, 0 ta+'".

R+e'at% e7er a*aa+ ,'at' e"$a!%t %"aa,% a!'t $a"# *%a!%/at!a" -e+ %"e!,%

,tret--', 3 +e-$t% #r-' A a*a te"##-r-!a" (ar%"#%t%,) teta% ta"a *%,erta% %"e!,%

a%" ata' t%*a! a*a %"e!,% ,tret--', *% teat a%" ,eert% *% !'%t. Kara!ter%,t%!

r+e'at% e7er e"*er'"# /er'a"# (re'rre"e) (U*&%a"t% 2010). R+e'at% e7er ter*%r%

ata, /e/eraa a"%e,ta,% !%"%, 1) art+r%t%, (a%"# ,er%"#) 2) ar*%t%, (a%"# ,er%',) 5) +-rea

(a%"# &ara"# *a" t%*a! /er!a%ta") 4) ,'/'ta"e-', "-*'e ) er$t+ea ar#%"at'

(U*&%a"t% 2010).

Se,e-ra"# $a"# e"#aa% *ea reat%! aa/%a t%*a! *%ta"#a"% ,eara a*e!'at ?a!a

,a"#at '"#!%" ,e!a% e"#aa% ,era"#a" e"$a!%t &a"t'"# reat%!. I"e!,% -e+ !'a"

Stret--', Beta He-$t%', #r-' A $a"# e"$e/a/!a" ,e,e-ra"# e"#aa% *ea

reat%! *%a"a *%a8a% ter&a*%"$a era*a"#a" a*a ,a'ra" te"##-r-!a" *%!are"a!a"

e"ataa!,a"aa" *a" e"#-/ata""$a $a"# !'ra"# terara+ e"$e/a/!a" ra'"t-C%" *ar%

!'a" %"% e"$e/ar ea'% ,%r!'a,% *ara+ *a" e"#a!%/at!a" era*a"#a" !at' &a"t'"#.

A!%/at"$a *a'"*a'" !at' e"#aa% ere"#!eta" ,e+%"##a e"$e%t ata' e"e/a *a"

e"#!er't ,e+%"##a !aa' e"'t' t%*a! ,e'r"a a#% *a" ter&a*% !e/--ra".

B. ETIOLOGI

Pe"$e/a/ ter&a*%"$a e"$a!%t &a"t'"# re'at%! *%er!%ra!a" a*aa+ rea!,% a't-%'"(!e!e/aa" t'/'+) $a"# *%,e/a/!a" -e+ *ea re'at%!. I"e!,% ,tret--', 3

+e-%t%!', #r' A a*a te"##-r-! ,ea' e"*a+''% ter&a*%"$a *ea re'at%! /a%!

*ea re'at%! ,era"#a" ertaa a''" *ea re'at%! ,era"#a" 'a"#.


5/18

a!t-ra!t-r re*%,-,%,% ter&a*%"$a e"$a!%t &a"t'"# reat%! R+e'at% Heart

De,ea,e ter*aat a*a *%r% %"*%7%*' %t' ,e"*%r% *a" &'#a a!t-r %"#!'"#a".

a!t-r *ar% I"*%7%*' *%a"tara"$a $a%t' :

1. a!t-r #e"et%!

A*a"$a a"t%#e" %-,%t a"',%a ( HLA ) $a"# t%"##%. HLA ter+a*a *ea reat%!

e"'"&'!a" +'/'"#a" *e"#a" a-a"t%#e" ,e B ,e,%%! *%!e"a *e"#a" a"t%/-*% -"-!-"a

*e"#a" ,tat', re'at%!',.

2. U'r

U'r a#a!"$a er'a!a" a!t-r re*%,-,%,% tere"t%"# a*a t%/'"$a *ea

re'at%! e"$a!%t &a"t'"# re'at%!. Pe"$a!%t %"% a%"# ,er%"# e"#e"a% a"a! ''r

a"tara 1 ta+'" *e"#a" '"a! ,e!%tar ''r = ta+'". T%*a! /%a,a *%te'!a" a*a a"a!

a"tara ''r 5 ta+'" *a" ,a"#at &ara"# ,e/e' a"a! /er''r 5 ta+'" ata' ,etea+ 20

ta+'". D%,tr%/',% ''r %"% *%!ata!a" ,e,'a% *e"#a" %",%*e", %"e!,% ,tret--', a*aa"a! ',%a ,e!-a+. Teta% ?ar!-8%t< e"e'!a" /a+8a e"*er%ta %"e!,% ,tret--',

a*aa+ ere!a $a"# /er''r 2 ta+'".

3. Kea*aa" #%


6/18

a!t-ra!t-r *ar% %"#!'"#a" %t' ,e"*%r% :

A. Kea*aa" ,-,%a e!-"-% $a"# /'r'!

?'"#!%" %"% er'a!a" a!t-r %"#!'"#a" $a"# tere"t%"# ,e/a#a% re*%,-,%,% '"t'!

ter&a*%"$a *ea reat%!. I",%*e", *ea re'at%! *% "e#ara"e#ara $a"# ,'*a+ a&'

&ea, e"'r'" ,e/e' era a"t%/%-t%! tera,'! *aa !ea*aa" ,-,%a e!-"-% $a"# /'r'!

,a"%ta,% %"#!'"#a" $a"# /'r'! r'a+r'a+ *e"#a" e"#+'"% a*at re"*a+"$a

e"*%*%!a" ,e+%"##a e"#ert%a" '"t'! ,e#era e"#-/at% a"a! $a"# e"*er%ta ,a!%t ,a"#at

!'ra"# e"*aata" $a"# re"*a+ ,e+%"##a /%a$a '"t'! era8ata" !e,e+ata" !'ra"# *a"

a%"a%". Se'a +a %"% er'a!a" a!t-ra!t-r $a"# e'*a+!a" t%/'"$a *ea

re'at%!.

B. ;'aa

Per'/a+a" 'aa $a"# e"*a*a! ,er%"# e"#a!%/at!a" %",%*e", %"e!,% ,a'ra" "aa,

/a#%a" ata, e"%"#!at ,e+%"##a %",%*e", *ea re'at%! &'#a e"%"#!at.

C. I!% *a" #e-#ra%

Dea re'at%! er'a!a" e"$a!%t !-,--%t. Pe"$a!%t ter/a"$a! *%*aat!a"

*%*aera+ $a"# /er%!% ,e*a"# teta% *ata a!+%ra!+%r %"% e"'"&'!!a" /a+8a *aera+

tr-%, '" e'"$a% %",%*e", $a"# t%"##% e/%+ t%"##% *ar% $a"# *%*'#a ,e'a.

D%*aera+ $a"# eta!"$a a#a! t%"##% a#a!"$a a"#!a !e&a*%a" *ea reat%! e/%+ t%"##%

*ar%a*a *%*atara" re"*a+.

;. PATOISIOLOGI

?e"'r't +%-te,a Kaa" *!! (2004) *a" a/r%,!%e (2010) ter&a*%"$a &a"t'"# reat%!

*%,e/a/!a" a"#,'"# -e+ *ea reat%! ,'at' e"$a!%t ,%,te%! $a"# *%,e/a/!a" -e+

%"e!,% ,tret-!-!', #r' A. *ea reat%! ee"#ar'+% ,e'a er,e"*%a" e"$e/a/!a"

-%artr%t%,. a"t'"# er'a!a" -r#a" ,a,ara" *a" er'a!a" /a#%a" $a"# !er',a!a""$a

a%"# ,er%',.

Ker',a!a" &a"t'"# *a" e,% ,e"*% /'!a" a!%/at %"e!,% art%"$a &ar%"#a" ter,e/'t t%*a!

e"#aa% %"e!,% ata' ,eara a"#,'"# *%r',a! -e+ -r#a"%, ter,e/'t "a'" +a %"%

er'a!a" e"-e"a ,e",%t%7%ta, ata' rea!,% $a"# ter&a*% ,e/a#a% re,-" ter+a*a

,tret-!-!', +e-%t%!',. Le'!-,%t *ara+ a!a" tert%/'" a*a &ar%"#a" $a"# ter!e"a *a"

e/e"t'! "-*' $a"# !e'*%a" a!a" *%#a"t% *e"#a" &ar%"#a" ar't. ?%-!ar*%' te"t' ,a&a

ter%/at *aa r-,e, %"aa,% %"% art%"$a /er!e/a"#a+ %-!ar*%t%, reat%! $a"#

,ee"tara eea+!a" te"a#a !-"tra!,% &a"t'"#. De%!%a" 'a er%ar*%' &'#a ter%/at

art%"$a &'#a ter&a*% er%ar*%t%, reat%! ,eaa er&aa"a" a!'t e"$a!%t. K-%!a,%

%-!ar*%a *a" er%ar*%a /%a,a"$a ta"a e"%"##a!a" #e&aa ,%,a $a"# ,er%',. Na'"

,e/a%!"$a e"*-!ar*%t%, reat%! e"#a!%/at!a" ee! ,a%"# !eaata" era"e".

E"*-!ar*%t%, reat%! ,eara a"at-%, *%a"%e,ta,%!a" *e"#a" a*a"$a t'/'+a"

!e% $a"# tra",ara" $a"# e"$er'a% a"%! *e"#a" '!'ra" ,e/e,ar !eaa &ar' e"t'

ter,','" *aa *ereta" ,ea"&a"# te% /%a+ !at'. ?a"%a"%! !e% %t' t%*a! taa!

/er/a+a$a *a" *aat e"#+%a"# ta"a er',a! /%a+ !at' "a'" $a"# e/%+ ,er%"# ere!ae"%/'!a" ee! ,er%',. ?ere!a e"&a*% a8a ter&a*%"$a ,'at' r-,e, $a"# ,eara /erta+a


7/18

e"e/a!a" /%a+/%a+ !at' e"$e/a/!a" e"&a*% ee"*e! *a" e"e/a *%,/a"*%"#

$a"# "-ra ,e+%"##a t%*a! *aat e"'t' *e"#a" ,e'r"a. Ter&a*%a+ !e/--ra" ,'at'

!ea*aa" $a"# *%,e/'t re#'r#%ta,% !at'. Teat $a"# a%"# ,er%"# e"#aa% re#'r#%ta,%

!at' a*aa+ !at' %tra.

D. ?ANIESTASI KLINIS

Pe"*er%ta ''"$a e"#aa% ,e,a! "aa, $a"# *%,e/a/!a" &a"t'"#"$a ,'*a+

e"#aa% #a"##'a" "$er% ,e"*% $a"# /er%"*a+ %"*a+ /era! !eera+a" *% !'%t

$a"# /er/ata, #era!a" ta"#a" $a"# ta! /erat'ra" *a" ta! ter!e"*a% (!-rea) ata'

/e"&-a" !e%!e% *%/a8a+ !'%t. Sea%" %t' ta"*a $a"# &'#a t'r't e"$erta%"$a a*aa+

"$er% er't !e+%a"#a" /erat /a*a" eat ea+ *a" te"t' ,a&a *ea.

Dea re'at%! er'a!a" !''a" ,e&'a+ #e&aa *a" ta"*a !%"%!. Dea

re'at%! er'a!a" e"$a!%t a*a /a"$a! ,%,te e"#e"a% ter'taa &a"t'"# ,e"*%

-ta! *a" &ar%"#a" !'%t. Ta"*a *a" #e&aa a!'t *ea re'at%! /er7ar%a,% ter#a"t'"#

-r#a" $a"# ter%/at *a" *era&at !eter%/ata""$a. B%a,a"$a #e&aa#e&aa %"% /era"#,'"#

,at' ,aa% e"a %"##' ,etea+ %"e!,% -e+ Stret--',. Ge&aa !%"%, a*a e"$a!%t

&a"t'"# re'at%! /%,a /er'a #e&aa !ar*%a! (&a"t'"#) *a" "-" !ar*%a!. Ge&aa"$a a"tara

a%":

1. ?a"%e,ta,% !ar*%a! *ar% *ea re'at%!

a) (%"e!,% *a" era*a"#a" &a"t'"#) a*aa+ !-%!a,% a%"# ,er%', *a" !e*'a

a%"# '' *ar% *ea re'at%! (,e!%tar 0 6). Pa*a !a,',!a,', $a"# e/%+

a"&'t a,%e" *aat e"#e'+ ,e,a! "aa, *a*a tera,a t%*a! "$aa" "$er% *a*a

e*ea (/e"#!a!) /at'! ata' -rt-"e' (,e,a! ,aat /er/ar%"#)

b) Pa*a eer%!,aa" %,%! !ar*%t%, (era*a"#a" a*a &a"t'"#) ''"$a *%*ete!,%

*e"#a" *%te'!a""$a /%,%"# &a"t'"# (#a"##'a" /'"$% &a"t'"#) ata' ta!%!ar*%a

(&a"t'"# /er*eta! F 100Ce"%t) *%'ar ter&a*%"$a *ea

c) ?a"%e,ta,% !ar*%a! a%" a*aa+ #a#a &a"t'"# !-"#e,t% *a" er%!ar*%t%, (ra*a"#

,ea't &a"t'"#)

d) Pa,%e" *e"#a" *%a#"-,%, *ea re'at%! a!'t +ar', *%!-"tr- ,e,er%"# '"#!%"

!are"a r-#re,%%ta, e"$a!%t"$a

e) ?'r'r (/%,%"# &a"t'"#) /ar' ata' er'/a+a" /'"$% 'r'r. ?'r'r $a"#

*%*e"#ar a*a *ea re'at%! a!'t /%a,a"$a *%,e/a/!a" -e+ %",'%,%e",% !at'

(#a"##'a" !at').

f) Ga#a &a"t'"# !-"#e,t%

Ga#a &a"t'"# *aat ter&a*% ,e!'"*er a!%/at %",'%,%e",% !at' $a"# /erat ata'

%-!ar*%t%, (ra*a"# a*a ,e -t-t &a"t'"#)

g) Per%!ar*%t%,

2. Ge&aa '' "-" !ar*%a! *a" a"%e,ta,% a%" *ar% *ea reat%! a!'t a"tara a%":


8/18

a) P-%artr%t%, (era*a"#a" a*a /a"$a! ,e"*%) a*aa+ #e&aa '' *a" er'a!a"

a"%e,ta,% a8a *ar% *ea re'at%! (0 6). U'"$a artr%t%, (ra*a"#

,e"*%) *%'a% a*a ,e"*%,e"*% /e,ar *% e!,tre%ta, /a8a+ ('t't *a" e"#!e) a'

/er%#ra,% !e ,e"*%,e"*% /e,ar a%" *% e!,tre%ta, ata, ata' /a8a+ (,%!' *a"

er#ea"#a" ta"#a"). Se"*% $a"# ter!e"a a!a" tera,a ,a!%t /e"#!a! tera,a +a"#at

er%te *a" er#era!a" ter/ata,. Be"#!a! *a" '"a! a*a er,e"*%a" "$er% $a"#

/er%"*a+%"*a+. a-'*, art+r%t%, (r-"% -,t r+e'at% e7er art+r-at+$)

$a%t' *e-r%ta, &ar% ta"#a" *a" !a!% /er'a '"ar *e7%a,% e!,% ,e"*%

etaar-aa"#ea +%ere!,te",% ,e"*% r-!,%a %"teraa"#ea. Ge&aa artr%t%,

e"aa% '"a!"$a a*a 8a!t' 12 24 &a *a" /erta+a" *aa 8a!t' 2 +ar%

(&ara"# ter&a*% e/%+ *ar% 5 %"##') *a" /ere,-" ,a"#at /a%! *e"#a" e/er%a"

a,%r%". P-%artr%t%, e/%+ '' *%&'a% a*a rea&a *a" -ra"# *e8a,a '*a

*%/a"*%"#!a" a*a a"a!a"a!.

b) K+-rea S$*e"+a !+-rea %"-r ata' St. Ja"e *a"e e"#e"a% +a%r 16

e"*er%ta *ea re'at%!. ?a"%e,ta,% %"% e"er%"!a" !eter%/ata" ,%,te,$ara ,e"tra a*a r-,e, ra*a"#. Pe"*er%ta *e"#a" !+-rea %"% *ata"# *e"#a"

#era!a"#era!a" $a"# t%*a! ter!--r*%"a,% *a" t%*a! /ert'&'a" *a" e-,% a/%.

?a"%e,ta,% %"% e/%+ "$ata /%a e"*er%ta /a"#'" *a" *aa !ea*aa" ,tre,.

Pe"*er%ta taa! ,ea' #'#' *a" ,er%"#!a% e"$er%"#a%. B%ara"$a terta+a"

ta+a" *a" ee*a!e*a!. K--r*%"a,% -t-t-t-t +a', ,'!ar. T'%,a" ta"#a""$a

&ee! *a" *%ta"*a% -e+ -reta" !e ata, $a"# t%*a! a"ta *e"#a" #ar%, $a"# ra#'

ra#'. Pa*a ,aat '"a! #e&aa"$a t'%,a""$a t%*a! *aat *%/aa ,aa ,e!a%.

c) Er%t+ea ar#%"at' er'a!a" r'a $a"# !+a, '"t'! *ea re'at%! *a"

&ara"# *%te'!a" a*a e"$a!%t a%". Kare"a !e!+a,a""$a ta"*a %"% *%a,'!!a"

*aa a"%e,ta,% %"-r. Kea%"a" %"% /er'a r'a t%*a! #ata a!'er *e"#a"

te% er%t+ea (!eera+a") $a"# e"&aar *ar% /a#%a" ,at' !e /a#%a" a%"

e"#e%%"#% !'%t $a"# taa! "-ra ter&a*% a*a 6 e"*er%ta. Ga"##'a" %"%

/er*%aeter 2 *a" a%"# ,er%"# *%te'!a" a*a /ata"# t'/'+ *a" t'"#!a%

/a#%a" ata, t%*a! e%/at!a" '!a. Er%t+ea %"% t%/' ,e8a!t'8a!t' ,eaa

,a!%t e,!%'" $a"# ter,er%"# a*aa+ a*a ,ta*%' a8a *a" /%a,a"$a ter&a*%

+a"$a a*a e"*er%ta *ea re'at%! *e"#a" !ar*%t%,.

d) N-*' ,'/!'ta". re!'e",% a"%e,ta,% %"% e"'r'" ,e&a! /e/eraa *e!a*e

tera!+%r *a" !%"% +a"$a *%te'!a" a*a e"*er%ta e"$a!%t &a"t'"# re'at%!

!+r-"%!. re!'e",%"$a !'ra"# *ar% 6 "a'" a*a e"&a"#!%ta" *% Uta+ "-*'',,'/!'ta" *%te'!a" a*a ,aa% 106 e"*er%ta. N-*'', (/e"&-a") %"% /%a,a"$a

tereta! a*a er'!aa" ,e"*% ter'taa r'a, &ar% 't't *a" er,e"*%a" !a!%.

Ka*a"#!a*a"## "-*'', %"% *%te'!a" a*a !'%t !eaa *a" *% ata, t'a"#

/ea!a"#. U!'ra""$a /er7ar%a,% *ar% 0 ,aa% *e"#a" 2 ,erta t%*a! "$er% *a"

*aat *%#era!!a" ,eara /e/a, /%a,a"$a !e% *a" e"#+%a"# e/%+ eat. K'%t

$a"# e"'t'% t%*a! 'at ata' era*a"#. N-*'', %"% '"' +a"$a ,e,'*a+

/e/eraa %"##' ,a!%t *a" !e/a"$a!a" +a"$a *%te'!a" a*a e"*er%ta *e"#a"

!ar*%t%,.

e) ?a"%e,ta,% a%" *ar% *ea re'at%! a"tara a%" "$er% er't e%,ta!,%,

(%%,a") *ea *e"#a" ,'+' *% ata, 59 ; *e"#a" -a $a"# t%*a!


9/18

!ara!ter%,t%! "e'-"%a re'at%! $a"# #e&aa"$a %r% *e"#a" "e'-"%a

!are"a %"e!,%.

f) Tr-/-e/-% (,'/ata" *% e/''+ *ara+) /%,a ter&a*% ,e/a#a% !-%!a,% *ar%

,te"-,%, %tra (#a"##'a" !at').

g) A"e%a +e-%t%! !ar*%a! /%,a ter&a*% a!%/at ea+"$a ,e *ara+ era+ !are"a

/er#e,e!a" *e"#a" !at' $a"# ter%"e!,%. Pe"%"#!ata" e"#+a"'ra" tr-/-,%t

/%,a &'#a ter&a*%.

h) Ar%t%a atr%' (#a"##'a" %raa &a"t'"#) /%a,a"$a ter&a*% !are"a e/e,ara"

atr%' !%r% !are"a #a"##'a" a*a !at' %tra.

?a"%e,ta,% K%"%! e"'r't -"e, (19=2)

?a$-r ?%"-r

1. ;ar*%t%, 1. e7er

2. P-%art+r%t%, 2. Art+ra#%a

5. ;+-rea 5. Per"a+ e"#aa% #a#a #%"&a

4. Er$t+ea ar#%"at' 4. LED t%"##%

. N-*' S'/'ta"e-', . ;Reat%7e Pr-te%";RP ()

. Le'!-,%t-,%,. I"ter7a PR ea"&a"#

E. PEN;EGAHAN

%!a !%ta %+at *%ata, /a+8a e"$a!%t &a"t'"# reat%! ,a"#at '"#!%" ter&a*% *e"#a"

a*a"$a !e&a*%a" a8a $a%t' *ea reat%! (DR). Pe"e#a+a" $a"# ter/a%! a*aa+ /a#a%a"a

'a$a !%ta &a"#a" ,aa% e"#aa% *ea reat%! (DR) (ter,era"# %"e!,% !'a"

Stret--', /eta +e-$t%',).

A*a /e/eraa a!t-r $a"# *aat e"*'!'"# ,e,e-ra"# ter,era"# !'a" ter,e/'t*%a"tara"$a a!t-r %"#!'"#a" ,eert% !-"*%,% !e+%*'a" $a"# &ee! !-"*%,% t%"##a $a"#

/er*e,a!a" *a" a!,e, !e,e+ata" $a"# !'ra"# er'a!a" *eter%"a" $a"# ,%#"%%!a" *aa

*%,tr%/',% e"$a!%t %"%. Jar%a,% 'aa &'#a e'"$a% era" $a"# /e,ar *aa ter&a*%"$a

%"e!,% ,tret-!-!!', '"t'! ter&a*% DR.

Se,e-ra"# $a"# ter%"e!,% !'a" Stret--', /eta +e-$t%', *a" e"#aa%

*ea reat%! +ar', *%/er%!a" t+era$ $a"# a!,%a *e"#a" a"t%/%-t%!"$a. Ha %"% '"t'!

e"#+%"*ar!a" !e'"#!%"a" ,era"#a" !e*'a !a%"$a ata' /a+!a" e"$e/a/!a" Pe"$a!%t

a"t'"# Reat%!.

F. Peer%!,aa" D%a#"-,t%!


10/18

1. Peer%!,aa" *ara+

a) LED t%"##% ,e!a%

b) Le!-,%t-,%,

c) N%a% +e-#-/%" *aat re"*a+

2. Peer%!,aa" /a!ter%--#%

a) B%a!a" +a', te"##-r-!a" '"t'! e/'!t%!a" a*a"$a ,tret--',.

b) Peer%!,aa" ,er--#%. D%'!'r t%ter ASTO a,t%,tret-!%"a,e a"t% +$a'r-"%*a,e.

3. Peer%!,aa" ra*%--#%

Ee!tr-!ar*-%#ra% *a" e!-!ar*%-#ra% '"t'! e"%a% a*a"$a !ea%"a" &a"t'"#.

4. EKG

a) I",'%,%e",% ?%tra (I?): +%ertr-% atr%' *a" 7e"tr%!e !%r% ,%"', ta!%!ar*%a

!-"tra!,% atr%' reat're %/ra,% atr%'

b) Pr-a (?JP): a/"-raa, #e-/a"#

c) Ste"-,%, ?%tra (S?) :e/e,ara" atr%' !%r% +%ertr-% 7e"tr%!e !a"a"

*e%a,% a!,%, !a"a" er'/a+a" #e-/a"# ST *ee! !-"*'!,% ( /-! AJ *era&at I

/-! a/a"# /er!a, !%r%)

d) I",'%,%e",% A-rt%! (IA) :+%ertr-% 7e"tr%!e !%r% a*a %/r%a,% atr%'/%a #a#a

!-"#e,t% /erat

e) Ste"-,%, Tr%!',%* (ST) : +%ertr-% atr%' !a"a" +%ertr-% 7e"tr%!e !%r%

!a"a" %/r%a,% atr%'

f) I",'%,%e",% Tr%!',%* (IT) : +%ertr-% 7e"tr%!e *a" atr%' !a"a" %/r%a,%

atr%'

g) Ste"-,%, P'-"%! (SP) : +%ertr-% 7e"tr%!e atr%' !a"a" *e7%,%a,% a!,e,

!a"a" %/r%a,% atr%'

h) I",'%,%e",% P'-"a%! (IP) : *%ata,% 7e"tr%!e !a"a" *a" atr%' !a"a"

. PENATALAKSANAAN

Pe"ataa!,a"aa" *ea re'at%! a!t% ata' rea!t%7a,% !e/a% *%a"tara"$a a*aa+

1. T%ra+ /ar%"# *a" -/%%,a,% (!e/a% !ea!t%7%ta, "-ra) ,eara /erta+a

2. Pe/era"ta,a" ter+a*a !'a" ,tret-!-!!', *e"#a" e/er%a" a"t%/%-t%

e"%,%%" ata' er%tr-%,%". U"t'! r-%a!,%, ata' e"e#a+a" *aat *%/er%!a"

a"t%/%-t% e"%,%%" /e"


11/18

Kare"a *ea reat%! /er+'/'"#a" erat *e"#a" ra*a"# Stret--', /eta

+e-$t%', #r' A a!a e/era"ta,a" *a" e"e#a+a" *%t'&'!a" a*a ra*a"#

ter,e/'t. I"% *aat /er'a :

a. Era*%!a,% !'a" Stret--', /eta+e-$t%', #r' A

Pe"#-/ata" a*e!'at +ar', *%'a% ,eeat"$a a*a DR *a" *%a"&'t!a"

*e"#a" e"e#a+a". Er$t+r-$%" *%/er%!a" !ea*a ere!a $a"# aer#%

ter+a*a e"%%%".

b. O/at a"t% reat%!

Ba%! -rt-%,ter-%* a''" ,a%,%at *%!eta+'% ,e/a#a% -/at $a"# /er#'"a

'"t'! e"#'ra"#%e"#+%a"#!a" #e&aa#e&aa ra*a"# a!'t a*a DR

c. D%et

?a!a"a" $a"# '!' !a-r% r-te%" *a" 7%ta%".

d. I,t%ra+at

I,t%ra+at *%a"&'r!a" ,aa% ta"*ata"*a %"aa,% +%a"# *a" /e"t'! &a"t'"#

e"#e% a*a !a,',!a,', !ar*%-e#a%. B%a,a"$a 14 +ar% a*a !a,', DR

%"', ar*%t%,. Pa*a !a,', ', ar*%t%, aa %,t%ra+at ratarata 5 %"##' 5

/'a" ter#a"t'"# a*a /erat r%"#a""$a !ea%"a" $a"# a*a ,erta !ea&'a"

er&aa"a" e"$a!%t.

e. O/at-/at La%"

D%/er%!a" ,e,'a% *e"#a" !e/'t'+a". Pa*a !a,', *e"#a" *e!-e",a,% !-r*%,*%/er%!a" *%#%ta%, *%'ret%!a *a" ,e*at%7e. B%a a*a +-rea *%/er%!a" ar#at%

*a" a%"a%".

H. KO?PLIKASI

K-%!a,% $a"# ,er%"# ter&a*% a*a Pe"$a!%t a"t'"# Re'at%! (PR) *%a"tara"$a

a*aa+ #a#a &a"t'"# a"!ar*%t%, (%"e!,% *a" era*a"#a" *% ,e'r'+ /a#%a" &a"t'"#)"e'-"%t%, re'at%! (%"e!,% ar') e/-% ata' ,'/ata" a*a ar' !ea%"a" !at'

&a"t'"# *a" %"ar! (!eat%a" ,e &a"t'"#).

A. De!-e",a,% ;-r*%,

Per%,t%8a *e!-e",a,% -r*%, a*a /a$% *a" a"a! e"##a/ar!a" ter*aat"$a

,%"*r-a !%"%! a!%/at $-ar*%' t%*a! a' ee"'+% !eer'a" eta/-%

tera,'! ert'/'+a". Kea*aa" %"% t%/' !are"a !er&a -t-t &a"t'"# $a"# /ere/%+a"

/%a,a"$a !are"a !ea%"a" ,tr'!t'r &a"t'"# !ea%"a" -t-t &a"t'"# ,e"*%r% ,eert% r-,e,

%"aa,% ata' #a/'"#a" !e*'a a!t-r ter,e/'t. Pa*a ''"$a a$a+ &a"t'"# a*a

a"a! *%-/at% ,eara !a,%! $a%t' *e"#a" *%#%ta%, *a" -/at-/at *%'ret%!a. T'&'a"


12/18

e"#-/ata" %aa+ e"#+%a"#!a" #e&aa (,%t-at%!) *a" $a"# a%"# e"t%"#

e"#-/at% e"$a!%t r%er.

B. Per%ar*%t%,

Pera*a"#a" a*a er%ar* 7%,era%, *a" ar%eta%, $a"# /er7ar%a,% *ar% rea!,% ra*a"#

$a"# r%"#a" ,aa% tert%/'"""$a a%ra" *aa a7' er%ar*.


13/18

BAB III

KONSEP ASUHAN KEPERAMATAN

A. PENGKAIAN

1. A!t%7%ta,%,tra+at

Ge&aa : Keea+a" !eea+a".

Ta"*a : Ta!%!ar*%a e"'r'"a" TD *%,"ea *e"#a" a!t%7%ta,.

2. S%r!'a,%

Ge&aa : R%8a$at e"$a!%t &a"t'"# !-"#e"%ta I? /e*a+ &a"t'"#. Pa%ta,% &at'+

%"#,a".

Ta"*a : Ta!%!ar*%a *%,r%t%a er%"*a+a" TI? !%r% *a" %"er%-r r%t%-" r'/'r'r e*ea ete!%e +e-ra#% ,%"ter.

3. E%%"a,%

Ge&aa : R%8a$at e"$a!%t #%"&a e"'r'"a" re!'e",%&'a+ 'r%"e.

Ta"*a : Ur%"e e!at #ea.

4. N$er%!et%*a!"$aa"a"

Ge&aa : N$er% a*a *a*a a"ter%-r $a"# *%er/erat -e+ %",%ra,% /at'! #era!a"

e"ea" /er/ar%"# "$er% *a*a'"##'"# ,e"*%.

Ta"*a : Per%a!' *%,tra!,% %,: #e%,a+.

5. Per"aa,a"

Ge&aa : *%,"ea /at'! e"eta ata' "-!t'r"a (,'t' '"#!%"t%*a! r-*'!t%).

Ta"*a : ta!%"ea /'"$% "aa, a*7e"t%,%', (!re!e, *a" e"#%) ,'t' /a"$a!

*a" /er/era! *ara+ (e*ea '-"a).

6. Keaa"a"

Ge&aa : R%8a$at %"e!,% 7%r', /a!ter% &a'r e"'r'"a" ,%,te %'".

Ta"*a : Dea.

B. DIAGNOSA KEPERAMATAN YANG ?UNGKIN ?UN;UL

1. Pe"'r'"a" 'ra+ &a"t'"# /* a*a"$a #a"##'a" a*a e"'t'a" a*a !at' %tra

( ,te"-,%, !at' )

2. Per',% &ar%"#a" er%er t%*a! ee!t% /er+'/'"#a" *e"#a" e"'r'"a" eta/-%,e

ter'taa er%er a!%/at 7a,-!-",tr%!,% e/''+ *ara+

3. N$er% a!'t /er+'/'"#a" *e"#a" era*a"#a" a*a e/ra" ,%"-7%a


14/18

4. H%erter%a /er+'/'"#a" *e"#a" Pera*a"#a" a*a e/ra" ,%"-7%a *a" era*a"#a"

!at' &a"t'"#

5. Ket%*a!,e%/a"#a" "'tr%,% !'ra"# *ar% !e/'t'+a" t'/'+ /er+'/'"#a" *e"#a"

e"%"#!ata" a,a a/'"# a!%/at !-e",a,% ,%,te ,ara ,%at%,.

6. I"t-era",% a!t%7%ta, /er+'/'"#a" *e"#a" !eea+a" -t-t t%ra+ /ar%"# ata' %-/%%,a,%

7. S$"*r-e !'ra"# era8ata" *%r% /er+'/'"#a" Ga"##'a" ',!'-,!eeta

P-tart+r%t%,art+a#%a *a" t+era% /e* re,t .

8. Ker',a!a" %"te#r%ta, !'%t /e+'/'"#a" *e"#a" era*a"#a" a*a !'%t *a" &ar%"#a"

,'/'ta".

9. Re,%!- !er',a!a" ert'!ara" #a, /er+'/'"#a" *e"#a" e"''!a" *ara+ *%ar'

a!%/at e"#%,%a" atr%' $a"# e"%"#!at

10. Re,%!- %*era /er+'/'"#a" *e"#a" Gera!a" %"7-'"ter%rr%#'aer eat *a"

!eea+a" -t-t!+-rea

C. REN;ANA TINDAKAN KEPERAMATAN

1. Penurunan curah jantung b/d adanya gangguan pada penutupan katup mitral

( stenosis katup )

T'&'a": Setea+ *%/er%!a" a,'+a" !eera8ata"e"'r'"a" 'ra+ &a"t'"# *aat

*%%"%a!a".

Kr%ter%a +a,%: ?e"'"&'!!a" ta"*ata"*a 7%ta *aa /ata, $a"# *aat *%ter%a

(*%,r%t%a ter!-"tr- ata' +%a"#) *a" /e/a, #e&aa #a#a &a"t'"# (%, : araeter

+e-*%"a%! *aa /ata, "-ra +a'ara" 'r%"e a*e!'at). ?ea-r!a" e"'r'"a"

e%,-*e *%,"eaa"#%"a. I!'t ,erta *aa a!$%7%ta, $a"# e"#'ra"#% /e/a" !er&a

&a"t'"#.

I"ter7e",% *a" ra,%-"a:

I!"r#"$% R&$%'&(

a. Ka&% re!'e",% "a*% RR TD

,eara terat'r ,et%a 4 &a.

b. Ka&% er'/a+a" 8ar"a !'%t

ter+a*a ,%a"-,%, *a" 'at.

c. Bata,% a!t%%ta, ,eara

a*e!'at.

d. Ber%!a" !-"*%,% ,%!--#%,

%"#!'"#a" $a"# te"a"#.

1) ?e-"%t-r a*a"$a er'/a+a"

,%r!'a,% &a"t'"# ,e*%"% '"#!%" *a"

ter&a*%"$a ta!%!ar*%a*%,r%t%a

,e/a#a% !-e",a,% e"%"#!at!a"

'ra+ &a"t'"#

2) P'at e"'"&'!!a" a*a"$a

e"'r'"a" er',% er%er ter+a*a

t%*a! a*e!'at"$a 'ra+ &a"t'"#.

S%a"-,%, ter&a*% ,e/a#a% a!%/at

a*a"$a -/,tr'!,% a%ra" *ara+ a*a7e"tr%!e.

3) I,t%ra+at ea*a% *%er'!a" '"t'!

eer/a%!% e%,%e",% !-"tra!,%

&a"t'"# *a" e"'r'"!a" !-,',%

O2 *a" !er&a /ere/%+a".

4) Stre, e-,% e"#+a,%!a"

7a,-!-"tr%!,% $a"# e"%"#!at!a" TD

*a" e"%"#!at!a" !er&a &a"t'"#.

5) ?e"%"#!at!a" ,e*%aa" -!,%#e" '"t'!

'"#,% %-!ar* *a" e"e#a++%-!,%a.


15/18

e. K-a/-ra,% '"t'! e/er%a"

-!,%#e"

f. K-a/-ra,% '"t'! e/er%a"

*%#%ta%,

6) D%/er%!a" '"t'! e"%"#!at!a"

!-"tra!t%%ta, %-!ar* *a"

e"'r'"!a" /e/a" !er&a &a"t'"#.


16/18

2. Per',% &ar%"#a" er%er t%*a! ee!t% /er+'/'"#a" *e"#a" er'/a+a"

eta/-%, ter'taa er%er a!%/at 7a,-!-",tr%!,% e/''+ *ara+

T'&'a" : Setea+ *%a!'!a" t%"*a!a" !eera8ata" er',% &ar%"#a" er%er ee!t%

Kr%ter%a +a,% : K%e" t%*a! 'at T%*a! a*a ,%a"-,%, T%*a! a*a e*ea

I"ter7e",% *a" ra,%-"a :

I"ter7e",% Ra,%-"a

a. Se%*%!% er'/a+a" t%/a

t%/a ata' #a"##'a" e"ta

!-"t%"$' -"t-+: ea,

/%"#'"# etar#% %"#,a".

b. L%+at 'at ,%a"-,%,

/ea"# !'%t *%"#%" ata'

e/a/. ;atat !e!'ata" "a*%er%er.

c. Ka&% ta"*a e*ea.

d. Pa"ta' er"aa,a" atat

!er&a er"aa,a".

2) . Pa"ta' *ata

a/-rat-r%' -"t-+: GDA BUN

reat%"%" *a" ee!tr-%t.

1. Per',% ,ere/ra ,eara

a"#,'"# ,e+'/'"#a" *e"#a" 'ra+

&a"t'"# *a" &'#a *%e"#ar'+% -e+

ee!tr-%t ata' 7ar%a,% a,a /a,a

+%-!,%a ata' e/-% ,%,te%!.

2. Ja,-!-"tr%!,% ,%,te%!

*%a!%/at!a" -e+ e"'r'"a" 'ra+

&a"t'"# '"#!%" *%/'!t%!a" -e+e"'r'"a" er',% !'%t *a"

e"'r'"a" "a*%.

3. I"*%!at-r tr-/-,%, 7e"a

*aa.

4. P-a &a"t'"# #a#a *aat

e"et',!a" *%,tre,,

er"aa,a". Na'" *%,"ea t%/at%/a

ata' /era"&'t

e"'"&'!!!a" !-%!a,%

tr-/-e/-% ar'.5. I"*%!at-r er',% ata'

'"#,% -r#a"


17/18

3. N$er% a!'t /er+'/'"#a" *e"#a" era*a"#a" a*a e/ra" ,%"-7%a

T'&'a" : Setea+ *%a!'!a" t%"*a!a" !eera8ata" a,aa+ "$er% terata,%.

Kr%ter%a +a,% : S!aa "$er% 01 ta"*ata"*a 7%ta *aa /ata, "-ra !%e" t%*a!

e"#e'+ "$er% t%*a! a*a "$er% te!a" *a" !%e" t%*a! e/ata,% #era!a"$a.K%e"

taa! r%e!,

I"ter7e",% *a" ra,%-"a:

I!"r#"$% R&$%'&(

1. Ka&% !e'+a" "$er%.

Per+at%!a" %"te",%ta, ( ,!aa

110 )

2. Pa"ta' ta"*ata"*a 7%ta

(TD Na*% RR ,'+').

3. Perta+a"!a" -,%,% *aera+

,e"*% $a"# "$er% *a" /er%

-,%,% $a"# "$aa"

4. K-re, *e"#a" a%r

+a"#at&%!a *%%"*%!a,%!a"

5. A&ar!a" te!"%! rea!,a,%

r-#re,% ( "aa, *aa

G'%* %a#er%7%,'a%,a,% )

6. K-a/-ra,% '"t'!e/er%a" a"a#et%!

1. ?e/er%!a" %"-ra,% ,e/a#a%

*a,ar *a" e"#a8a,a" %"ter7e",%

2. ?e"#eta+'% !ea*aa" '' *a"

e/er%!a" %"-ra,% ,e/a#a%

*a,ar *a" e"#a8a,a" %"ter7e",%

3. ?e"'r'"!a" ,a,e te#a"#a"

,e"*% *a" &ar%"#a" ,e!%tar

4. ?e"#+a/at !er&a re,et-r "$er%

5. ?e/a"t' e"'r'"!a" ,a,e

,e"*%,e"*% e"%"#!at!a" ra,a

!-"tr- *a" a' e"#a%+!a"

"$er%.

6. ?e"#+%a"#!a" "$er%


18/18

DATAR PUSTAKA

U*&%a"t% Ma&a" '"%. 2010. Keera8ata" Kar*%-7a,!'er. a!arta: Sae/a ?e*%!a

Art+'r ;. G'$t-" a"* -+" E. Ha ( 199) Buku Ajar Fisiologi Kedokteran Edisi 9

Pe"er/%t B'!' Ke*-!tera" EG; a!arta

?ar$%" E. D-e"#-e, ?ar$ ra"e, ?--r+-',e A%e ;. Ge%,,er (2000)encana

Asuhan Kepera!atan" Pedoman #ntuk Perencanaan dan Pendokumentasian

Pera!atan Pasien Edisi $ Pe"er%/%t B'!' Ke*-!tera" EG; a!arta

Ne,-" (1995)%lmu Kesehatan Anak" &e'tbook o Pediatrics Edisi * B'!' !e*-!tera"

EG; a!arta.

S'"-t- Prata"' (1990)Penyakit +antung ematik,?a!aa+ T%*a! *%'/%!a,%!a"

S'ra/a$a

S$7%a A. Pr%e (199)Patoisiologi" Konsep Klinis Proses - Proses Penyakit Edisi . B'!'

!e*-!tera" EG; a!arta.

M-"# a"* M+ae$, (199) linical 0anual o Pediatrics 1ursing . thEdit%-" ?-,/$Year

B--! St.L-'%, ?%,,-'r%.

He"%*!! (2001)Buku Ajar kepera!atan Kardio2asculer Edisi Haraa" K%ta a!arta

S'**art+ /r'""er ( 2002).Buku Ajar kepera!atan 0edikal Bedah 34l * Edisi 5 EG;

a!arta.

eko prayugo saputro (14.401.11.029) laporan pendahuluan rhd

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