ASUHAN KEPERAWATAN GAWAT DARURAT GAGAL NAPAS AKUT
TUGAS KEPERAWATAN GAWAT DARURAT GAGAL NAPA NA PAS S AKUT
Disusun oleh: Vinsensius Bate
PROGRAM STUDY STRATA STRATA 1 PROGRAM B STIKES BETHESPERTUKARAN GAS YANG YANG TIDAK DA YAKKUM YAKKUM YOGYAKARTA 21! KONSEP MEDIS GAGAL GAGA L NAPAS AKUT AKUT I.
LANDASAN TEORI
A. PENGERTIAN G"#"l G"# "l n"$ n"$"s "s "%u "%u&& "'" "'"l"h l"h $e( $e(&u% &u%"("n "("n #"s )" )"n# n# &i' &i'"% "% "'e "'e%u" %u"&& sehi sehin## n##"" &e( &e(*"' *"'ii hi$ hi$o%s o%si"+ i"+ hi$e(%"$ni" ,$enin#%"&"n %onsen&("si %"(-on 'io%si'" "(&e(i.+ '"n "si'osis ,/o(0in+ 2. G"#"l G"# "l n"$ n"$"s "s "%u "%u&& "'" "'"l"h l"h 3e3 3e3-u( -u(u%n u%n)" )" $(o $(oses ses $e( $e(&u% &u%"(" "("n n #"s $"( $"(u u )" )"n# n# 3en 3en'"' '"'"% "% '"n 3en#"n4"3 *i0"+ 3en)e-"-%"n (e&ensi %"(-on 'io%si'" '"n o%si#en )"n# &i'"% "'e%u"& ,Mo(&on+ 211. U('en+ S&"4) '"n Lou#h Lou#h 3en'i5inisi%"n #"#"l n"$"s "%u& se-"#"i su"&u %e"'""n %linis )"i&u sis&e3 $ul3on"l &i'"% 3"3$u 3e3$e(&"h"n%"n $e(&u%"("n #"s )"n# "'e%u"& ,/h"n#+ 2. G"#"l n"5"s "'"l"h $e(&u%"("n #"s )"n# &i'"% "'e%u"& sehin##" &e(*"'i hi$o%si"+ hi$e(%"$ni" ,$enin#%"&"n %onsen&("si %"(-on'io%si'" "(&e(i. '"n "si'osis B. ANATOMI DAN FISIOLOGI 1 Saluran Nafas Bagian Atas " Ron##" hi'un# U'"(" )"n# 'ihi(u$ 3el"lui hi'un# "%"n 3en#"l"3i &i#" h"l : Dih"n#"&%"n • Dis"(in# • D"n 'ile3-"-%"n •
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In&e(s&i&i"l s$"4e 3e(u$"%"n (u"n#"n )"n# 'i-en&u% oleh : endotel kapilerepitel al#eoli+ s"lu("n limfe+ *"(in#"n kolagen dan se'i%i& se(u3 Sirkulasi Paru Men#"&u( "li("n '"("h #ena & #ena '"(i#entrikel %"n"n %e arteri pulmonalis '"n 3en#"li(%"n '"("h )"n# -e(si5"& arterial 3el"ului #ena pulmonalis %e3-"li %e#entrikel %i(i Ke$"&en"n =en&il"si &e(#"n&un# $"'" e3$"& 5"%&o( : Ke-e(sih"n *"l"n n"5"s+ "'"n)" su3-"&"n "&"u o-s&(u%si *"l"n n"5"s "%"n 3en#h"l"n#i 3"su% '"n %elu"(n)" '"(i '"n %e $"(u9$"(u A'e%u"&n)" s)s&e3 s)"("5 $us"& '"n $us"& $e(n"5"s"n A'e%u"&n)" $en#e3-"n#"n '"n $en#e3$es"n $e(u9$e(u Ke3"3$u"n o&o9o&o& $e(n"5"s"n se$e(&i 'i"5$("#3"+ e%s&e(n"l in&e(%os"+ in&e(n"l in&e(%os"+ o&o& "-'o3in"l =en&il"si $"(u 3en#"4u %e$"'" $e(#e("%"n u'"(" '"(i "&3os5i( 3"su% '"n %elu"( $"(u =en&il"si -e(l"n#sun# se4"(" -ul% 5lo0Bul% 5lo0 "'"l"h $e($in'"h"n "&"u $e(#e("%"n #"s "&"u 4"i("n '"(i &e%"n"n &in##i %e (en'"h >"%&o(95"%&o( )"n# 3e3$en#"(uhi
5. #. 2. ". -. 4. . ". -.
Pe3-es"("n &onsil '"n "'enoi' A$ne" &i'u( o-s&(u%&i5 Pen)"%i& -(on%i"l: B(on%i&is %(onis As3" B(on%ioli&is "%u& Pen)"%i& $"(en%i3: E35ise3s $ul3on"l >i-(osis $ul3on"l '"n $en)"%i& in5il&("&i5 'i5usi %(onis l"inn)"
4. '. !. ". -. 4. - 1. ". -. 4. '. e. 5. 2. ". -. 4. '. e. 5. . ". -. 4. '. e. 5. !. ". -. 4. '. e. 5. #.
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D. Patfisilgi G"#"l n"5"s "%u& '"$"& 'ise-"-%"n oleh -e(-"#"i %e"'""n+ 'i"n&"("n)" 3en#"%i-"&%"n
E. !lasifikasi
Be('"s"(%"n $en)e-"- o(#"n )"n# &e(#"n##u '"$"& 'i-"#i 3en*"'i 2+ )"i&u: 1 %"('i"% G"n##u"n #"#"l n"5"s -is" &e(*"'i "%i-"& "'"n)" $enu(un"n P"O2 '"n $enin#%"&"n P"/O2 "%i-"& *"uhn)" *"("% 'i5usi "%i-"& e'e3" $"(u E'e3" $"(u ini &e(*"'i "%i-"& %e#"#"l"n *"n&un# un&u% 3el"%u%"n 5un#sin)" sehin3##" &e(*"'i $enin#%"&"n $e($in'"h"n 4"i("n '"(i <"s%ule( %e in&e(s&i&i"l '"n "l
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hi'(os&"&i% %"$ile( $"(u+ 4"i("n -e($in'"h %e 9Pen)"%i& )"n# 3en)e-"-%"n 'is5un#si 3io%"(' : in5"(% 3io%"('+ %"('io3io$"&i+ '"n 3io%"('i&is Pen)"%i& )"n# 3en)e-"-%"n $enin#%"&"n L=ED= '"n L=EDP : Menin#%"&%"n -e-"n &e%"n"n : "o(&" s&enosis+ hi$e(&ensi+ '"n /o"(&"sio Ao(&" Menin#%"&%"n
2 Ti$e 1 #"#"l n"5"s hi$o%se3i" : %e#"#"l"n ini 'i'es%(i$si%"n se-"#"i o%si#en"si '"("h )"n# "-no(3"l Se-"#"i3"n" 'i&un*u%%"n oleh n"3"n)"+ $"'" &i$e #"#"l n"5"s ini+ P"O2 $"sien ini '"$"& (en'"h , 33H# "&"u %u("n# . '"n S"O2 "%"n (en'"h , %u("n# '"(i .+ n"3un P"O2 '"$"& no(3"l hin##" (en'"h "'i+ 3e%"nis3e $(i3e( $"'" &i$e %e#"#"l"n ini "'"l"h %e#"#"l"n &i$e 2 3e(u$"%"n %o3-in"si (e&ensi /O2 , hi$e(%"$ne" . 'en#"n o%si#en"si )"n# &i'"% "'e%u"& , hi$o%se3i" .
F. Manif"stasi!linis
1 Si"nosis 2 Dis$ne"-e("&
G. P"#"riksaan $iagnstik 1 H- : 'i-"0"h 12 #( 2 An"lis" #"s '"("h : $H 'i-"0"h F+C "&"u 'i "&"s F+!C $"O2 Hi$o%se3i"(in#"n : P"O2 33H# Hi$o%se3i"se'"n# : P"O2 33H# Hi$o%se3i"-e("& : P"O2 ! 33H# $/O2 'i -"0"h C "&"u 'i "&"s !C 33H#
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/"(" $e3-e(i"n o%si#en se4"(" u3u3 "'" 2 3"4"3 )"i&u sis&e3 "(us (en'"h '"n sis&e3 "(us &in##i ,T"-el . K"&e&e( n"s"l %"nul 3e(u$"%"n "l"& 'en#"n sis&e3 "(us (en'"h )"n# 'i#un"%"n se4"(" lu"s N"s"l K"nul "(us (en'"h 3en#"li(%"n o%si#en %e n"so5"(in# 'en#"n "li("n 19 L63n&+ 'en#"n >iO2 "n&"(" +2!9+!! ,2! 9!!. Ali("n )"n# le-ih &in##i &i'"% 3enin#%"&%"n >iO2 se4"(" -e(3"%n" 'i"&"s !! '"n '"$"& 3en#"%i-"&%"n 3u%os" 3e3-("n 3en*"'i %e(in# Un&u% 3e3$e(-"i%i e5isiensi $e3-e(i"n o%si#en+ &el"h 'i'is"in -e-e("$" "l"&+ 'i"n&"("n)" electronic demand de#ice reser#oir nasal canul '"n transtracheal cathethers+ '"n 'i-"n'in#%"n n"s"l %"nul %oniO2 '"n $"sien hi$o%si" 'en#"n isiolo#is: " Hi$o%se3i" 3ene&"$ se&el"h $e3-e(i"n o%si#en - P"/O2 CC 33H# 'en#"n $H F+2C 4 K"$"si&"s
/"&"&"n: Pe(i3-"n#%"n &("%eos&o3i *i%" o-s&(u%si 'i "&"s &("%e" ,Sue '"n Bon#"('+ 2. P"n'u"n un&u% 3e3ilih $"sien )"n# 3e3e(lu%"n in&u-"si en'o&("%e"l 'i "&"s 3un#%in -e(#un"+ &e&"$i $en#%"*i"n %linis (es$on &e(h"'"$ &e("$i le -ih -e(#un" '"n -e(3"n5""& >"%&o( l"in )"n# $e(lu 'i$i%i(%"n "'"l"h %e&e(se'i""n 5"sili&"s '"n $o&ensi 3"n5""&
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# Penatalaksanaan 2ausatif1$pesifik S"3-il 'il"%u%"n (esusi&"si ,&e("$i su$o(&i5. 'iu$")"%"n 3en4"(i $en)e-"- #"#"l n"5"s Pen#o-"&"n s$esi5i% 'i&u*u%"n $"'" e&iolo#in)"+ sehin##" $en#o-"&"n un&u% 3"sin#93"sin# $en)"%i& "%"n -e(l"in"n ,Muh"('i+ 1. Se3u" &e("$i 'i"&"s 'il"%u%"n '"l"3 u$")" 3en#o$&i3"l%"n $"sien #"#"l n"5"s 'i UGD se-elu3 sel"n*u&n)" n"n&i 'i ("0"& 'i I/U Pen"n#"n"n le-ih l"n*u& &e(u&"3" 3"s"l"h $en##un""n
!#&likasi O%si#en"si %e o(#"n l"in )"n# -u(u% '"$"& 3en)e-"-%"n %e#"#"l"n 3ul&i o(#"n In'i
-. Prgnsis Mo(&"li&"s ("&"9("&" se%i&"( C9 Mo(&"li&"s se%i&"( ! 'i'"$"&%"n $"'" $"sien 'en#"n #"#"l n"5"s s"*"+ se'"n#%"n $"'" $"sien 'en#"n se$sis "&"u "'"n)" %e#"#"l"n o(#"n u&"3" 'i'"$"&%"n 3o(&"li&"s se%i&"( F9 '"n -"h%"n -is" s"3$"i %"l"u sin'(o3 #"#"l n"5"s "3"& -e("& P"'" $"sien )"n# -e(&"h"n hi'u$+ u3u3n)" 5un#si $"(u "%"n %e3-"li se&el"h -e(-ul"n9-ul"n+ n"3un h"("$"n &e(se-u& s"n#"& %e4il %"(en" $"sien )"n# 3en'e(i&" ARDS "%"n 3en#"l"3i %e(us"%"n $"(u )"n# $e(3"nen 'en#"n in5e%si '"n 5i-(osis II. !ONSEP DASAR !EPERAATAN A Pen#%"*i"n Pen#%"*i"n P(i3e( 1 Ai(0") " Penin#%"&"nse%(esi$e(n"$"s"n - Bun)in"5"s%(e%els+ (on%i'"n3en#i 2 B(e"&hin# " Dis&(ess $e(n"$"s"n :$e(n"$"s"n4u$in#hi'un#+ &"%i$neu6-("'i$neu+ (e&("%si - Men##un"%"no&o&"%seso(i$e(n"$"s"n 4 Kesuli&"n-e(n"5"s : 'i"5o(esis+ si"nosis /i(4ul"&ion " Penu(un"n4u("h*"n&un# : #elis"h+ le&"(#i+ &"%i%"('i" - S"%i&%e$"l" 4 G"n##u"n&in#%"&%es"'"("n : "nsie&"s+ #elis"h+ %"4"u 3en&"l+ 3en#"n&u% ' P"$ile'e3"
e Penu(un"nh"lu"("n u(ine 5 K"$ile( (e5ill # Si"nosis
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