Askep Anak Dengan DHF

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}}}\pard\sb0\sl-240\par\pard\ql \li4578\sb0\sl-276\slmult0 \par\pard\ql\li4578\s
b0\sl-276\slmult0 \par\pard\ql\li4578\sb0\sl-276\slmult0 \par\pard\ql\li4578\sb0
\sl-276\slmult0 \par\pard\ql\li4578\sb0\sl-276\slmult0 \par\pard\ql\li4578\sb97\
sl-276\slmult0 \up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf1\f2\fs24 ASUHAN
KEPERAWATAN ANAK \par\pard\ql \li3308\sb0\sl-276\slmult0 \up0 \expndtw-4\charsca

lex100 PADA PASIEN DENGAN DEMAM BERDARAH DENGUE \par\pard\ql \li2270\sb0\sl-276\
slmult0 \par\pard\ql\li2270\sb276\sl-276\slmult0 \up0 \expndtw-3\charscalex100 I
. PENGERTIAN \par\pard\qj \li2630\ri1508\sb1\sl-275\slmult0 \up0 \expndtw0\char
scalex100 \ul0\nosupersub\cf2\f3\fs24 DHF adalah suatu infeksi arbovirus aku
t yang masuk ke dalam tubuh melalui \up0 \expndtw0\charscalex102 gigitan nyamuk
spesies aides. Penyakit ini sering menyerang anak, remaja, dan \up0 \expndtw0\ch
arscalex104 dewasa yang ditandai dengan demam, nyeri otot dan sendi. Demam Berda
rah \up0 \expndtw-3\charscalex100 Dengue sering disebut pula Dengue Haemoragic F
ever ( DHF ). \par\pard\ql \li2270\sb0\sl-276\slmult0 \par\pard\ql\li2270\sb1\sl
-276\slmult0 \up0 \expndtw-6\charscalex100 \ul0\nosupersub\cf1\f2\fs24 II. PATOF
ISIOLOGI \par\pard\qj \li2628\ri1505\sb0\sl-276\slmult0\fi720 \up0 \expndtw0\cha
rscalex106 \ul0\nosupersub\cf2\f3\fs24 Setelah virus dengue masuk ke dalam tubuh
, pasien akan mengalami \up0 \expndtw0\charscalex100 keluhan dan gejala karena v
iremia, seperti demam, sakit kepala, mual, nyeri otot, \up0 \expndtw-1\charscale
x100 pegal seluruh badan, hiperemi ditenggorokan, timbulnya ruam dan kelainan ya
ng \up0 \expndtw0\charscalex104 mungkin muncul pada system retikuloendotelial se
perti pembesaran kelenjar\up0 \expndtw0\charscalex100 kelenjar getah bening,
hati dan limpa. Ruam pada DHF disebabkan karena \up0 \expndtw-3\charscale
x100 kongesti pembuluh darah dibawah kulit. \par\pard\qj \li2628\ri1508\sb0\sl-2
76\slmult0\fi720 \up0 \expndtw0\charscalex102 Fenomena patofisiologi utama yan
g menentukan berat penyakit dan \up0 \expndtw0\charscalex105 membedakan DF d
an DHF ialah meningginya permeabilitas dinding kapiler \up0 \expndtw0\charscalex
102 karena pelepasan zat anafilaktosin, histamin dan serotonin serta aktivasi sy
stem \up0 \expndtw-1\charscalex100 kalikreain yang berakibat ekstravasasi ca
iran intravaskuler. Hal ini berakibat \up0 \expndtw0\charscalex108 berkurang
nya volume plama, terjadinya hipotensi, hemokonsentrasi, \up0 \expndtw
-3\charscalex100 hipoproteinemia, efusi dan renjatan. \par\pard\qj \li2628\ri150
7\sb1\sl-275\slmult0\fi720 \up0 \expndtw0\charscalex104 Adanya kebocoran plasma
ke daerah ekstravaskuler ibuktikan dengan \up0 \expndtw-2\charscalex100 ditemuka
nnya cairan dalam rongga serosa, yaitu dalam rongga peritoneum, pleura \up0 \exp
ndtw0\charscalex100 dan perikard. Renjatan hipovolemik yang terjadi sebaga
i akibat kehilangan \up0 \expndtw0\charscalex100 plasma, bila tidak segera ter
atasi akan terjadi anoxia jaringan, asidosis metabolic \up0 \expndtw0\charscalex
105 dan kematian. Sebab lain kematian pada DHF adalah perdarahan hebat.
\up0 \expndtw0\charscalex103 Perdarahan umumnya dihubungkan dengan trombositope
nia, gangguan fungsi \up0 \expndtw-3\charscalex100 trombosit dan kelainan fungsi
trombosit. \par\pard\qj \li2628\ri1507\sb1\sl-276\slmult0\fi720 \up0 \expndtw0\
charscalex107 Fungsi agregasi trombosit menurun mungkin disebabkan proses
\line \up0 \expndtw0\charscalex100 imunologis terbukti dengan terdapatnya kompl
eks imun dalam peredaran darah. \line \up0 \expndtw0\charscalex106 Kelainan syst
em koagulasi disebabkan diantaranya oleh kerusakan hati yang \line \up0 \expndtw
0\charscalex104 fungsinya memang tebukti terganggu oleh aktifasi system koagulas
i. Masalah \line \up0 \expndtw0\charscalex102 terjadi tidaknya DIC pada DHF/ DSS
, terutama pada pasien dengan perdarahan \line \up0 \expndtw-3\charscalex100 heb
at. \par\pard\ql \li2270\sb276\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul0
\nosupersub\cf1\f2\fs24 III.KLASIFIKASI DHF \par\pard\qj \li2630\ri1512\sb2\sl-2
75\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf2\f3\fs24 WHO, 1986 me
ngklasifikasikan DHF menurut derajat penyakitnya menjadi 4 \up0 \expndtw-3\chars
calex100 golongan, yaitu : \par\pard\ql \li2630\sb1\sl-274\slmult0 \up0 \expndtw
-3\charscalex100 Derajat I \par\pard\qj \li2630\ri1513\sb2\sl-275\slmult0 \up0 \
expndtw0\charscalex100 Demam disertai gejala klinis lain, tanpa perdarahan spont
an. Panas 2-7 hari, Uji \up0 \expndtw-3\charscalex100 tourniquet positif, trombo
sitipenia, dan hemokonsentrasi. \par\pard\ql \li2630\sb2\sl-276\slmult0 \up0 \ex
pndtw-3\charscalex100 Derajat II \par\pard\qj \li2630\ri1514\sb1\sl-275\slmult0
\up0 \expndtw-1\charscalex100 Sama dengan derajat I, ditambah dengan gejala-geja
la perdarahan spontan seperti \up0 \expndtw-3\charscalex100 petekie, ekimosis, h
ematemesis, melena, perdarahan gusi. \par\pard\ql \li2630\sb1\sl-276\slmult0 \up
0 \expndtw-3\charscalex100 Derajat III \par\pard\ql \li2630\ri1509\sb0\sl-300\sl
mult0 \up0 \expndtw0\charscalex105 Ditandai oleh gejala kegagalan peredaran dara
h seperti nadi lemah dan cepat \up0 \expndtw0\charscalex106 (>120x/mnt ) tekanan

nadi sempit ( \ul0\nosupersub\cf3\f4\fs24 \ul0\nosupersub\cf2\f3\fs24 120 mmHg
), tekanan darah menurun, \up0 \expndtw-3\charscalex100 (120/80 \ul0\nosupersub\
cf3\f4\fs24 \ul0\nosupersub\cf2\f3\fs24 120/100 \ul0\nosupersub\cf3\f4\fs24 \ul0\
nosupersub\cf2\f3\fs24 120/110 \ul0\nosupersub\cf3\f4\fs24 \ul0\nosupersub\cf2\f
3\fs24 90/70 \ul0\nosupersub\cf3\f4\fs24 \ul0\nosupersub\cf2\f3\fs24 80/70 \ul0
\nosupersub\cf3\f4\fs24 \ul0\nosupersub\cf2\f3\fs24 80/0 \ul0\nosupersub\cf3\f4\
fs24 \ul0\nosupersub\cf2\f3\fs24 0/0 ) \line \up0 \expndtw-3\charscalex100 Deraj
at IV \par\pard\qj \li2630\ri1507\sb0\sl-294\slmult0 \up0 \expndtw-1\charscalex1
00 Nadi tidak teaba, tekanan darah tidak teatur (denyut jantung \ul0\nosupersub\
cf3\f4\fs24 \ul0\nosupersub\cf2\f3\fs24 140x/mnt) anggota \up0 \expndtw-3\charsc
alex100 gerak teraba dingin, berkeringat dan kulit tampak biru. \par\pard\li2270
\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-27
6\slmult0\par\pard\li2270\sb9\sl-276\slmult0\fi0\tx3988\tx4420\tx10398 \up0 \exp
ndtw0\charscalex110 \ul0\nosupersub\cf4\f5\fs24 DOKUMEN\tab \up0 \expndtw-3\char
scalex100 :\tab \up0 \expndtw0\charscalex126 SUBHAN PSIK FK UNAIR SURABAYA\t
ab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf5\f6\fs24 1\par\pard\ql \li22
70\sb4\sl-276\slmult0 \up0 \expndtw0\charscalex111 \ul0\nosupersub\cf4\f5\fs24 A
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sl-276\slmult0 \up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf1\f2\fs24 IV.TAND
A DAN GEJALA \par\pard\qj \li2630\ri1508\sb0\sl-276\slmult0 \up0 \expndtw0\chars
calex100 \ul0\nosupersub\cf2\f3\fs24 Selain tanda dan gejala yang ditampilkan be
rdasarkan derajat penyakitnya, tanda \up0 \expndtw-3\charscalex100 dangejala lai
n adalah : \par\pard\li2270\sb0\sl-276\slmult0\fi360\tx2990 \up0 \expndtw-3\char
scalex100 -\tab \up0 \expndtw-3\charscalex100 Hati membesar, nyeri spontan yang
diperkuat dengan reaksi perabaan.\par\pard\li2270\sb0\sl-276\slmult0\fi360\tx299
0 \up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw-3\charscalex100 Asites\par\p
ard\li2270\sb0\sl-276\slmult0\fi360\tx2990 \up0 \expndtw-3\charscalex100 -\tab \
up0 \expndtw-3\charscalex100 Cairan dalam rongga pleura ( kanan )\par\pard\li227
0\sb0\sl-276\slmult0\fi360\tx2990 \up0 \expndtw-3\charscalex100 -\tab \up0 \expn
dtw-3\charscalex100 Ensephalopati : kejang, gelisah, sopor koma.\par\pard\li2270
\sb276\sl-276\slmult0\fi0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\f
s24 V. PEMERIKSAAN DAN DIGNOSIS\par\pard\li2270\sb18\sl-276\slmult0\fi360\tx2990
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 -\tab \up0 \expndtw-3
\charscalex100 Trombositopeni ( \ul0\nosupersub\cf3\f4\fs24 \ul0\nosupersub\cf2\f
3\fs24 100.000/mm\ul0\super\cf6\f7\fs21 3\ul0\nosupersub\cf2\f3\fs24 )\par\pard
\li2270\sb38\sl-276\slmult0\fi360\tx2990 \up0 \expndtw-3\charscalex100 -\tab \up
0 \expndtw-3\charscalex100 Hb dan PCV meningkat ( \ul0\nosupersub\cf3\f4\fs24 \ul
0\nosupersub\cf2\f3\fs24 20% )\par\pard\li2270\sb18\sl-276\slmult0\fi360\tx2990
\up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw-3\charscalex100 Leukopeni ( m
ungkin normal atau lekositosis )\par\pard\li2270\sb0\sl-276\slmult0\fi360\tx2990
\up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw-3\charscalex100 Isolasi virus
\par\pard\li2270\sb0\sl-276\slmult0\fi360\tx2990 \up0 \expndtw-3\charscalex100 \tab \up0 \expndtw-3\charscalex100 Serologi ( Uji H ): respon antibody sekunder\
par\pard\li2270\sb0\sl-276\slmult0\fi360\tx2990 \up0 \expndtw-3\charscalex100 -\
tab \up0 \expndtw-1\charscalex100 Pada renjatan yang berat, periksa : Hb, PCV be
rulang kali ( setiap jam atau 4-\par\pard\qj \li2990\ri1513\sb0\sl-276\slmult0 \
up0 \expndtw0\charscalex102 6 jam apabila sudah menunjukkan tanda perbaikan ), F
aal hemostasis, FDP, \up0 \expndtw-3\charscalex100 EKG, Foto dada, BUN, creatini
n serum. \par\pard\ql \li2270\sb276\sl-276\slmult0 \up0 \expndtw-4\charscalex100
\ul0\nosupersub\cf1\f2\fs24 VI.PENATALAKSANAAN \par\pard\ql \li2630\sb0\sl-276\
slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 Indikasi rawat
tinggal pada dugaan infeksi virus dengue : \par\pard\li2630\sb0\sl-276\slmult0\
fi0\tx2990 \up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw0\charscalex103 Pana
s 1-2 hari disertai dehidrasi ( karena panas, muntah, masukan kurang )\par\pard\
li2630\sb0\sl-276\slmult0\fi360 \up0 \expndtw-3\charscalex100 atau kejang-kejang
.\par\pard\li2630\sb0\sl-276\slmult0\fi0\tx2990 \up0 \expndtw-3\charscalex100 -\
tab \up0 \expndtw0\charscalex104 Panas 3-5 hari disertai nyeri perut, pembesaran
hati, uji tourniquet positif /\par\pard\li2630\sb0\sl-276\slmult0\fi360 \up0 \e
xpndtw-2\charscalex100 negatif, kesan sakit keras ( tidak mau bermain ), Hb dan
PCV meningkat.\par\pard\li2630\sb0\sl-276\slmult0\fi0\tx2990 \up0 \expndtw-3\cha
rscalex100 -\tab \up0 \expndtw-3\charscalex100 Panas disertai perdarahan\par\par
d\li2630\sb0\sl-276\slmult0\fi0\tx2990 \up0 \expndtw-3\charscalex100 -\tab \up0
\expndtw-3\charscalex100 Panas disertai renjatan.\par\pard\ql \li2630\sb276\sl-2
76\slmult0 \up0 \expndtw-3\charscalex100 Belum atau tanpa renjatan: \par\pard\ql
\li2630\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex100 1. Grade I dan II : \p
ar\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a. Oral ad
libitum atau \par\pard\ql \li2990\ri1506\sb2\sl-275\slmult0\tx3350\tx3350\tx335
0\tx3350 \up0 \expndtw0\charscalex105 b. Infus cairan Ringer Laktat dengan dosi
s 75 ml/Kg BB/hari untuk anak \line\tab \up0 \expndtw-3\charscalex100 dengan BB
< 10 kg atau 50 ml/Kg BB/hari untuk anak dengan BB < 10 kg \line \tab \up0 \expn
dtw-3\charscalex100 bersama-sama diberikan minuman oralit, air buah atau susu se
cukupnya. \line \tab \up0 \expndtw0\charscalex101 Untuk kasus yang menunjukka
n gejala dehidrasi disarankan minum \line \tab \up0 \expndtw-3\charscalex100
sebnyak-banyaknya dan sesering mungkin. \par\pard\qj \li3350\ri1508\sb3\sl-275\
slmult0 \up0 \expndtw-2\charscalex100 Apabila anak tidak suka minum sama sekali
sebaiknya jumlah cairan infus \up0 \expndtw0\charscalex104 yang harus diberikan
sesuai dengan kebutuhan cairan penderita dalam \up0 \expndtw-3\charscalex100 kur
un waktu 24 jam yang diestimasikan sebagai berikut : \par\pard\li3350\sb19\sl-27

6\slmult0\fi0\tx3710 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf3\f4\fs24 \t
ab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 100 ml/Kg BB/24 jam
, untuk anak dengan BB < 25 Kg\par\pard\li3350\sb39\sl-276\slmult0\fi0\tx3710 \u
p0 \expndtw-3\charscalex100 \ul0\nosupersub\cf3\f4\fs24 \tab \up0 \expndtw-3\char
scalex100 \ul0\nosupersub\cf2\f3\fs24 75 ml/KgBB/24 jam, untuk anak dengan BB 26
-30 kg\par\pard\li3350\sb35\sl-276\slmult0\fi0\tx3710 \up0 \expndtw-3\charscalex
100 \ul0\nosupersub\cf3\f4\fs24 \tab \up0 \expndtw-3\charscalex100 \ul0\nosupersu
b\cf2\f3\fs24 60 ml/KgBB/24 jam, untuk anak dengan BB 31-40 kg\par\pard\li3350\s
b38\sl-276\slmult0\fi0\tx3710 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf3\
f4\fs24 \tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 50 ml/KgBB
/24 jam, untuk anak dengan BB 41-50 kg\par\pard\ql \li3350\ri1510\sb22\sl-294\sl
mult0\tx3710 \up0 \expndtw0\charscalex100 \ul0\nosupersub\cf3\f4\fs24 \ul0\nosupe
rsub\cf2\f3\fs24 Obat-obatan lain : antibiotika apabila ada infeksi lain, anti
piretik untuk \line\tab \up0 \expndtw-3\charscalex100 anti panas, darah 15 cc/kg
BB/hari perdarahan hebat. \par\pard\ql \li2630\sb273\sl-276\slmult0 \up0 \expndt
w-3\charscalex100 Dengan Renjatan ; \par\pard\ql \li2630\sb1\sl-276\slmult0 \up0
\expndtw0\charscalex102 2. Grade III \par\pard\ql \li2990\sb0\sl-275\slmult0 \
up0 \expndtw-3\charscalex100 a. Berikan infus Ringer Laktat 20 mL/KgBB/1 jam \
par\pard\qj \li3350\ri1507\sb1\sl-276\slmult0 \up0 \expndtw0\charscalex101 Apabi
la menunjukkan perbaikan (tensi terukur lebih dari 80 mmHg dan \up0 \expndtw-1\c
harscalex100 nadi teraba dengan frekuensi kurang dari \up0 \expndtw0\charsc
alex106 120/mnt dan akral hangat) \up0 \expndtw0\charscalex102 lanjutkan dengan
Ringer Laktat 10 mL/KgBB/1jam. Jika nadi dan tensi \up0 \expndtw0\charscalex100
stabil lanjutkan infus tersebut dengan jumlah cairan dihitung berdasarkan \up0 \
expndtw-1\charscalex100 kebutuhan cairan dalam kurun waktu 24 jam dikurangi cair
an yang sudah \up0 \expndtw0\charscalex101 masuk dibagi dengan sisa waktu ( 24 j
am dikurangi waktu yang dipakai \par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2
270\sb160\sl-276\slmult0\fi0\tx3987\tx4420\tx10397 \up0 \expndtw0\charscalex110
\ul0\nosupersub\cf4\f5\fs24 DOKUMEN\tab \up0 \expndtw-3\charscalex100 :\tab \up0
\expndtw0\charscalex126 SUBHAN PSIK FK UNAIR SURABAYA\tab \up0 \expndtw-3\c
harscalex100 \ul0\nosupersub\cf5\f6\fs24 2\par\pard\ql \li2270\sb4\sl-276\slmult
0 \up0 \expndtw0\charscalex111 \ul0\nosupersub\cf4\f5\fs24 ANGKATAN III \par\par
d\sect\sectd\fs24\paperw12240\paperh18720{\shp
z-10000\shplid2
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5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}\pard\sb0\sl-240\par\pard\qj \li3350\sb0\sl-275\slmult0 \par\pard\qj\li3350\s
b0\sl-275\slmult0 \par\pard\qj\li3350\sb0\sl-275\slmult0 \par\pard\qj\li3350\sb0
\sl-275\slmult0 \par\pard\qj\li3350\sb0\sl-275\slmult0 \par\pard\qj\li3350\ri151
4\sb103\sl-275\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf2\f3\fs24
untuk mengatasi renjatan ). Perhitungan kebutuhan cairan dalam 24 jm \up0 \expnd
tw-3\charscalex100 diperhitungkan sebagai berikut : \par\pard\li3350\sb19\sl-276
\slmult0\fi0\tx3710 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf3\f4\fs24 \ta
b \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 100 mL/Kg BB/24 jam
untuk anak dengan BB < 25 Kg\par\pard\li3350\sb38\sl-276\slmult0\fi0\tx3710 \up0
\expndtw-3\charscalex100 \ul0\nosupersub\cf3\f4\fs24 \tab \up0 \expndtw-3\charsc
alex100 \ul0\nosupersub\cf2\f3\fs24 75 mL/Kg BB/24 jam untuk anak dng berat bada
n 26-30 Kg.\par\pard\li3350\sb36\sl-276\slmult0\fi0\tx3710 \up0 \expndtw-3\chars
calex100 \ul0\nosupersub\cf3\f4\fs24 \tab \up0 \expndtw-3\charscalex100 \ul0\nosu
persub\cf2\f3\fs24 60 mL/Kg BB/24 jam untuk anak dengan BB 31-40 Kg.\par\pard\li
3350\sb38\sl-276\slmult0\fi0\tx3710 \up0 \expndtw-3\charscalex100 \ul0\nosupersu
b\cf3\f4\fs24 \tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 50 m
L/Kg BB/24 jam untuk anak dengan BB 41-50 Kg.\par\pard\ql \li2990\sb0\sl-276\slm
ult0 \par\pard\ql\li2990\ri1506\sb18\sl-276\slmult0\tx3350\tx3350\tx3350\tx3350\
tx3350\tx3350\tx3350 \up0 \expndtw0\charscalex107 b. Apabila satu jam setelah p
emakaian cairan RL 20 mL/Kg BB/1 jam \line\tab \up0 \expndtw-1\charscalex100 ke
adaan tensi masih terukur kurang dari 80 mmHg dan andi cepat lemah, \line \tab
\up0 \expndtw0\charscalex104 akral dingin maka penderita tersebut memperoleh pla
sma atau plasma \line \tab \up0 \expndtw-2\charscalex100 ekspander ( dextran L a
tau yang lainnya ) sebanyak 10 mL/ Kg BB/ 1 jam \line \tab \up0 \expndtw0\charsc
alex102 dan dapat diulang maksimal 30 mL/Kg BB dalam kurun waktu 24 jam. \line \
tab \up0 \expndtw0\charscalex103 Jika keadaan umum membai dilanjutkan cairan RL
sebanyk kebutuhan \line \tab \up0 \expndtw0\charscalex105 cairan selama 24 jam
dikurangi cairan yang sudah masuk dibagi sisa \line \tab \up0 \expndtw-3\charsca
lex100 waktu setelah dapat mengatasi renjatan. \par\pard\ql \li2990\ri1507\sb276
\sl-276\slmult0\tx3350\tx3350\tx3350\tx3350\tx3350 \up0 \expndtw-1\charscalex100
c. Apabila satu jam setelah pemberian cairan Ringer Laktat 10 mL/Kg BB/ 1 \li
ne\tab \up0 \expndtw0\charscalex102 jam keadaan tensi menurun lagi, tetapi masih
terukur kurang 80 mmHg \line \tab \up0 \expndtw0\charscalex104 dan nadi cepat
lemah, akral dingin maka penderita tersebut harus \line \tab \up0 \expnd
tw0\charscalex105 memperoleh plasma atau plasma ekspander \up0 \expndtw-1\charsc
alex100 (dextran L atau lainnya) \line \tab \up0 \expndtw0\charscalex102 seba
nyak 10 Ml/Kg BB/ 1 jam. Dan dapat diulang maksimal 30 mg/Kg \line \tab \up0 \ex
pndtw-3\charscalex100 BB dalam kurun waktu 24 jam. \par\pard\ql \li2270\sb0\sl-2
76\slmult0 \par\pard\ql\li2270\sb276\sl-276\slmult0 \up0 \expndtw-6\charscalex10
0 \ul0\nosupersub\cf1\f2\fs24 VII.ASUHAN KEPERAWATAN \par\pard\ql \li2707\sb0\sl
-276\slmult0 \up0 \expndtw0\charscalex102 1. Pengkajian \par\pard\ql \li2630\s
b0\sl-276\slmult0\tx2990 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs
24 1.1 \tab \up0 \expndtw-3\charscalex100 Identitas \par\pard\qj \li2990\ri1502\
sb1\sl-275\slmult0 \up0 \expndtw0\charscalex100 DHF merupakan penyakit daerah tr
opis yang sering menyebabkan kematian \up0 \expndtw-3\charscalex100 anak, remaja
dan dewasa ( Effendy, 1995 ) \par\pard\ql \li2630\sb1\sl-276\slmult0\tx2990 \up
0 \expndtw-3\charscalex100 1.2 \tab \up0 \expndtw-3\charscalex100 Keluhan Utama
\par\pard\qj \li2990\ri1515\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex103 Pasi

en mengeluh panas, sakit kepala, lemah, nyeri ulu hati, mual dan nafsu \up0 \exp
ndtw-3\charscalex100 makan menurun. \par\pard\li2630\sb1\sl-274\slmult0\fi0\tx29
90 \up0 \expndtw-3\charscalex100 1.3\tab \up0 \expndtw-3\charscalex100 Riwayat p
enyakit sekarang\par\pard\li2630\sb1\sl-276\slmult0\fi360 \up0 \expndtw0\charsca
lex102 Riwayat kesehatan menunjukkan adanya sakit kepala, nyeri otot, pe
gal\par\pard\li2630\sb0\sl-276\slmult0\fi360 \up0 \expndtw0\charscalex106 seluru
h tubuh, sakit pada waktu menelan, lemah, panas, mual, dan nafsu\par\pard\li2630
\sb0\sl-276\slmult0\fi360 \up0 \expndtw-3\charscalex100 makan menurun.\par\pard\
li2630\sb1\sl-276\slmult0\fi0\tx2990 \up0 \expndtw-3\charscalex100 1.4\tab \up0
\expndtw-3\charscalex100 Riwayat penyakit terdahulu\par\pard\li2630\sb0\sl-275\s
lmult0\fi360 \up0 \expndtw-3\charscalex100 Tidak ada penyakit yang diderita seca
ra specific.\par\pard\li2630\sb1\sl-276\slmult0\fi0\tx2990 \up0 \expndtw-3\chars
calex100 1.5\tab \up0 \expndtw-3\charscalex100 Riwayat penyakit keluarga\par\par
d\qj \li2990\ri1509\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex105 Riwayat adan
ya penyakit DHF pada anggota keluarga yang lain sangat \up0 \expndtw0\charsca
lex106 menentukan, karena penyakit DHF adalah penyakit yang bisa ditularkan \up0
\expndtw-3\charscalex100 melalui gigitan nyamuk aides aigepty. \par\pard\li2630
\sb1\sl-274\slmult0\fi0\tx2990 \up0 \expndtw-3\charscalex100 1.6\tab \up0 \expnd
tw-3\charscalex100 Riwayat Kesehatan Lingkungan\par\pard\li2630\sb1\sl-276\slmul
t0\fi360 \up0 \expndtw-2\charscalex100 Biasanya lingkungan kurang bersih, banyak
genangan air bersih seperti kaleng\par\pard\li2630\sb0\sl-276\slmult0\fi360 \up
0 \expndtw0\charscalex102 bekas, ban bekas, tempat air minum burung yang jarang
diganti airnya, bak\par\pard\li2630\sb0\sl-276\slmult0\fi360 \up0 \expndtw-3\cha
rscalex100 mandi jarang dibersihkan.\par\pard\li2630\sb1\sl-276\slmult0\fi0\tx29
90 \up0 \expndtw-3\charscalex100 1.7\tab \up0 \expndtw-3\charscalex100 Riwayat T
umbuh Kembang\par\pard\li2630\sb0\sl-275\slmult0\fi0\tx2990 \up0 \expndtw-3\char
scalex100 1.8\tab \up0 \expndtw-3\charscalex100 Pengkajian Per Sistem\par\pard\l
i2630\sb1\sl-276\slmult0\fi360\tx3710 \up0 \expndtw-3\charscalex100 1.8.1\tab \u
p0 \expndtw-3\charscalex100 Sistem Pernapasan\par\pard\qj \li3710\ri1510\sb1\sl275\slmult0 \up0 \expndtw0\charscalex101 Sesak, perdarahan melalui hidung, per
napasan dangkal, epistaksis, \up0 \expndtw0\charscalex104 pergerakan dada simet
ris, perkusi sonor, pada auskultasi terdengar \up0 \expndtw-3\charscalex100 ronc
hi, krakles. \par\pard\ql \li2990\sb1\sl-276\slmult0\tx3710 \up0 \expndtw-3\char
scalex100 1.8.2 \tab \up0 \expndtw-3\charscalex100 Sistem Persyarafan \par\pard\
ql \li3710\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex103 Pada grade III pasien
gelisah dan terjadi penurunan kesadaran serta \par\pard\li2270\sb0\sl-276\slmul
t0\par\pard\li2270\sb270\sl-276\slmult0\fi0\tx3987\tx4420\tx10397 \up0 \expndtw0
\charscalex110 \ul0\nosupersub\cf4\f5\fs24 DOKUMEN\tab \up0 \expndtw-3\charscale
x100 :\tab \up0 \expndtw0\charscalex126 SUBHAN PSIK FK UNAIR SURABAYA\tab \u
p0 \expndtw-3\charscalex100 \ul0\nosupersub\cf5\f6\fs24 3\par\pard\ql \li2270\sb
4\sl-276\slmult0 \up0 \expndtw0\charscalex111 \ul0\nosupersub\cf4\f5\fs24 ANGKAT
AN III \par\pard\sect\sectd\fs24\paperw12240\paperh18720{\shp
z-10000\shplid3
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010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
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0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 pada gr
ade IV dapat trjadi DSS \par\pard\ql \li2990\sb0\sl-276\slmult0\tx3710 \up0 \exp
ndtw-3\charscalex100 1.8.3 \tab \up0 \expndtw-3\charscalex100 Sistem Cardiovasku
ler \par\pard\qj \li3710\ri1504\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex102
Pada grde I dapat terjadi hemokonsentrasi, uji tourniquet positif, \up0 \e
xpndtw0\charscalex101 trombositipeni, pada grade III dapat terjadi kegagalan sir
kulasi, nadi \up0 \expndtw0\charscalex102 cepat, lemah, hipotensi, cyanosis seki
tar mulut, hidung dan jari-jari, \up0 \expndtw-3\charscalex100 pada grade IV nad
i tidak teraba dan tekanan darah tak dapat diukur. \par\pard\li2990\sb0\sl-276\s
lmult0\fi0\tx3710 \up0 \expndtw-3\charscalex100 1.8.4\tab \up0 \expndtw-3\charsc
alex100 Sistem Pencernaan\par\pard\qj \li3710\ri1507\sb0\sl-276\slmult0 \up0 \ex
pndtw-3\charscalex100 Selaput mukosa kering, kesulitan menelan, nyeri tekan pada
epigastrik, \line \up0 \expndtw0\charscalex103 pembesarn limpa, pembesaran hati
, abdomen teregang, penurunan \line \up0 \expndtw0\charscalex101 nafsu makan,
mual, muntah, nyeri saat menelan, dapat hematemesis, \line \up0 \expndtw-3\chars
calex100 melena. \par\pard\li2990\sb0\sl-276\slmult0\fi0\tx3710 \up0 \expndtw-3\
charscalex100 1.8.5\tab \up0 \expndtw-3\charscalex100 Sistem perkemihan\par\pard
\li2990\sb0\sl-276\slmult0\fi720\tx8783 \up0 \expndtw0\charscalex104 Produksi u
rine menurun, kadang kurang dari\tab \up0 \expndtw0\charscalex104 30 cc/jam
, akan\par\pard\li2990\sb0\sl-276\slmult0\fi720 \up0 \expndtw-3\charscalex100 m
engungkapkan nyeri sat kencing, kencing berwarna merah.\par\pard\li2990\sb0\sl-2
76\slmult0\fi0\tx3710 \up0 \expndtw-3\charscalex100 1.8.6\tab \up0 \expndtw-3\ch
arscalex100 Sistem Integumen.\par\pard\qj \li3710\ri1514\sb0\sl-276\slmult0 \up0
\expndtw0\charscalex103 Terjadi peningkatan suhu tubuh, kulit kering, pada grad
e I terdapat \up0 \expndtw0\charscalex100 positif pada uji tourniquet, terjadi p
ethike, pada grade III dapat terjadi \up0 \expndtw-3\charscalex100 perdarahan sp
ontan pada kulit. \par\pard\ql \li2707\sb276\sl-276\slmult0 \up0 \expndtw0\chars
calex100 \ul0\nosupersub\cf1\f2\fs24 2. Diagnosa Keperawatan \par\pard\ql \li2
990\sb0\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24
Hipertermi berhubungan dengan proses infeksi virus dengue \par\pard\qj \li2990\
ri1508\sb1\sl-275\slmult0 \up0 \expndtw0\charscalex102 Resiko defisit cairan ber
hubungan dengan pindahnya ciran intravaskuler ke \up0 \expndtw-3\charscalex100 e
kstravaskuler \par\pard\qj \li2990\ri1511\sb2\sl-275\slmult0 \up0 \expndtw0\char
scalex100 Resiko syok hypovolemik berhubungan dengan perdarahan yang berlebihan,
\up0 \expndtw-3\charscalex100 pindahnya cairan intravaskuler ke ekstravaskuler
\par\pard\qj \li2990\ri1514\sb2\sl-275\slmult0 \up0 \expndtw0\charscalex100 Resi

ko gangguan pemenuhan kebutuhan nutrisi kurang dari kebutuhan tubuh \up0 \expndt
w0\charscalex100 berhubungan dengan intake nutrisi yang tidak adekwat akibat mua
l dan nafsu \up0 \expndtw-3\charscalex100 makan yang menurun. \par\pard\qj \li29
90\ri1508\sb2\sl-275\slmult0 \up0 \expndtw0\charscalex105 Resiko terjadi perda
rahn berhubungan dnegan penurunan factor-fakto \up0 \expndtw-3\charscalex100
pembekuan darah ( trombositopeni ) \par\pard\qj \li2990\ri1510\sb2\sl-275\slmul
t0 \up0 \expndtw0\charscalex106 Kecemasan berhubungan dengan kondisi klien
yang memburuk dan \up0 \expndtw-3\charscalex100 perdaahan \par\pard\ql \li2990
\sb1\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Kurang pengetahuan berhubungan
dengan kurangya informasi. \par\pard\ql \li2707\sb0\sl-276\slmult0 \par\pard\ql
\li2707\sb1\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf1\f2\
fs24 3. Rencana Asuhan Keperawatan. \par\pard\qj \li2990\ri2666\sb0\sl-275\slm
ult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 DP : Hipertermie
berhubungan dengan proses infeksi virus dengue \up0 \expndtw-3\charscalex100 Tuj
uan : Suhu tubuh normal \par\pard\ql \li2990\ri5085\sb2\sl-275\slmult0\tx4250 \u
p0 \expndtw-2\charscalex100 Kriteria hasil : Suhu tubuh antara 36 - 37 \line\tab
\up0 \expndtw-3\charscalex100 Nyeri otot hilang \par\pard\ql \li2990\sb2\sl-276
\slmult0 \up0 \expndtw-3\charscalex100 Intervensi : \par\pard\ql \li2990\sb0\sl275\slmult0 \up0 \expndtw-2\charscalex100 a. Beri komres air kran \par\pard\li
3350\sb1\sl-276\slmult0\fi0\tx4365 \up0 \expndtw-3\charscalex100 Rasional\tab \u
p0 \expndtw0\charscalex103 : Kompres dingin akan terjadi pemindahan panas
secara\par\pard\li3350\sb0\sl-276\slmult0\fi0 \up0 \expndtw-3\charscalex100 ko
nduksi\par\pard\ql \li2990\ri1511\sb0\sl-276\slmult0\tx3350 \up0 \expndtw0\chars
calex100 b. Berika / anjurkan pasien untuk banyak minum 1500-2000 cc/hari ( ses
uai \line\tab \up0 \expndtw-3\charscalex100 toleransi ) \par\pard\ql \li3350\sb0
\sl-275\slmult0 \up0 \expndtw-3\charscalex100 Rasional : Untuk mengganti cairan
tubuh yang hilang akibat evaporasi. \par\pard\ql \li2990\ri1508\sb2\sl-275\slmul
t0\tx3350 \up0 \expndtw0\charscalex100 c. Anjurkan pasien untuk menggunakan
pakaian yang tipis dan mudah \line\tab \up0 \expndtw-3\charscalex100 menye
rap keringat \par\pard\qj \li3350\ri1508\sb2\sl-275\slmult0\tx4333 \up0 \expndtw
-3\charscalex100 Rasional \tab \up0 \expndtw0\charscalex100 : Memberikan rasa
nyaman dan pakaian yang tipis mudah \up0 \expndtw-3\charscalex100 menyerap
keringat dan tidak merangsang peningkatan suhu tubuh. \par\pard\ql \li2990\ri15
12\sb2\sl-275\slmult0\tx3350 \up0 \expndtw0\charscalex100 d. Observasi intake d
an output, tanda vital ( suhu, nadi, tekanan darah ) tiap \line\tab \up0 \expndt
w-3\charscalex100 3 jam sekali atau lebih sering. \par\pard\qj \li3350\ri1509\sb
2\sl-275\slmult0\tx4405 \up0 \expndtw-3\charscalex100 Rasional \tab \up0 \expndt
w0\charscalex106 : Mendeteksi dini kekurangan cairan serta mengetahui \up
0 \expndtw0\charscalex101 keseimbangan cairan dan elektrolit dalam tubuh. Tanda
vital merupakan \up0 \expndtw-3\charscalex100 acuan untuk mengetahui keadaan umu
m pasien. \par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb143\sl-276\slmul
t0\fi0\tx3987\tx4420\tx10397 \up0 \expndtw0\charscalex110 \ul0\nosupersub\cf4\f5
\fs24 DOKUMEN\tab \up0 \expndtw-3\charscalex100 :\tab \up0 \expndtw0\charscalex1
26 SUBHAN PSIK FK UNAIR SURABAYA\tab \up0 \expndtw-3\charscalex100 \ul0\nosu
persub\cf5\f6\fs24 4\par\pard\ql \li2270\sb4\sl-276\slmult0 \up0 \expndtw0\chars
calex111 \ul0\nosupersub\cf4\f5\fs24 ANGKATAN III \par\pard\sect\sectd\fs24\pape
rw12240\paperh18720{\shp
z-10000\shplid4
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01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110803e7028d03012200021101031101ffc4001f00000105010101010101000000000000000001
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2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
}}}\pard\sb0\sl-240\par\pard\li2990\sb0\sl-276\slmult0\par\pard\li2990\sb0\sl-27
6\slmult0\par\pard\li2990\sb0\sl-276\slmult0\par\pard\li2990\sb0\sl-276\slmult0\
par\pard\li2990\sb0\sl-276\slmult0\par\pard\li2990\sb97\sl-276\slmult0\fi0\tx455
5 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf2\f3\fs24 e. Kolaborasi\tab
\up0 \expndtw0\charscalex101 : pemberian cairan intravena dan pemberian ob
at sesuai\par\pard\li2990\sb0\sl-276\slmult0\fi360 \up0 \expndtw-3\charscalex10
0 program.\par\pard\qj \li3350\ri1508\sb1\sl-275\slmult0 \up0 \expndtw-2\charsca
lex100 Rasional : Pemberian cairan sangat penting bagi pasien dengan suhu tubuh
\up0 \expndtw-3\charscalex100 yang tinggi. Obat khususnyauntuk menurunkan suhu t
ubuh pasien. \par\pard\ql \li2990\sb0\sl-275\slmult0 \par\pard\ql\li2990\ri1503\
sb3\sl-275\slmult0\tx3710 \up0 \expndtw0\charscalex102 DP 2. Resiko defisit volu
me cairan berhubungan dengan pindahnya cairan \line\tab \up0 \expndtw-3\charsc
alex100 intravaskuler ke ekstravaskuler. \par\pard\ql \li2990\ri4909\sb2\sl-275\
slmult0\tx3890\tx3890\tx3890 \up0 \expndtw-4\charscalex100 Tujuan : Tidak terjad
i devisit voume cairan \line \up0 \expndtw-5\charscalex100 Kriteria :
Input d
an output seimbang \line \tab \up0 \expndtw-4\charscalex100 Vital sign dalam bat
as normal \line \tab \up0 \expndtw-3\charscalex100 Tidak ada tanda presyok \line
\tab \up0 \expndtw-3\charscalex100 Akral hangat \par\pard\qj \li2990\ri5810\sb2
\sl-275\slmult0\fi900 \up0 \expndtw-3\charscalex100 Capilarry refill < 3 detik \
up0 \expndtw-3\charscalex100 Intervensi : \par\pard\ql \li2990\sb1\sl-276\slmult
0 \up0 \expndtw-3\charscalex100 a. Awasi vital sign tiap 3 jam/lebih sering \p
ar\pard\li3350\sb0\sl-276\slmult0\fi0\tx4385 \up0 \expndtw-3\charscalex100 Rasio
nal\tab \up0 \expndtw0\charscalex102 : Vital sign membantu mengidentifikas
i fluktuasi cairan\par\pard\li3350\sb0\sl-276\slmult0\fi0 \up0 \expndtw-3\char
scalex100 intravaskuler\par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-1\c
harscalex100 b. Observasi capillary Refill \par\pard\ql \li3350\sb0\sl-276\slmu
lt0 \up0 \expndtw-3\charscalex100 Rasional : Indikasi keadekuatan sirkulasi peri
fer \par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c. O
bservasi intake dan output. Catat warna urine / konsentrasi, BJ \par\pard\qj \li
3350\ri1506\sb1\sl-275\slmult0 \up0 \expndtw-1\charscalex100 Rasional : Penuruna
n haluaran urine pekat dengan peningkatan BJ diduga \up0 \expndtw-3\charscalex10
0 dehidrasi. \par\pard\ql \li2990\ri2719\sb1\sl-276\slmult0\tx3350 \up0 \expndtw
-2\charscalex100 d. Anjurkan untuk minum 1500-2000 ml /hari ( sesuai toleransi
) \line\tab \up0 \expndtw-3\charscalex100 Rasional : Untuk memenuhi kabutuhan ca

iran tubuh peroral \par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-3\chars
calex100 e. Kolaborasi : Pemberian cairan intravena \par\pard\qj \li3350\ri151
2\sb1\sl-275\slmult0 \up0 \expndtw0\charscalex103 Rasional : Dapat meningkatkan
jumlah cairan tubuh, untuk mencegah \up0 \expndtw-3\charscalex100 terjadinya hi
povolemic syok. \par\pard\ql \li2990\sb0\sl-276\slmult0 \par\pard\ql\li2990\ri15
06\sb1\sl-276\slmult0\tx3710 \up0 \expndtw0\charscalex103 DP. 3 Resiko Syok hy
povolemik berhubungan dengan perdarahan yang \line\tab \up0 \expndtw-3\charsca
lex100 berlebihan, pindahnya cairan intravaskuler ke ekstravaskuler. \line \up0
\expndtw-4\charscalex100 Tujuan : Tidak terjadi syok hipovolemik \par\pard\qj \l
i2990\ri5078\sb1\sl-275\slmult0 \up0 \expndtw-4\charscalex100 Kriteria : Tanda V
ital dalam batas normal \up0 \expndtw-3\charscalex100 Intervensi : \par\pard\ql
\li2990\sb1\sl-276\slmult0 \up0 \expndtw-3\charscalex100 a. Monitor keadaan um
um pasien \par\pard\qj \li3350\ri1508\sb2\sl-275\slmult0 \up0 \expndtw-2\charsca
lex100 Raional ; Untuk memonitor kondisi pasien selama perawatan terutama saat \
up0 \expndtw-3\charscalex100 terdi perdarahan. Perawat segera mengetahui tanda-t
anda presyok / syok \par\pard\ql \li2990\sb1\sl-276\slmult0 \up0 \expndtw-2\char
scalex100 b. Observasi vital sign setiap 3 jam atau lebih \par\pard\qj \li3350\
ri1508\sb1\sl-275\slmult0\tx4393 \up0 \expndtw-3\charscalex100 Rasional \tab \up
0 \expndtw0\charscalex106 : Perawat perlu terus mengobaservasi vital sign
untuk \up0 \expndtw-3\charscalex100 memastikan tidak terjadi presyok / syok \p
ar\pard\ql \li2990\ri1513\sb3\sl-275\slmult0\tx3350 \up0 \expndtw0\charscalex100
c. Jelaskan pada pasien dan keluarga tanda perdarahan, dan segera laporkan \l
ine\tab \up0 \expndtw-3\charscalex100 jika terjadi perdarahan \par\pard\qj \li33
50\ri1508\sb2\sl-275\slmult0\tx4333 \up0 \expndtw-3\charscalex100 Rasional \tab
\up0 \expndtw0\charscalex100 : Dengan melibatkan psien dan keluarga maka
tanda-tanda \up0 \expndtw-2\charscalex100 perdarahan dapat segera diketahui dan
tindakan yang cepat dan tepat dapat \up0 \expndtw-3\charscalex100 segera diberik
an. \par\pard\ql \li2990\sb2\sl-276\slmult0 \up0 \expndtw-2\charscalex100 d. Ko
laborasi : Pemberian cairan intravena \par\pard\qj \li3350\ri1506\sb0\sl-275\slm
ult0 \up0 \expndtw-1\charscalex100 Rasional : Cairan intravena diperlukan untuk
mengatasi kehilangan cairan \up0 \expndtw-3\charscalex100 tubuh secara hebat. \p
ar\pard\ql \li2990\sb1\sl-276\slmult0 \up0 \expndtw-3\charscalex100 e. Kolabor
asi : pemeriksaan : HB, PCV, trombo \par\pard\qj \li3350\ri1512\sb1\sl-275\slmul
t0 \up0 \expndtw0\charscalex103 Rasional : Untuk mengetahui tingkat kebocoran p
embuluh darah yang \up0 \expndtw-3\charscalex100 dialami pasien dan untuk acuan
melakukan tindakan lebih lanjut. \par\pard\ql \li2990\sb0\sl-275\slmult0 \par\pa
rd\ql\li2990\ri1510\sb3\sl-275\slmult0\tx3530\tx3530 \up0 \expndtw0\charscalex10
0 DP. 4 Resiko gangguan pemenuhan kebutuhan nutrisi kurang dari kebutuhan \line\
tab \up0 \expndtw-3\charscalex100 tubuh berhubungan dengan intake nutrisi yang t
idak adekuat akibat mual \line \tab \up0 \expndtw-3\charscalex100 dan nafsu maka
n yang menurun. \par\pard\ql \li2990\sb1\sl-276\slmult0 \up0 \expndtw-3\charscal
ex100 Tujuan : Tidak terjadi gangguan kebutuhan nutrisi \par\pard\li2270\sb0\sl276\slmult0\par\pard\li2270\sb142\sl-276\slmult0\fi0\tx3987\tx4420\tx10397 \up0
\expndtw0\charscalex110 \ul0\nosupersub\cf4\f5\fs24 DOKUMEN\tab \up0 \expndtw-3\
charscalex100 :\tab \up0 \expndtw0\charscalex126 SUBHAN PSIK FK UNAIR SURABA
YA\tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf5\f6\fs24 5\par\pard\ql \
li2270\sb4\sl-276\slmult0 \up0 \expndtw0\charscalex111 \ul0\nosupersub\cf4\f5\fs
24 ANGKATAN III \par\pard\sect\sectd\fs24\paperw12240\paperh18720{\shp
z-10000\shplid5
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110803e7028d03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
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0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 Kriteri
a : Tidak ada tanda-tanda malnutrisi \par\pard\qj \li2990\ri4086\sb0\sl-276\slmu
lt0\fi900 \up0 \expndtw-3\charscalex100 Menunjukkan berat badan yang seimbang. \
up0 \expndtw-3\charscalex100 Intervensi : \par\pard\ql \li2990\sb0\sl-276\slmult
0 \up0 \expndtw-3\charscalex100 a. Kaji riwayat nutrisi, termasuk makanan yang
disukai \par\pard\ql \li3350\sb0\sl-276\slmult0 \up0 \expndtw-3\charscalex100 R
asional : Mengidentifikasi defisiensi, menduga kemungkinan intervensi \par\pard\
ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-2\charscalex100 b. Observasi dan ca
tat masukan makanan pasien \par\pard\li3350\sb0\sl-276\slmult0\fi0\tx4341 \up0 \
expndtw-3\charscalex100 Rasional\tab \up0 \expndtw0\charscalex100 : Mengawasi
masukan kalori/kualitas kekurangan konsumsi\par\pard\li3350\sb0\sl-276\slmult
0\fi0 \up0 \expndtw-3\charscalex100 makanan\par\pard\ql \li2990\sb0\sl-276\slmul
t0 \up0 \expndtw-3\charscalex100 c. Timbang BB tiap hari (bila memungkinkan )
\par\pard\ql \li3350\sb0\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Rasional :
Mengawasi penurunan BB / mengawasi efektifitas intervensi. \par\pard\ql \li2990
\ri1512\sb1\sl-275\slmult0\tx3350 \up0 \expndtw0\charscalex103 d. Berikan makan
an sedikit namun sering dan atau makan diantara waktu \line\tab \up0 \expndtw-3\
charscalex100 makan \par\pard\li2990\sb1\sl-276\slmult0\fi360\tx4425\tx4725 \up0
\expndtw-3\charscalex100 Rasional\tab \up0 \expndtw-3\charscalex100 :\tab \up0
\expndtw0\charscalex108 Makanan sedikit dapat menurunkan kelemahan dan\par\
pard\li2990\sb0\sl-276\slmult0\fi360 \up0 \expndtw-3\charscalex100 meningkatkan
masukan juga mencegah distensi gaster.\par\pard\li2990\sb0\sl-276\slmult0\fi0 \u
p0 \expndtw-3\charscalex100 e. Berikan dan Bantu oral hygiene.\par\pard\ql \li
3350\sb0\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Rasional : Meningkatkan na
fsu makan dan masukan peroral \par\pard\ql \li2990\ri3144\sb0\sl-276\slmult0\tx3
350 \up0 \expndtw-2\charscalex100 f. Hindari makanan yang merangsang dan menga
ndung gas. \line\tab \up0 \expndtw-3\charscalex100 Rasional : Menurunkan distens
i dan iritasi gaster. \par\pard\qj \li2990\ri1514\sb276\sl-276\slmult0 \up0 \exp
ndtw-2\charscalex100 DP. 5. Resiko terjadi perdarahan berhubungan dengan penurun
an factor-faktor \up0 \expndtw-3\charscalex100 pembekuan darah ( trombositopeni

) \par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-4\charscalex100 Tujuan :
Tidak terjadi perdarahan \par\pard\ql \li2990\ri2531\sb0\sl-276\slmult0 \up0 \e
xpndtw-3\charscalex100 Kriteria : TD 100/60 mmHg, N: 80-100x/menit reguler, puls
asi kuat \up0 \expndtw-3\charscalex100 Tidak ada tanda perdarahan lebih lanjut,
trombosit meningkat \line \up0 \expndtw-3\charscalex100 Intervensi : \par\pard\q
l \li2990\sb0\sl-276\slmult0 \up0 \expndtw-2\charscalex100 a. Monitor tanda-ta
nda penurunan trombosit yang disertai tanda klinis. \par\pard\qj \li3350\ri1506\
sb0\sl-276\slmult0\tx4343 \up0 \expndtw-3\charscalex100 Rasional \tab \up0 \expn
dtw0\charscalex100 : Penurunan trombosit merupakan tanda adanya kebocoran
\up0 \expndtw-2\charscalex100 pembuluh darah yang pada tahap tertentu dapat meni
mbulkan tanda-tanda \up0 \expndtw-3\charscalex100 klinis seperti epistaksis, pti
ke. \par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-1\charscalex100 b. Mo
nitor trombosit setiap hari \par\pard\qj \li3350\ri1506\sb1\sl-275\slmult0 \up0
\expndtw0\charscalex103 Rasional : Dengan trombosit yang dipantau setiap hari, d
apat diketahui \up0 \expndtw0\charscalex101 tingkat kebocoran pembuluh darah d
an kemungkinan perdarahan yang \up0 \expndtw-3\charscalex100 dialami pasien. \pa
r\pard\ql \li2990\sb1\sl-276\slmult0 \up0 \expndtw-3\charscalex100 c. Anjurkan
pasien untuk banyak istirahat ( bedrest ) \par\pard\li2990\sb1\sl-276\slmult0\f
i360\tx4327 \up0 \expndtw-3\charscalex100 Rasional\tab \up0 \expndtw-1\charscale
x100 : Aktifitas pasien yang tidak terkontrol dapat menyebabkan\par\pard\
li2990\sb0\sl-275\slmult0\fi360 \up0 \expndtw-3\charscalex100 terjadinya perdara
han.\par\pard\li2990\sb1\sl-276\slmult0\fi0 \up0 \expndtw0\charscalex100 d. Ber
ikan penjelasan kepada klien dan keluarga untuk melaporkan jika ada\par\pard\li2
990\sb0\sl-276\slmult0\fi360 \up0 \expndtw-3\charscalex100 tanda perdarahan spt
: hematemesis, melena, epistaksis.\par\pard\li2990\sb0\sl-276\slmult0\fi360\tx43
43 \up0 \expndtw-3\charscalex100 Rasional\tab \up0 \expndtw0\charscalex100 : K
eterlibatan pasien dan keluarga dapat membantu untuk\par\pard\li2990\sb1\s
l-276\slmult0\fi360 \up0 \expndtw-3\charscalex100 penaganan dini bila terjadi pe
rdarahan.\par\pard\ql \li2990\ri1514\sb0\sl-275\slmult0\tx3350\tx3350 \up0 \expn
dtw0\charscalex104 e. Antisipasi adanya perdarahan : gunakan sikat gigi yang l
unak, pelihara \line\tab \up0 \expndtw-2\charscalex100 kebersihan mulut, berikan
tekanan 5-10 menit setiap selesai ambil darah. \line \tab \up0 \expndtw-3\chars
calex100 Rasional : Mencegah terjadinya perdarahan lebih lanjut. \par\pard\li227
0\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-2
76\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0
\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\
li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0
\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\sl
mult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb143\sl-276\slmult0\fi
0\tx3987\tx4420\tx10397 \up0 \expndtw0\charscalex110 \ul0\nosupersub\cf4\f5\fs24
DOKUMEN\tab \up0 \expndtw-3\charscalex100 :\tab \up0 \expndtw0\charscalex126 SU
BHAN PSIK FK UNAIR SURABAYA\tab \up0 \expndtw-3\charscalex100 \ul0\nosupersu
b\cf5\f6\fs24 6\par\pard\ql \li2270\sb4\sl-276\slmult0 \up0 \expndtw0\charscalex
111 \ul0\nosupersub\cf4\f5\fs24 ANGKATAN III \par\pard\sect\sectd\fs24\paperw122
40\paperh18720{\shp
z-10000\shplid6
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05145140051451401fffd9}}}}}\pard\sb0\sl-240\par\pard\ql \li4001\sb0\sl-275\slmul
t0 \par\pard\ql\li4001\sb0\sl-275\slmult0 \par\pard\ql\li4001\sb0\sl-275\slmult0
\par\pard\ql\li4001\sb0\sl-275\slmult0 \par\pard\ql\li4001\sb0\sl-275\slmult0 \
par\pard\ql\li4001\ri3215\sb103\sl-275\slmult0\tx5020 \up0 \expndtw-6\charscalex
100 \ul0\nosupersub\cf1\f2\fs24 ASUHAN KEPERAWATAN PADA ANAK E.C \line\tab \up0
\expndtw-3\charscalex100 DENGAN DHF GRADE II \par\pard\ql \li2863\sb1\sl-276\slm
ult0 \up0 \expndtw-4\charscalex100 DI RUANG MENULAR ANAK RSUD DR. SOETOMO SURABA
YA \par\pard\li2330\sb0\sl-276\slmult0\par\pard\li2330\sb110\sl-276\slmult0\fi0\
tx2690 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 A.\tab \up0 \ex
pndtw-3\charscalex100 PENGKAJIAN\par\pard\li2330\sb0\sl-276\slmult0\fi300\tx2990
\up0 \expndtw-3\charscalex100 1.\tab \up0 \expndtw-3\charscalex100 Identitas\pa
r\pard\li2330\sb0\sl-276\slmult0\fi660\tx5150 \up0 \expndtw-3\charscalex100 Nama
\tab \up0 \expndtw-4\charscalex100 : An. E.C\par\pard\li2330\sb0\sl-276\slmult0\
fi660\tx5150 \up0 \expndtw-3\charscalex100 Umur\tab \up0 \expndtw-3\charscalex10
0 : 9 thn\par\pard\li2330\sb0\sl-276\slmult0\fi660\tx5150 \up0 \expndtw-3\charsc
alex100 Alamat\tab \up0 \expndtw-4\charscalex100 : Tambak Asri 23/27 Surabaya\pa
r\pard\li2330\sb0\sl-276\slmult0\fi660\tx5150 \up0 \expndtw-3\charscalex100 Agam
a\tab \up0 \expndtw-3\charscalex100 : Kristen\par\pard\li2330\sb0\sl-276\slmult0
\fi660\tx5150 \up0 \expndtw-3\charscalex100 Nama Ibu\tab \up0 \expndtw-6\charsca
lex100 : Ny. T\par\pard\li2330\sb0\sl-276\slmult0\fi660\tx5150 \up0 \expndtw-3\c
harscalex100 Pendidikan\tab \up0 \expndtw-3\charscalex100 :\par\pard\li2330\sb0\
sl-276\slmult0\fi660\tx5150 \up0 \expndtw-6\charscalex100 Nama Ayah\tab \up0 \ex
pndtw-4\charscalex100 : Tn S\par\pard\li2330\sb0\sl-276\slmult0\fi660\tx5150 \up
0 \expndtw-3\charscalex100 Pendidikan\tab \up0 \expndtw-3\charscalex100 : SMA\pa
r\pard\li2330\sb0\sl-276\slmult0\fi660\tx5150 \up0 \expndtw-3\charscalex100 Peke
rjaan\tab \up0 \expndtw-3\charscalex100 : Karyawan swasta\par\pard\li2330\sb0\sl
-276\slmult0\fi660\tx5150 \up0 \expndtw-3\charscalex100 Diagnosa Medik\tab \up0
\expndtw-3\charscalex100 : DBD Grade II\par\pard\li2330\sb0\sl-276\slmult0\fi660
\tx5150 \up0 \expndtw-3\charscalex100 Pengkajian tanggal\tab \up0 \expndtw-3\cha
rscalex100 : 13 Desember 2001\par\pard\li2330\sb276\sl-276\slmult0\fi300\tx2990
\up0 \expndtw-3\charscalex100 2.\tab \up0 \expndtw-3\charscalex100 Keluhan Utama
:\par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Sakit ke
pala, panas dan tidak nafsu makan. \par\pard\ql \li2630\sb276\sl-276\slmult0\tx2
990 \up0 \expndtw-3\charscalex100 3. \tab \up0 \expndtw-3\charscalex100 Riwayat
penyakit sekarang : \par\pard\qj \li2990\ri1506\sb0\sl-276\slmult0 \up0 \expndtw
-1\charscalex100 Senin pagi panas, dibawa ke puskesmas dapat paracetamol. Panas
turun. Rabu \up0 \expndtw0\charscalex103 malam anak tiba-tiba muntah-muntah air,
makan tidak mau, minum masih \up0 \expndtw0\charscalex100 mau. Kamis jam 03 pag
i keluar darah dari hiding pada waktu bersin, keluhan \up0 \expndtw-3\charscalex
100 pusing, mencret air, dibawa ke IRD. \par\pard\ql \li2630\sb276\sl-276\slmult
0\tx2990 \up0 \expndtw-3\charscalex100 4. \tab \up0 \expndtw-3\charscalex100 Riw
ayat penyakit dahulu \par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-3\cha
rscalex100 Sebelumnya klien tidak penah dirawat karena penyakit apapun. \par\par
d\ql \li2630\sb276\sl-276\slmult0\tx2990 \up0 \expndtw-3\charscalex100 5. \tab \
up0 \expndtw-3\charscalex100 Riwayat penyakit keluarga \par\pard\qj \li2990\ri15
15\sb1\sl-275\slmult0 \up0 \expndtw0\charscalex106 Menurut keluarga ( Ibu ) tida
k ada keluarga yang dalam waktu dekat ini \up0 \expndtw-3\charscalex100 menderit
a sakit DBD. \par\pard\ql \li2630\sb0\sl-276\slmult0 \par\pard\ql\li2630\sb2\sl276\slmult0\tx2990 \up0 \expndtw-3\charscalex100 6. \tab \up0 \expndtw-3\charsca
lex100 Riwayat kesehatan lingkungan. \par\pard\qj \li2990\ri1507\sb0\sl-276\slmu
lt0 \up0 \expndtw0\charscalex100 Menurut ibu kondisi lingkungan rumah cukup bers
ih, walaupun tinggal dekat \line \up0 \expndtw0\charscalex102 kali kecil, seki
tar rumah terdapat beberapa ban bekas untuk menanam \line \up0 \expndtw0\
charscalex105 tanaman yang belum dipakai, bak mandi dikuras setiap seminggu 1 k
ali. \line \up0 \expndtw0\charscalex104 Menurut ibu seminggu yang lalu ada tetan
gga gang yang menderita DHF, \line \up0 \expndtw0\charscalex104 tetapi sekarang
sudah sembuh, dan lingkungan wilayah belum pernah \line \up0 \expndtw-3\
charscalex100 disemprot. \par\pard\ql \li2630\sb275\sl-276\slmult0\tx2990 \up0 \
expndtw-3\charscalex100 7. \tab \up0 \expndtw-3\charscalex100 Riwayat kehamilan

\par\pard\qj \li2990\ri1504\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex103 Anak
lahir pada usia kehamilan 7 bulan, dengan berat badan lahir 4 kg, ibu \up0 \exp
ndtw-1\charscalex100 tidak tahu mengapa kehamilannya hanya 7 bulan. Lahir sponta
n dan selama 1 \up0 \expndtw-2\charscalex100 tahun anak mendapat imunisasi lengk
ap dan minum PASI Lactona s/d 2 tahun. \par\pard\ql \li2630\sb276\sl-276\slmult0
\tx2990 \up0 \expndtw-3\charscalex100 8. \tab \up0 \expndtw-3\charscalex100 Peng
kajian Persistem \par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-2\charsca
lex100 a. Sistem Gastrointestinal \par\pard\qj \li3350\ri1508\sb0\sl-276\slmul
t0 \up0 \expndtw0\charscalex100 Nafsu makan menurun, anak hanya mau makan 3 send
ok makan, minum \up0 \expndtw0\charscalex102 tidak suka, harus dipaksakan baru m
au minum. Mual tidak ada, muntah \up0 \expndtw0\charscalex102 tidak terjadi. Ter
dapat nyeri tekan daerah hepar dan asites positif, bising \up0 \expndtw-3\charsc
alex100 usus 8x/mnt. \par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-1\cha
rscalex100 b. Sistem muskuloskeletal : \par\pard\ql \li3350\sb0\sl-276\slmult0
\up0 \expndtw-2\charscalex100 Tidak terdapat kontraktur sendi, tidak ada deformi
tas, keempat ekstremitas \par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb3
2\sl-276\slmult0\fi0\tx3987\tx4420\tx10397 \up0 \expndtw0\charscalex110 \ul0\nos
upersub\cf4\f5\fs24 DOKUMEN\tab \up0 \expndtw-3\charscalex100 :\tab \up0 \expndt
w0\charscalex126 SUBHAN PSIK FK UNAIR SURABAYA\tab \up0 \expndtw-3\charscale
x100 \ul0\nosupersub\cf5\f6\fs24 7\par\pard\ql \li2270\sb4\sl-276\slmult0 \up0 \
expndtw0\charscalex111 \ul0\nosupersub\cf4\f5\fs24 ANGKATAN III \par\pard\sect\s
ectd\fs24\paperw12240\paperh18720{\shp
z-10000\shplid7
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14500145145001451450014514500145145001451450014514500145145001451450014514500145
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45145001451450014514500145145001451450014514500145145007e127ec15ff0029c2ff0082fd
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00d5a5a2d007edfd1451400514514005145140051451400514514005145140051451400514514005
1451400514514005145140051451401f833ff0737ffca0fbf6dbff00bb6dff00d6baf8075fbcd5f8
33ff000737ff00ca0fbf6dbffbb6dffd6baf8075fbcd40051451401f843ff05dbff9077fc120ff00
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1267ff005993e2bd7eedd00145145001451450014514500145145001451450014514500145145001
4514500145145007c7ff00f050aff9304fdb8bfeccff00f697ff00d52fe35af04ff822bffca247fe
09c9ff006679f02bff00503d22bdeffe0a15ff002609fb717fd99ffed2ff00faa5fc6b5e09ff0004
57ff009448ff00c1393feccf3e057fea07a45007e9dd145140051451400514514005145140051451
40057e207fc10f3fe45dff0082a8ff00da6fff00e0a5bffab4b45afdbfafc40ff821e7fc8bbff055
1ffb4dff00fc14b7ff0056968b401fb7f45145001451450014514500145145001451450014514500
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17fc17effec05ff0499ffd664f8af5fbb74005145140051451400514514005145140051451400514
51400514514005145140051451401f1fff00c142bfe4c13f6e2ffb33ff00da5fff0054bf8d6bc13f
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5145001451450015f881ff00043cff009177fe0aa3ff0069bfff008296ff00ead2d16bf6febf103f
e0879ff22eff00c1547fed37ff00f052dffd5a5a2d007edfd1451400514514005145140051451400
5145140051451400514514005145140051451400514514005145140051451401f833ff000737ff00
ca0fbf6dbffbb6dffd6baf8075fbcd5f237eddbfb18fc31ff82847eca9f153f641f8c9e21f881e14
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bed5af782f4bb2d4ff00b47c2daa79da3dc6a105a7d8afa5b6d46d3ce7fe18dff68aff00a4b17edf
ff00f86e7fe0965ffd2d3a00fbfe8af803fe18dff68aff00a4b17edfff00f86e7fe0965ffd2d3a3f
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bfe09b7ffa9578fabf77abf227e3bffc12775cfda623f8410fc6eff82967edff00e368fe02fc78f8
6dfb4cfc275ff8473fe09bfe1bff008453e377c21bbd42f7e1df8db3e11ff8279682daeffc23d75a
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12cbff00a5a7401f7fd15f007fc31bfed15ff4962fdbff00ff000dcffc12cbff00a5a747fc31bfed
15ff004962fdbfff00f0dcff00c12cbffa5a7401f7fd15f007fc31bfed15ff004962fdbfff00f0dc
ff00c12cbffa5a747fc31bfed15ff4962fdbff00ff000dcffc12cbff00a5a7401f7fd15f007fc31b
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bffa5a7401f7fd15f007fc31bfed15ff004962fdbfff00f0dcff00c12cbffa5a747fc31bfed15ff4
962fdbff00ff000dcffc12cbff00a5a7401f7fd15f007fc31bfed15ff4962fdbff00ff000dcffc12
cbff00a5a747fc31bfed15ff004962fdbfff00f0dcff00c12cbffa5a7401f7fd15f007fc31bfed15
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fdbfff00f0dcff00c12cbffa5a7401f7fd15f007fc31bfed15ff004962fdbfff00f0dcff00c12cbf
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2fdbff00ff000dcffc12cbff00a5a747fc31bfed15ff004962fdbfff00f0dcff00c12cbffa5a7401
f11fec15ff0029c2ff0082fdff00d80bfe0933ff00acc9f15ebf76ebf227c05ff049ed73e18fc71f
8fff00b48781bfe0a59fb7fe87f1a3f6a383e12db7c75f19ff00c239ff0004dfd4bfe13983e06786
356f06fc2c4ff847757ff8278ea1e14f0cff00c22fe1bd7354d377783b42f0fbeb7f6afb67889b57
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fda2bfe92c5fb7ff00fe1b9ff82597ff004b4e8ff8637fda2bfe92c5fb7fff00e1b9ff0082597ff4
b4e803effa2be00ff8637fda2bfe92c5fb7fff00e1b9ff0082597ff4b4e8ff008637fda2bfe92c5f
b7ff00fe1b9ff82597ff004b4e803eff00a2be00ff008637fda2bfe92c5fb7ff00fe1b9ff82597ff
004b4e8ff8637fda2bfe92c5fb7fff00e1b9ff0082597ff4b4e803effa2be00ff8637fda2bfe92c5
fb7fff00e1b9ff0082597ff4b4e8ff008637fda2bfe92c5fb7ff00fe1b9ff82597ff004b4e803eff
00a2be00ff008637fda2bfe92c5fb7ff00fe1b9ff82597ff004b4e8ff8637fda2bfe92c5fb7fff00
e1b9ff0082597ff4b4e803effa2be00ff8637fda2bfe92c5fb7fff00e1b9ff0082597ff4b4e8ff00
8637fda2bfe92c5fb7ff00fe1b9ff82597ff004b4e803eff00a2be00ff008637fda2bfe92c5fb7ff
00fe1b9ff82597ff004b4e8ff8637fda2bfe92c5fb7fff00e1b9ff0082597ff4b4e803effa2be00f
f8637fda2bfe92c5fb7fff00e1b9ff0082597ff4b4e8ff008637fda2bfe92c5fb7ff00fe1b9ff825
97ff004b4e803eff00a2be00ff008637fda2bfe92c5fb7ff00fe1b9ff82597ff004b4e8ff8637fda
2bfe92c5fb7fff00e1b9ff0082597ff4b4e803bfff0082857fc9827edc5ff667ff00b4bffea97f1a
d7827fc115ff00e5123ff04e4ffb33cf815ffa81e91573e21ffc13e7e2f7c55f0078e7e17f8fbfe0
a99fb7febde05f891e0ff137807c69a1ff00c20fff0004c4d2ff00b67c27e30d16f7c3de23d27fb4
f45ff826fe9dac69dfda3a3ea37967f6ed2750b1d4ad3cefb458de5add4714e981f057fe09a5f107
f677f849f0e3e057c1dff829f7edff00e0ff00855f093c1da17803e1f785bfe110ff0082687883fe
11ff00097866c21d3344d27fb73c53ff0004e7d6fc47aafd8ac6de283edfadeafa96a773b3cdbbbc
b8999a4600fd4ea2be00ff008637fda2bfe92c5fb7ff00fe1b9ff82597ff004b4e8ff8637fda2bfe
92c5fb7fff00e1b9ff0082597ff4b4e803effa2be00ff8637fda2bfe92c5fb7fff00e1b9ff008259
7ff4b4e8ff008637fda2bfe92c5fb7ff00fe1b9ff82597ff004b4e803eff00a2be00ff008637fda2
bfe92c5fb7ff00fe1b9ff82597ff004b4e8ff8637fda2bfe92c5fb7fff00e1b9ff0082597ff4b4e8
03effa2be00ff8637fda2bfe92c5fb7fff00e1b9ff0082597ff4b4e8ff008637fda2bfe92c5fb7ff
00fe1b9ff82597ff004b4e803eff00a2be00ff008637fda2bfe92c5fb7ff00fe1b9ff82597ff004b
4e8ff8637fda2bfe92c5fb7fff00e1b9ff0082597ff4b4e803effafc40ff00821e7fc8bbff000551
ff00b4dfff00c14b7ff56968b5f607fc31bfed15ff004962fdbfff00f0dcff00c12cbffa5a75d9fe
c4dfb13f82bf61df05fc60f09783fe277c5df8bda87c75fda37e2b7ed4df123c71f1a2e3e18cbe2b
d5be2c7c699f47d43c7f75696df08be17fc21f05693a16a5ad69326b969a2e9de0eb78b4bbdd5b52
b5b19a1d1934ad2b4c00fb328a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a002
8a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a0028a28a002
8a28a0028a28a0028a28a0028a28a00fffd9}}}}}\pard\sb0\sl-240\par\pard\ql \li3350\sb
0\sl-276\slmult0 \par\pard\ql\li3350\sb0\sl-276\slmult0 \par\pard\ql\li3350\sb0\
sl-276\slmult0 \par\pard\ql\li3350\sb0\sl-276\slmult0 \par\pard\ql\li3350\sb0\sl
-276\slmult0 \par\pard\ql\li3350\sb97\sl-276\slmult0 \up0 \expndtw-3\charscalex1
00 \ul0\nosupersub\cf2\f3\fs24 simetris, kekuatan otot baik. \par\pard\ql \li299
0\sb276\sl-276\slmult0 \up0 \expndtw-2\charscalex100 c. Sistem Genitourinary \
par\pard\qj \li3350\ri1508\sb0\sl-276\slmult0 \up0 \expndtw-1\charscalex100 BAK
lancar, spontan, warna kuning agak pekat ditampung oleh ibu untuk \up0 \expndtw3\charscalex100 diukur, BAB dari malam belum ada. \par\pard\ql \li2990\sb276\sl276\slmult0 \up0 \expndtw0\charscalex100 d. Sistem Respirasi. \par\pard\qj \li3
350\ri1504\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex103 Pergerakan napas sime
tris, tidak terdapt pernapasan cuping hidung, pd \up0 \expndtw0\charscalex102 sa
at pengkajian tanda-tanda epistaksis sudah tidak ada, Frekuensi napas \up0 \expn
dtw-3\charscalex100 25x/menit. Bunyi nafas tambahan tidak terdengar. \par\pard\q
l \li2990\sb276\sl-276\slmult0 \up0 \expndtw-2\charscalex100 e. Sistem Cardiov
askuler \par\pard\qj \li3350\ri1509\sb1\sl-275\slmult0 \up0 \expndtw0\charscalex
104 TD : 100/60, nadi 98x/mnt, akral dingin, tidak terdapat tanda-tanda \li
ne \up0 \expndtw0\charscalex104 cyanosis, cap. Refill < 3 detik, tidak terjadi p
erdarahan spontan, tanda-\line \up0 \expndtw0\charscalex103 tanda petikhie spont
an tidak terlihat, hanya tanda pethike bekas rumple \line \up0 \expndtw-3\charsc
alex100 leed. \par\pard\ql \li2990\sb0\sl-275\slmult0 \par\pard\ql\li2990\ri3449
\sb3\sl-275\slmult0\tx3350 \up0 \expndtw-1\charscalex100 f. Sistem Neurosensor
i \line\tab \up0 \expndtw-3\charscalex100 Tidak ada kelainan. \par\pard\ql \li29
90\sb0\sl-276\slmult0 \par\pard\ql\li2990\sb1\sl-276\slmult0 \up0 \expndtw0\char
scalex100 g. Sistem Endokrin \par\pard\ql \li3350\sb0\sl-276\slmult0 \up0 \expn
dtw-3\charscalex100 Tidak ada kelainan. \par\pard\ql \li2990\sb276\sl-276\slmult
0 \up0 \expndtw0\charscalex100 h. Sistem Integumen. \par\pard\qj \li3350\ri1513
\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex107 S : 37\ul0\super\cf6\f7\fs21 6
\ul0\nosupersub\cf2\f3\fs24 turgor baik, tidak ada luka, pethikae bekas rumple l
eed, tidak \up0 \expndtw-3\charscalex100 terdapat perdarahan spontan pada kulit.
\par\pard\ql \li2630\sb276\sl-276\slmult0\tx2990 \up0 \expndtw-3\charscalex100

9. \tab \up0 \expndtw-3\charscalex100 Pemeriksaan Penunjang \par\pard\ql \li2990
\sb0\sl-276\slmult0 \up0 \expndtw-4\charscalex100 Hb : 11.8 \par\pard\ql \li2990
\sb0\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Leko : 5,5 \par\pard\ql \li299
0\ri3968\sb1\sl-275\slmult0 \up0 \expndtw-4\charscalex100 Trombo : 133 \line \up
0 \expndtw-3\charscalex100 PCV : 0,30 \par\pard\ql \li2630\sb0\sl-276\slmult0 \p
ar\pard\ql\li2630\sb1\sl-276\slmult0\tx2990 \up0 \expndtw-3\charscalex100 10. \t
ab \up0 \expndtw-6\charscalex100 Terapi \par\pard\ql \li2990\ri3062\sb2\sl-275\s
lmult0 \up0 \expndtw-3\charscalex100 Infus D saline 1600 cc/24 jam \line \up0 \e
xpndtw-3\charscalex100 Minum manis \par\pard\ql \li2990\sb1\sl-276\slmult0 \up0
\expndtw-4\charscalex100 Vit B compleks / C 3 x 1 \par\pard\qj \li2990\ri5362\sb
1\sl-275\slmult0 \up0 \expndtw-3\charscalex100 Diet TKTP 1600 Kkal + 50 gr Prote
in. \up0 \expndtw-3\charscalex100 Nasi 3 x sehari \par\pard\ql \li2990\sb2\sl-27
6\slmult0 \up0 \expndtw-3\charscalex100 Susu : 3 x 200 cc \par\pard\li2325\sb275
\sl-276\slmult0\fi4\tx2690 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\
fs24 B.\tab \up0 \expndtw-6\charscalex100 ANALISA DATA\par\pard\li2325\sb10\sl-2
76\slmult0\fi4\tx3947\tx6672\tx9131 \up0 \expndtw-3\charscalex100 NO\tab \up0 \e
xpndtw-8\charscalex100 DATA\tab \up0 \expndtw-3\charscalex100 ETIOLOGI\tab \up0
\expndtw-3\charscalex100 MASALAH\par\pard\li2325\sb10\sl-276\slmult0\fi0\tx2910\
tx3320\tx3661\tx5970\tx8940 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3
\fs24 1\tab \up0 \expndtw-3\charscalex100 S\tab \up0 \expndtw-3\charscalex100 :\
tab \up0 \expndtw0\charscalex102 Klien mengatakan\tab \up0 \expndtw-3\charscal
ex100 Proses infeksi virus dengue\tab \up0 \expndtw-3\charscalex100 Peningkatan\
par\pard\li2325\sb1\sl-276\slmult0\fi1195\tx7177\tx8940 \up0 \expndtw-2\charscal
ex100 badanya terasa panas,\tab \dn3 \expndtw-3\charscalex100 \ul0\nosupersub\cf
3\f4\fs24 \u-3884?\tab \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24
suhu tubuh\par\pard\li2325\sb18\sl-254\slmult0\fi1195\tx6900 \up0 \expndtw-3\ch
arscalex100 pusing\tab \dn2 \expndtw-5\charscalex100 Viremia\par\pard\li2325\sb1
9\sl-258\slmult0\fi584\tx7177 \up0 \expndtw-4\charscalex100 O : Akral dingin\ta
b \dn2 \expndtw-3\charscalex100 \ul0\nosupersub\cf3\f4\fs24 \u-3884?\par\pard\li
2325\sb38\sl-216\slmult0\fi1015\tx5512\tx6525\sa40 \up0 \expndtw0\charscalex118
\ul0\nosupersub\cf2\f3\fs24 Panas hari ke\tab \up0 \expndtw-3\charscalex100
2\tab \dn4 \expndtw-3\charscalex100 Thermoregulasi\par\pard\li2325\sb39\sl-216\s
lmult0\fi1015 \up0 \expndtw-3\charscalex100 panjang.\par\pard\li2325\sb7\sl-276\
slmult0\fi1015 \up0 \expndtw0\charscalex115 TTV : S : 37\ul0\super\cf6\f7\fs21
6, \ul0\nosupersub\cf2\f3\fs24 Nadi\par\pard\li2325\sb0\sl-276\slmult0\fi1015\t
x6133\sa40\tx8940 \up0 \expndtw0\charscalex103 98x/mnt, TD : 100/60,\tab \dn4 \e
xpndtw-3\charscalex100 Peningkatan suhu tubuh\tab \up0 \expndtw-3\charscalex100
Cairan tubuh\par\pard\li2325\sb32\sl-216\slmult0\fi1015\tx6410 \up0 \expndtw-3\c
harscalex100 RR 25x/mnt.\tab \dn3 \expndtw-3\charscalex100 Ektravasasi cairan\pa
r\pard\li2325\sb45\sl-276\slmult0\fi4297 \up0 \expndtw-3\charscalex100 Intake ku
rang\par\pard\li2325\sl-216\tx2910\tx7177\sa40 \tab \up0 \expndtw0\charscalex101
S : Klien mengatakan tidak\tab \dn4 \expndtw-3\charscalex100 \ul0\nosupersub\cf
3\f4\fs24 \u-3884?\par\pard\li2325\sb50\sl-216\slmult0\fi1015\tx6027\sa40 \up0 \
expndtw0\charscalex104 \ul0\nosupersub\cf2\f3\fs24 suka minum dan perut\tab \dn4
\expndtw-4\charscalex100 Volume plasma berkurang\par\pard\li2270\sb0\sl-276\slm
ult0\par\pard\li2270\sb77\sl-276\slmult0\fi0\tx3987\tx4420\tx8737\tx10397 \up0 \
expndtw0\charscalex110 \ul0\nosupersub\cf4\f5\fs24 DOKUMEN\tab \up0 \expndtw-3\c
harscalex100 :\tab \up0 \expndtw0\charscalex130 SUBHAN PSIK FK UNAIR\tab \up0
\expndtw0\charscalex105 SURABAYA\tab \up0 \expndtw-3\charscalex100 \ul0\nosuper
sub\cf5\f6\fs24 8\par\pard\ql \li2270\sb4\sl-276\slmult0 \up0 \expndtw0\charscal
ex111 \ul0\nosupersub\cf4\f5\fs24 ANGKATAN III \par\pard\sect\sectd\fs24\paperw1
2240\paperh18720{\shp
z-10000\shplid8
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101
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010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
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0086c8fda2bfe913bfb7ff00fe1c6ff82597ff004cb28ff86c8fda2bfe913bfb7fff00e1c6ff0082
597ff4cb2beffa2803e00ff86c8fda2bfe913bfb7fff00e1c6ff0082597ff4cb28ff0086c8fda2bf
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2597ff004cb28ff86c8fda2bfe913bfb7fff00e1c6ff0082597ff4cb2beffa2803e00ff86c8fda2b
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28ff0086c8fda2bfe913bfb7ff00fe1c6ff82597ff004cb2beff00a2803e00ff0086c8fda2bfe913
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03f9d7fd999bf6d8f831ff000519ff00829efed79e28ff00825d7ed897ff000d7f6d4d37f61fb3f8
59a2681f16bfe09a575e38d025fd9a7e0f78dfe1f78edbc7fa6ea3ff000504d2f40d2a3d5b59f12d
8dcf848f877c4de2a6bfd322bb9b585d06ee386ca7fd29ff0086c8fda2bfe913bfb7ff00fe1c6ff8
2597ff004cb2beff00a2803e00ff0086c8fda2bfe913bfb7ff00fe1c6ff82597ff004cb28ff86c8f
da2bfe913bfb7fff00e1c6ff0082597ff4cb2beffa2803e00ff86c8fda2bfe913bfb7fff00e1c6ff
0082597ff4cb28ff0086c8fda2bfe913bfb7ff00fe1c6ff82597ff004cb2beff00a2803e00ff0086
c8fda2bfe913bfb7ff00fe1c6ff82597ff004cb28ff86c8fda2bfe913bfb7fff00e1c6ff0082597f
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ff004cb28ff86c8fda2bfe913bfb7fff00e1c6ff0082597ff4cb2beffa2803e00ff86c8fda2bfe91
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00a2803e00ff0086c8fda2bfe913bfb7ff00fe1c6ff82597ff004cb28ff86c8fda2bfe913bfb7fff
00e1c6ff0082597ff4cb2beffa2803e00ff86c8fda2bfe913bfb7fff00e1c6ff0082597ff4cb28ff
0086c8fda2bfe913bfb7ff00fe1c6ff82597ff004cb2beff00a2803e00ff0086c8fda2bfe913bfb7
ff00fe1c6ff82597ff004cb28ff86c8fda2bfe913bfb7fff00e1c6ff0082597ff4cb2beffa2803f2
23f6a6f8f1fb54fc70fd98bf68df82de13ff008254fedcfa7f8a7e2ffc07f8bdf0bfc357fe21f89d
ff0004bfb4d02c75ff001ffc3ef10f84f46bcd72eb4dff00828e6ada8db68f6da8ead6d36a77161a
56a77b0d924f25ae9f7b3ac76d27997fc13dbe22fed7bfb26fec35fb277eccdf117fe0961fb6c6b5
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dbff00ff000e37fc12cbff00a65947fc3647ed15ff00489dfdbfff00f0e37fc12cbffa6595f7fd14
01f007fc3647ed15ff00489dfdbfff00f0e37fc12cbffa65947fc3647ed15ff489dfdbff00ff000e
37fc12cbff00a6595f7fd1401f007fc3647ed15ff489dfdbff00ff000e37fc12cbff00a65947fc36
47ed15ff00489dfdbfff00f0e37fc12cbffa6595f7fd1401f007fc3647ed15ff00489dfdbfff00f0
e37fc12cbffa65947fc3647ed15ff489dfdbff00ff000e37fc12cbff00a6595f7fd1401f007fc364
7ed15ff489dfdbff00ff000e37fc12cbff00a65947fc3647ed15ff00489dfdbfff00f0e37fc12cbf
fa6595f7fd1401f007fc3647ed15ff00489dfdbfff00f0e37fc12cbffa6595e15ff047df81bf1efe
0a7c3efdb7b54fda0be0d7897e056bbfb427fc14d3f6c7fda93c05e05f1878b3e1278bfc4f17c26f
8ebe26f0ef8b7c117bafdefc15f891f157c13a76b690bdf68fad68b6fe30bfb8b0d6348bff0025ef
3489b4ad5f53fd74a2800a28a2800a28a2800a28a2800a28a2800a28a2800a28a2800a28a2800a28
a2800a28a2800a28a2800a28a2800a28a2800a28a2800a28a2800a28a2803fffd9}}}}}\pard\sb0
\sl-240\par\pard\li2910\sb0\sl-276\slmult0\par\pard\li2910\sb0\sl-276\slmult0\pa
r\pard\li2910\sb0\sl-276\slmult0\par\pard\li2910\sb0\sl-276\slmult0\par\pard\li2
910\sb0\sl-276\slmult0\par\pard\li2910\sb107\sl-276\slmult0\fi431\tx7177 \up0 \e
xpndtw0\charscalex100 \ul0\nosupersub\cf2\f3\fs24 terasa kenyang minum\tab \dn3
\expndtw-3\charscalex100 \ul0\nosupersub\cf3\f4\fs24 \u-3884?\par\pard\li2910\s
b0\sl-276\slmult0\fi431\tx6060 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2
\f3\fs24 terus.\tab \dn2 \expndtw-3\charscalex100 Penurunan volume cairan\par\pa
rd\li2910\sb15\sl-258\slmult0\fi0\tx7012 \up0 \expndtw-4\charscalex100 O : Turg
or kulit baik\tab \dn2 \expndtw-3\charscalex100 tubuh\par\pard\li2910\sb18\sl-25
8\slmult0\fi431 \up0 \expndtw-3\charscalex100 Mukosa bibir kering\par\pard\li291
0\sb4\sl-276\slmult0\fi431 \up0 \expndtw0\charscalex108 Urine banyak warna\par
\pard\li2910\sb0\sl-276\slmult0\fi431 \up0 \expndtw-3\charscalex100 kuning pekat
\par\pard\li2910\sb0\sl-276\slmult0\fi431\tx8940 \up0 \expndtw-3\charscalex100 P
anas hari ke 2 panjang\tab \up0 \expndtw-3\charscalex100 Nutrisi\par\pard\li2910
\sb0\sl-276\slmult0\fi431\tx6193 \up0 \expndtw-3\charscalex100 Trombosit ; 133.0
00\tab \dn2 \expndtw-3\charscalex100 Nafsu makan menurun\par\pard\li2910\sb15\sl
-258\slmult0\fi431\tx3896\tx4195\tx5563\tx7177\sa40 \up0 \expndtw-3\charscalex10
0 TD\tab \up0 \expndtw-3\charscalex100 :\tab \up0 \expndtw0\charscalex108 100/60
, N\tab \up0 \expndtw-3\charscalex100 ;\tab \dn4 \expndtw-3\charscalex100 \ul0\
nosupersub\cf3\f4\fs24 \u-3884?\par\pard\li2910\sb38\sl-216\slmult0\fi431\tx5975
\up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 98x/mnt.\tab \dn3 \ex
pndtw-3\charscalex100 Intake nutrisi tidak adekuat\par\pard\li2910\sb68\sl-276\s
lmult0\fi4267 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf3\f4\fs24 \u-3884?
\par\pard\li2910\sl-216\tx6373\sa40 \up0 \expndtw0\charscalex101 \ul0\nosupersub
\cf2\f3\fs24 S : Klien menyatakan tidak\tab \dn4 \expndtw-3\charscalex100 Nutris
i kurang dari\par\pard\li2910\sb47\sl-216\slmult0\fi0\tx6483\sa40 \up0 \expndtw0
\charscalex107 mau makan, tetapi tidak\tab \dn4 \expndtw-3\charscalex100 kebu
tuhan tubuh\par\pard\ql \li2910\sb4\sl-216\slmult0 \up0 \expndtw-3\charscalex100
mual. \par\pard\ql \li2910\sb11\sl-276\slmult0 \up0 \expndtw-3\charscalex100 O
: KU lemah \par\pard\ql \li2910\ri3303\sb1\sl-275\slmult0 \up0 \expndtw0\charsca
lex106 Makan pagi hanya mau 3 \line \up0 \expndtw-3\charscalex100 sendok \par\p
ard\ql \li2330\sb0\sl-276\slmult0 \par\pard\ql\li2330\sb0\sl-276\slmult0 \par\pa
rd\ql\li2330\sb11\sl-276\slmult0\tx2690 \up0 \expndtw-3\charscalex100 \ul0\nosup
ersub\cf1\f2\fs24 C. \tab \up0 \expndtw-6\charscalex100 DIAGNOSA KEPERAWATAN : \
par\pard\ql \li3050\sb0\sl-276\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupe
rsub\cf2\f3\fs24 1. Peningkatan suhu tubuh berhubungan dengan proses infeksi vi
rus dengue. \par\pard\ql \li3050\ri1512\sb1\sl-275\slmult0\tx3410 \up0 \expndtw0

\charscalex100 2. Resiko defisit volume cairan berhubungan dengan pindahn
ya cairan \line\tab \up0 \expndtw-3\charscalex100 intravaskuler ke ekstravaskul
er \par\pard\ql \li3050\ri1508\sb2\sl-275\slmult0\tx3410 \up0 \expndtw0\charscal
ex101 3. Resiko gangguan nutrisi kurang berhubungan dengan nafsu makan yang \li
ne\tab \up0 \expndtw-3\charscalex100 menurun. \par\pard\li2330\sb277\sl-276\slmu
lt0\fi0\tx2690 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 D.\tab
\up0 \expndtw-3\charscalex100 PERENCANAAN\par\pard\li2330\sb0\sl-276\slmult0\fi3
00\tx2990 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf2\f3\fs24 1.\tab \up0
\expndtw-3\charscalex100 Peningkatan suhu tubuh berhubungan dengan proses infeks
i virus dengue\par\pard\li2330\sb0\sl-276\slmult0\fi660 \up0 \expndtw-3\charscal
ex100 Tujuan : Suhu tubuh kembali normal\par\pard\ql \li2990\ri2942\sb0\sl-276\s
lmult0\tx3830 \up0 \expndtw-2\charscalex100 Kriteria : TTV khususnya suhu dalam
batas normal ( 36\ul0\super\cf6\f7\fs21 5\ul0\nosupersub\cf2\f3\fs24 - 37\ul0\s
uper\cf6\f7\fs21 5\ul0\nosupersub\cf2\f3\fs24 ) \line\tab \up0 \expndtw-3\chars
calex100 Membran mukosa basah. \par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \exp
ndtw-3\charscalex100 Rencana Intervensi ; \par\pard\ql \li2990\sb0\sl-276\slmult
0 \up0 \expndtw-1\charscalex100 1. Observasi TTV setiap 1 jam \par\pard\ql \li3
350\sb0\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Rasional : Menentukan inter
vensi lanjutan bila terjadi perubahan \par\pard\ql \li2990\sb1\sl-276\slmult0 \u
p0 \expndtw-1\charscalex100 2. Berikan kompres air biasa / kran \par\pard\ql \l
i3350\sb0\sl-275\slmult0 \up0 \expndtw-3\charscalex100 Rasional : Kompres akan m
emberikan pengeluaran panas secara induksi. \par\pard\ql \li2990\sb1\sl-276\slmu
lt0 \up0 \expndtw-1\charscalex100 3. Anjurkan klien untuk banyak minum 1500 - 2
000 ml \par\pard\qj \li3350\ri1508\sb1\sl-275\slmult0 \up0 \expndtw-2\charscalex
100 Rasional : Mengganti cairan tubuh yang keluar karena panas dan memacu \up0 \
expndtw-3\charscalex100 pengeluaran urine guna pembuangan panas lewt urine. \par
\pard\ql \li2990\sb2\sl-276\slmult0 \up0 \expndtw-2\charscalex100 4. Anjurkan u
ntuk memakai pakaian yang tipis dan menyengat keringat. \par\pard\ql \li3350\sb0
\sl-275\slmult0 \up0 \expndtw-3\charscalex100 Rasional : Memberikan rasa nyaman
dan memperbesar penguapan panas \par\pard\ql \li2990\sb1\sl-276\slmult0 \up0 \ex
pndtw-1\charscalex100 5. Observasi intake dan out put \par\pard\ql \li3350\sb0\
sl-276\slmult0 \up0 \expndtw-3\charscalex100 Rasional : Deteksi terjadinya kekur
angan volume cairan tubuh. \par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw
-2\charscalex100 6. Kolaborasi untuk pemberian antipiretik \par\pard\ql \li3350
\sb1\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Rasional : Antipireik berguna
bagi penurunan panas. \par\pard\li2630\sb275\sl-276\slmult0\fi0\tx2990 \up0 \exp
ndtw-3\charscalex100 2.\tab \up0 \expndtw0\charscalex107 Resiko defisit volume
cairan berhubungan dengan pindahnya cairan\par\pard\li2630\sb0\sl-276\slmu
lt0\fi360 \up0 \expndtw-3\charscalex100 intravaskuler ke ekstravaskuler.\par\par
d\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-4\charscalex100 Tujuan : Tidak ter
jadi syok hipovolemik \par\pard\ql \li2990\ri4695\sb0\sl-276\slmult0\tx3890 \up0
\expndtw-3\charscalex100 Kriteria : TD 100/70 mmHg, N: 80-120x/mnt \line\tab \u
p0 \expndtw-3\charscalex100 Pulsasi kuat \par\pard\ql \li3890\sb0\sl-276\slmult0
\up0 \expndtw-3\charscalex100 Akral hangat \par\pard\ql \li2990\sb0\sl-276\slmu
lt0 \par\pard\ql\li2990\sb276\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Renca
na Intervensi ; \par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb122\sl-276
\slmult0\fi0\tx3987\tx4420\tx10397 \up0 \expndtw0\charscalex110 \ul0\nosupersub\
cf4\f5\fs24 DOKUMEN\tab \up0 \expndtw-3\charscalex100 :\tab \up0 \expndtw0\chars
calex126 SUBHAN PSIK FK UNAIR SURABAYA\tab \up0 \expndtw-3\charscalex100 \ul
0\nosupersub\cf5\f6\fs24 9\par\pard\ql \li2270\sb4\sl-276\slmult0 \up0 \expndtw0
\charscalex111 \ul0\nosupersub\cf4\f5\fs24 ANGKATAN III \par\pard\sect\sectd\fs2
4\paperw12240\paperh18720{\shp
z-10000\shplid9
ffd8ffe000104a46494600010101006000600000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
00110803e7028d03012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
sl-276\slmult0 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf2\f3\fs24 1. Obs
ervasi Vital sign setiap jam atau lebih. \par\pard\qj \li3350\ri1503\sb0\sl-276\
slmult0 \up0 \expndtw0\charscalex100 Rasional : Mengetahui kondisi dan mengident
ifikasi fluktuasi cairan intra \up0 \expndtw-4\charscalex100 vaskuler. \par\pard
\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-1\charscalex100 2. Observasi capil
lary refill \par\pard\ql \li3350\sb0\sl-276\slmult0 \up0 \expndtw-3\charscalex10
0 Rasional : Indikasi keadekuatan sirkulasi perifer. \par\pard\li2990\sb0\sl-276
\slmult0\fi0 \up0 \expndtw-1\charscalex100 3. Observasi intake dan output, cata
t jumlah, warna / konsentrasi urine.\par\pard\li2990\sb0\sl-276\slmult0\fi360\tx
4380\tx7547 \up0 \expndtw-3\charscalex100 Rasional\tab \up0 \expndtw0\charscalex
102 : Penurunan haluaran urine\tab \up0 \expndtw0\charscalex105 / urine y
ang pekat dengan\par\pard\li2990\sb0\sl-276\slmult0\fi360 \up0 \expndtw-3\char
scalex100 peningkatan BJ diduga dehidrasi.\par\pard\ql \li2990\ri3686\sb0\sl-276
\slmult0\tx3350 \up0 \expndtw-2\charscalex100 4. Anjurkan anak untuk banyak min
um 1500-2000 mL \line\tab \up0 \expndtw-3\charscalex100 Rasional : Untuk pemenuh
an kebutuhan ciran tubuh \par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-2
\charscalex100 5. Kolaborasi pemberian cairan intra vena atau plasma atau darah
. \par\pard\qj \li3350\ri1512\sb0\sl-276\slmult0 \up0 \expndtw-1\charscalex100 R
asional : Meningkatkan jumlah cairan tubuh untuk mencegah terjadinya \up0 \expnd
tw-3\charscalex100 hipovolemik syok. \par\pard\li2630\sb276\sl-276\slmult0\fi0\t
x2990 \up0 \expndtw-3\charscalex100 3.\tab \up0 \expndtw0\charscalex104 Resiko g
angguan nutrisi kurang berhubungan dengan nafsu makan yang\par\pard\li2630\sb0
\sl-276\slmult0\fi360 \up0 \expndtw-3\charscalex100 menurun.\par\pard\ql \li2990
\sb0\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Tujuan : Nutrisi terpenuhi \pa
r\pard\ql \li2990\ri5707\sb1\sl-275\slmult0\tx3890 \up0 \expndtw-5\charscalex100
Kriteria : Nafsu makan meningkat \line\tab \up0 \expndtw-3\charscalex100 Pors

i makan dihabiskan \par\pard\ql \li2990\sb1\sl-276\slmult0 \up0 \expndtw-3\chars
calex100 Rencana Intervensi : \par\pard\ql \li2990\ri3274\sb1\sl-275\slmult0\tx3
350 \up0 \expndtw-2\charscalex100 1. Kaji keluhan mual, muntah atau penurunan n
afsu makan \line\tab \up0 \expndtw-3\charscalex100 Rasional : Menentukan interve
nsi selanjutnya. \par\pard\ql \li2990\sb1\sl-276\slmult0 \up0 \expndtw-2\charsca
lex100 2. Berikan makanan yang mudah ditelan mudah cerna \par\pard\qj \li3350\r
i1511\sb1\sl-275\slmult0\tx4380 \up0 \expndtw-3\charscalex100 Rasional \tab \up0
\expndtw0\charscalex103 : Mengurangi kelelahan klien dan mencegah perdar
ahan \up0 \expndtw-3\charscalex100 gastrointestinal. \par\pard\ql \li2990\ri4706
\sb2\sl-275\slmult0\tx3350 \up0 \expndtw-2\charscalex100 3. Berikan makanan por
si kecil tapi sering. \line\tab \up0 \expndtw-3\charscalex100 Rasional : Menghin
dari mual dan muntah \par\pard\ql \li2990\sb1\sl-276\slmult0 \up0 \expndtw-2\cha
rscalex100 4. Hindari makanan yang merangsang : pedas, asam. \par\pard\li3350\s
b0\sl-276\slmult0\fi0\tx4353 \up0 \expndtw-3\charscalex100 Rasional\tab \up0 \ex
pndtw0\charscalex101 : Mencegah terjadinya distensi pada lambung yang da
pat\par\pard\li3350\sb0\sl-276\slmult0\fi0 \up0 \expndtw-3\charscalex100 menstim
ulasi muntah.\par\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-1\charscalex1
00 5. Beri makanan kesukaan klien \par\pard\ql \li3350\sb0\sl-276\slmult0 \up0
\expndtw-3\charscalex100 Rasional : Memungkinkan pemasukan yang lebih banyak \pa
r\pard\ql \li2990\sb0\sl-276\slmult0 \up0 \expndtw-2\charscalex100 6. Kolaboras
i pemberian cairan parenteral \par\pard\qj \li3350\ri1514\sb0\sl-276\slmult0 \up
0 \expndtw0\charscalex100 Rasional : Nutrisi parenteral sangat diperlukan jika i
ntake peroral sangat \up0 \expndtw-3\charscalex100 kurang. \par\pard\li2270\sb0\
sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slm
ult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\p
ard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270
\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-27
6\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\
par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\l
i2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\
sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slm
ult0\par\pard\li2270\sb0\sl-276\slmult0\par\pard\li2270\sb0\sl-276\slmult0\par\p
ard\li2270\sb141\sl-276\slmult0\fi0\tx3987\tx4420\tx10277 \up0 \expndtw0\charsca
lex110 \ul0\nosupersub\cf4\f5\fs24 DOKUMEN\tab \up0 \expndtw-3\charscalex100 :\t
ab \up0 \expndtw0\charscalex126 SUBHAN PSIK FK UNAIR SURABAYA\tab \up0 \expn
dtw-3\charscalex100 \ul0\nosupersub\cf5\f6\fs24 10\par\pard\li2270\sb4\sl-276\sl
mult0\fi0 \up0 \expndtw0\charscalex111 \ul0\nosupersub\cf4\f5\fs24 ANGKATAN III\
par\pard\sect\sectd\fs24}

Askep Anak Dengan DHF

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Askep Anak Dengan DHF

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{\rtf1{\fonttbl

{\f2 Times New Roman Bold;}

KEPERAWATAN ANAK \par\pard\ql \li3308\sb0\sl-276\slmult0 \up0 \expndtw-4\charsca

h seperti nadi lemah dan cepat \up0 \expndtw0\charscalex106 (>120x/mnt ) tekanan

\sl-276\slmult0 \par\pard\ql\li2270\sb0\sl-276\slmult0 \par\pard\ql\li2270\sb97\

un waktu 24 jam yang diestimasikan sebagai berikut : \par\pard\li3350\sb19\sl-27

\par\pard\qj \li2990\ri1515\sb0\sl-276\slmult0 \up0 \expndtw0\charscalex103 Pasi

\par\pard\qj \li2990\ri1514\sb2\sl-275\slmult0 \up0 \expndtw0\charscalex100 Resi

) \line\tab \up0 \expndtw-3\charscalex100 Rasional : Untuk memenuhi kabutuhan ca

an factor-faktor \up0 \expndtw-3\charscalex100 pembekuan darah ( trombositopeni

expndtw-3\charscalex100 7. \tab \up0 \expndtw-3\charscalex100 Riwayat kehamilan

\par\pard\ql \li2630\sb276\sl-276\slmult0\tx2990 \up0 \expndtw-3\charscalex100

rus dengue. \par\pard\ql \li3050\ri1512\sb1\sl-275\slmult0\tx3410 \up0 \expndtw0

Kriteria : Nafsu makan meningkat \line\tab \up0 \expndtw-3\charscalex100 Pors

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