ASUHAN KEPERAWATAN BAYI BAYI DENGAN DE NGAN KELAINAN KE LAINAN KONGENITA K ONGENITAL L
Disusun Oleh : SUCI MAUDY AULIA PO.71.20.4.16.034
Dosen Pembimbin : !s. "is#i S$i %&$'&n'i( M. M. )*i+.
D-IV Keperawatan Palemban P!lte""e# Kemen"e# Palemban $%&'
BAB & LATAR LATAR BELAKANG
,el&in&n b&-&&n #el&in&n #oneni'&l/ &+&l&h su&'u #el&in&n *&+& s'$u#'u$ unsi m&u*un me'&bolism me'&bolism 'ubuh &n +i'emu#&n +i'emu#&n *&+& b&i #e'i#& +i& +il&hi$#&n. +il&hi$#&n. Se#i'&$ Se#i'&$ 34 b&i b&$u l&hi$ memili#i #el&in&n b&-&&n &n be$&'. ebe$&*& #el&in&n b&$u +i'emu#&n *&+& s&&' &n mul&i 'umbuh( &i'u se#i'&$ 7(5 'e$+i&nos& #e'i#& &n be$usi& 5 '&hun( 'e'&*i #eb&&n be$si&' $in&n Muslih&'um( 2010/. M&lo$m&si #oneni'&l #el&in&n #oneni'&l/ &+&l&h #el&in&n +&l&m *e$'umbuh&n &nin &n 'e$&+i se #onse*si +&n sel&m& +&l&m #&n+un&n. Di*e$#i$&n 10 20 +&$i #em&'i&n &nin +&l&m #&n+un&n +&n #em&'i&n neon&'&l +iseb&b#&n oleh #el&in&n #oneni'&l. ,hususn& *&+& b&i be$&' b&+&n +i*e$#i$&n #i$& #i$& 20 +i&n'&$&n& menin&l #&$en& #el&in&n #oneni'&l +&l&m minu *e$'&m& #ehi+u*&nn& Soi&n( 2011/. Seb&b 'e$&+in& #el&in&n #oneni'&l +&*&' +i seb&b#&n: #el&in&n #$omosom( #e#u$&n&n nu'$isi nu'$isi 'e$'en'u( 'e$'en'u( &en 'e$&'oeni8. 'e$&'oeni8. Den&n +emi#i&n( +emi#i&n( +&*&' +i&mb&$#&n +i&mb&$#&n b&h-& #e&+i&n #el&in&n& #oneni'&l +&*&' +i seb&b#&n oleh: &8'o$ ene'i# 40( &nu&n *e$#emb&n&n &nin 'e$+i$i &'&s: ib&' ine#si 5( ob&'ob&'&n 5( &nu&n me'&bolisme ibu9 *&+& #el&in&n #oneni'&l mi9'i*el #em&'i&nn& lebih +&$i 5060. ,el&in&n& #oneni'&l +imsu+ +en&n #e'i+m&m*u&n be$unsi no$m&l &'&u #e'i+m&m*u&n hi+u* no$m&l. ,e&+i&n #el&in&n #oneni'&l 'e$&n'un +&$i: &8'o$ lin#un&n eo$&is +&n &8'o$ $&si& M&nu&b&( 2007/. Semu& b&i b&$u l&hi$ h&$us +inil&i '&n+&'&n+& #e&-&'&n#el&in&n &n menunu##&n su&'u *eni'. &i b&$u l&hi$ +in&'&n l&hi$ si' &*&bil& mem*un&i s&'u &'&u '&n+&'&n+& ses n&*&s( $e#uensi n&*&s lebih +&$i 60 #&li *e$ meni'( '&m* 'e$'$si +in+in +&+&( m&l&s minum( *&n&s &'&u suhu b&+&n b&i $en+&h( #u$&n 'i be$&' b&+&n l&hi$ $en+&h +en&n #esuli'&n umum se+&n#&n *&+& b&i l&bios#i;is +i'&n+&i +en&n &+&n'& #el&in&n *&+& ben'u# bibi$ sumbin &'&u 'i+ sem*u$n& sem*u$n& Muslih&'un( 2010/. An#& An#& #e&+i #e&+i&n &n #&l&in #&l&in&n &n #onen #oneni'& i'&ll se#i'& se#i'&$$ 1700 1700 #el&hi #el&hi$&n $&n +&n me$u*& me$u*&n #&n s&l&h s&l&h s&'u #onen #oneni'& i'&ll &n &n se$in se$in +i'emu +i'emu#&n #&n(( #el&in #el&in&n &n ini be$-u be$-uu+ u+ seb&&i seb&&i l&bios l&bios#i; #i;is is +i se$'&i se$'&i *&l&'os#i;is 50( l&bios#i;is s&& 25 +&n *&l&'os#i;is s&& 25. P&+& 20 +&$i #elom*o# ini +i'emu +i'emu#&n #&n &+&n& &+&n& $i-&& $i-&&'' #el&in #el&in&n &n sumbin sumbin +&n #e'u$u #e'u$un&n n&n.. ,e&+i ,e&+i&n &n ini mun#i mun#in n +iseb&b#&n +iseb&b#&n &+&n& &8'o$ 'o#si# +&n lin#un&n lin#un&n &n mem*en&$uhi mem*en&$uhi en *&+& *e$io+e esi
#e2 bel&h&n 'e$sebu'. Pen&$uh 'o#si# 'e$h&+&* usi &n 'el&h 'e$&+i 'i+ &n memis&h#&n l&i bel&h&n 'e$sebu' Muslih&'un( 2010/. ,e&+i&n #el&in&n #oneni'&l +ium*&i se#i'&$ 1(53(5 +&$i semu& *e$s&lin&n. An#& #e&+i&n 'e$sebu' +iin+onesi& m&sih belum #e'&hui( se#&li*un &n#& #e&i&n +i $um&h si'. D&$i #e&+i&n 1(53(5( seb& 2 #&sus 'e$+&*&' #el&in&n #oneni'&l m&o$ sehin& #em&m*u&n hi+u*n& *$'is 'i+ mun#in. Den&n *e$#emb&n&n ul'$&sono$&i &n min *es&' m& +i&nose #el&in&n #oneni'&l su+&h +&*&' +i'e#&n se #eh&mil&n +ini. il& +o#'e$ mene'&hui b&h-& *&+& #eh&mil&nn& +ium*&i #el&in&n #oneni'&l( *&sien h&$us +ibe$i'&hu +en&n 8&$& sim*&'i#( +en&n *enel&s&n +&$i be$b&&i &s*e# sehin& #elu&$&n& memi#i$#&n +&*&' #el&nu'&nn& M&nu&b&( 2007/. P&+& #el&in&n #oneni'&l m&o$ seb&i#n& +i&nu$#&n un'u# melu#&n 'e$min&si #eh&mil&n se+&n#&n #el&in&n #oneni'& mino$ +i*e$'&h&n#&n &n +&*&' hi+u* +i'en&h #elu&$&n&. Oleh #&$en& i'u *enel&s&n &n *&lin u'&m& h&$us +&*&' menumbuh #emb&n#&n *ene$'i&n 'en'&n #el&in&n #oneni'&l moni$ &n mun#in +&*&' hi+u* 'e$us. P&+& #el&in&n #oneni'&l mino$( &+& #emun#in&n un'u# +&*&' melu#&n o*e$&si $e#ons'$u#si sehin& +&*&' be$unsi +en&n no$m&l M&nu&b&( 2007/. T()(an
1/
Un'u# meni+en'ii#&si #onse* me+is ,el&in&n ,oneni'&l *&+& !eon&'us &n meli*u'i +einisi( e'ioloi( m&nies'&si #linis +&n *&'oisioloi.
b. Un'u# meni+en'ii#&si *$oses #e*e$&-&'&n ,el&in&n ,oneni'&l *&+& !eon&'us
meli*u'i *en#&i&n( +i&nos&( in'e$=ensi( im*lemen'&si +&n e=&lu&si.
BAB $ TIN*AUAN TORITIS &+ K!n#ep ,e.# a+ Anat!m. Dan /.#.!l!. 1. Mulu'
Me$u*&n su&'u $on& 'e$bu#& 'em*&' m&su#n& m&n&n +&n &i$. Mulu' me$u*&n b&i&n &-&l +&$i sis'em *en8e$n&&n len#&* +&n &l&n m&su# un'u# ss'em *en8e$n&&n &n be$hi$ +i &nus. &i&n +&l&m +&$i mulu' +il&*isi oleh sel&*u' len+i$. Pene8&*&n +i$&s&n oleh o$&n *e$&s& &n 'e$+&*&' +i *e$mu#&&n li+&h. Pene8&*&n se+e$h&n& 'e$+i$i +&$i m&nis(&s&m( &sin +&n *&hi'. Pen8ium&n +i$&s&n oleh s&$& ol'o$ius hi+un( 'e$+i$i +&$i be$b&&i m&8&m b&u. M&n&n +i*o'on*o'on oleh ii +e*&n in8isi=us/ +&n +i #un&h oleh ii bel&n mol&$( e$&h&m/( men&+i b&i&nb&i&n #e8il &n lebih mu+&h +i8e$n&. Lu+&h +&$i #elen&$ lu+&h &n membun#us b&i&nb&i&n +&$i m&n&n 'e$sebu' +en&n en;imen;im *en8e$n&&n +&n mul&i men8e$n&n&. Lu+&h u& men&n+un &n'ibo+i +&n en;im mis&ln& liso;im/( &n meme8&h *$o'ein +&n mene$&n b'e$i se8&$& l&nsun. P$oses menel&n +imul&i se8&$& s&+&$ +&n be$l&nu' se8&$& o'om&'is S&iu+in(2011/.
$+ Pen0a".t K!nen.tal paa Ne!nat(# a+ H.p!#pe.a 1.
Deinisi %i*os*e+i& me$u*&n su&'u 8&8&' b&-&&n +im&n& lub&n u$e'$& 'i+ 'e$le' *&+& 'em*&'n& M&$&n'i( 2011/. en'u# hi*os*&+i& &n lebih be$&' 'e$&+i i#& lub&n u$e'$& 'e$+&*&' +i 'en&h b&'&n *enis &'&u *&+& *&n#&l *enis +&n #&+&n *&+& s#$o'um &'&u +i b&-&h s#$o'um. ,el&in&n ini se$in#&li be$hubun&n +en&n #o$+i &'&u su&'u &$in&n ib$os& &n #en8&n( &n meneb&b#&n *enis melen#un #e b&-&h *&+& s&&' e$e#si. >i#& 'i+ +iob&'i( mun#in &n 'e$&+i #esuli'&n +&l&m *el&'ih&n be$#emih *&+& &n +&n &nu&n be$hubun&n se#su&l *&+& s&&' +e-&s& M&$&n'i( 2011/.
2. )'ioloi )'ioloi belum +&*&' +i el&s#&n( n&mun 'eo$i &n be$#emb&n #&$en& #el&in&n ho$mon&l.
se*&n&n &$is 'en&h *enis 'e$&n'un s&&' 'e$&+in& &nu&n ho$mon&l. Semin +ini 'e$&+i &nu&n ho$mon&l( m& lub&n #en8in &bno$m&l &n be$mu&$& #e *&n#&l M&$&n'i( 2011/. 3. Pen&'&ls&n&&n a. Sube#'i Ino$m&si +&$i ibu $i-&&' #eseh&'&n sel&m& h&mil +&n 'o$ e'ioloi 'i+ l&nsun #el&in&n b&-&&n se*e$'i : 'o$ ine#si( me#&ni#( ob&'( usi& ibu( ho$mon&l( $&+i&si +&n i;i. b. Obe#'i 1/ Lub&n *enis 'i+ 'e$+&*&' +i uun *enis( 'e'&*i +i b&-&h &'&u +i +&s&$ *enis. 2/ Penis melen#un #eb&-&h 3) ,&+&n 'e$&+i #eluh&n be$#emih 8. Assessmen' !eon&'us +en&n hi*os*&+i&. a) Pl&nnin e$i *enel&s&n *&+& #elu&$& 'en'&n #e&+&&n neon&'us e$i su**o$' *&+& #elu&$& un'u# mene$im& #e&+&&n neon&'us b)
i#& neon&'us memili#i mi#$o *enis( m&
&n
men+&*&'#&n 'e$&*i ho$mon&l s&m*&i u#u$&n *enis sesu&i. O*e$&si seb&i#n& 'el&h 'un'&s sebelum *en+e$i'& m&su# se#ol&h M&$&n'i( 2011/.
b+ Ep.#pa.a )*is*&+i& &+&l&h su&'u &nom&li #oneni'&l &i'u me&'us u$e'$& 'e$le' *&+&
*e$mu#&&n +o$s&l *enis. Insi+ens e*is*&+i& &n len#&* se#i'&$ 1 +&l&m 120.000 lili. ,e&+&&n ini bi&s&n& 'i+ 'e$&+i sen+i$i&n( 'e'&*i u& +ise$'&i &nom&li s&lu$&n #emih. )*is*&+i& +i #l&sii#&si#&n be$+&s&$#&n le' me&'us #emih +ise*&n&n b&'&n *enis : l&n+ul&$ *&+& l&ns b&i&n +o$s&l/( *enis &n'&$& simisis *ubis +&n sul#us #o$on&$ius/( +&n *eno*ubis *&+& *e$'emu&n &n'&$& *enis +&n *ubis/. Me&'us u$e'$& melu&s( +&n *e$lu&s&n &lu$ +o$s&l +&$i me&'us 'e$le' +i b&-&h l&ns. P$e*usium men&n'un +&$i sisi =en'$&l *enis. Penis *i*ih mu#in &n melen#un #e +o$s&l ib&' &+&n& 8ho$+ee P$i8e( 2005/. In#on'inensi& u$ine 'imbul *&+& e*is*&+i& *eno*ubis ?5/ +&n *enis 75/ #&$en& *e$#emb&n&n &n s&l&h +&$i s*in'e$ u$in&$ius. Pen&'&ls&n&&n &n +&*&' +i lu#&n &+&l&h *embe+&h&n un'u# mem*e$b&i#i in#o'inensi&( un'u# membu&n 8ho$+ee( +&n me*e$lu&s u$e'$& #e l&s. P$e*usium +i un&n +&l&m
*$oses $e#ons'$u#si( sehin& b&i b&$u l&hi$ +en& e*is*&+i& 'i+ boleh +i su$#umsisi P$i8e( 2005/ 1+ Atre#.a D(!en(m 1. Deinisi A'$esi& +uo+enum &+&l&h +ee# +i m&n& +uo+enum( b&i&n *e$'&m& usus
h&lus( 'i+ be$#emb&n +en&n sem*u$n&. Su&'u b&i&n +uo+enum 'e$'u'u* sehin& m&n&n +&n 8&i$&n 'i+ +&*&' m&su#. &i&n +uo+enum &n 'e$'u'u* bi&s&n& &+&l&h &m*ul& =&'e$i. ,on+isi ini se$in be$hubun&n +en&n +ee# #oneni'&l &n l&in S&*u'$&( 2014 /. 2. )'ioloi Peneb&b u'&m& &'$esi& +uo+enum belum +i#e'&hui. !&mun( se8&$& umum &'$esi& +uo+enum +iib&'#&n oleh #e&&l&n $e#&n&lis&si se'el&h '&h&* @ soli+ 8o$+ +&$i *e$'umbuh&n usus *$o#sim&l S&*u'$&( 2014 /. 3. M&nies'&si #linis B&mb&$&n #linis &n +i um*&i *&+& b&i +en&n &'$esi& +uo+enum &n'&$& l&in : &. Men&l&mi mun'&h *&+& &-&l 'e$&+in& &'$esi& +uo+enum( bi&s&n& *&+& h&$i *e$'&m& &'&u #e+u& *os'n&'&l b. Polihi+$&mnion 'e$lih&' *&+& 50 b&i +en&n &'$esi& +uo+enum 8. e$&' b&+&n menu$un &'&u su#&$ be$'&mb&h +. Pe$u' #embun +i +&e$&h e*i&s'$um *&+& 24 &m &'&u sesu+&hn& 4. P&+& o'o *olos +&l&m *osisi 'e &n '&m* &mb&$&n *eleb&$&n l&mbun +&n b&i&n *$o#sim&l +uo+enum( '&n*& &+&n& u+&$& +i b&i&n usus l&in
5.
Pen&'l&s&n&&n: Sebu&h sel&n +iun&n un'u# men+e#om*$esi l&mbun. Dehi+$&si +&n #e'i+seimb&n&n ele#'$oli' +i*e$b&i#i +en&n membe$i#&n 8&i$&n se8&$& I. )=&lu&si #el&in&n #oneni'&l l&in *e$lu +ilu#&n. Pembe+&h&n un'u# mem*e$b&i#i sumb&'&n +uo+en&l +iin+i#&si#&n un'u# semu& b&i &n men&l&mi #el&in&n ini #&$en& m&lo$m&si ini +&*&' +i*e$b&i#i +en&n sem*u$n&. !&mun( i#& &+& #on+isi &n men&n8&m i-&( o*e$&si ini +&*&' +i'un+&. D&*&'#&n ino$me+ 8onsen' +&$i o$&n'u&
sebelum melu#&n $uu#&n &'&u *embe+&n S&*u'$&( 2014/. + Sp.na B.2.a 1. Deinisi S*in& bii+& &+&l&h +ee# #oneni'&l &n +i'&n+&i +en&n *enu'u*&n #&n&l neu$&l &n 'i+ #om*li' +&n bi&s&n& +i $eio lumbos$&lis
$oo#e$(200/. S*in& bii+& +&*&' meneb&b#&n &nu&n isi# +&n in'ele#'u&l &n be$=&$i&si +&$i $in&n hin& be$&'.
#e$us&n
s&$&.
Menino#el
ini
+&*&'
meneb&b#&n &nu&n #e8il. 8/ Mielomenino#el Mielomenino#el &+&l&h 'i*e s*in& bii+& &n *&lin se$ius. P&s& #on+isi ini( #&n'un 8&i$&n mun8ul +&$i lub&n *&+& *unun b&i. Seb&i&n me+ul& s*in&lis +&n s&$& 'e$+&*&' +&l&m
#&n'un
'e$sebu'
+&n
$us.
Mielomenino#el
me$u*&n 'i*e s*in& bii+& &n lebih s$in 'e$&+i +&n lebih se$ius. i&s&n& 'e$le' *&+& +&e$&h lumbol&s$&l. Peneb&b *&s'i s*in& bii+& 'i+ +i#e'&hui( *$e+is*osisi ene'i# mun#in &+&. 3. )'ioloi "isi#o &nu&n ini meni#&' *&+& +eesiensi &s&m ol&' m&'e$n&l. Den&n +emi#i&n( semu& -&ni'& &n h&mil &'&u se+&n me$en8&n&n un'u# h&mil +i&nu$#&n un'u# mul&i me+&*&' su*lemen =i'&min &s&m ol&' minim&l 'i& bul&n sebelum #onse*si S&*u'$&(2014/. 4. B&mb&$&n ,linis a+ S*in& bii+& o#ul'& S*in& bii+& o#ul'& +&*&' '&n*& e&l& &'&u be$#&i'&n +en&n:
1/ Pe$'umbuh&n $&mbu' &n 'e$&++i +i se*&n&n s*in& 2/ Le#u#&n +i&$is 'en&h( bi&s&n& +i+&e$&h lumbos$&l. 3/ Abno$m&li'&s && be$&l&n &'&u #i. 4/ ,on'$ol #&n+un #emih &n 'i+ b&i#. b+ Menino#el Menino#el +&*&' '&n*& e&l& &'&u be$#&i'&n +en&n : 1/
membu'uh#&n
*enob&'&n.
!&mun(
menino#el
+&n
mieolomenino#el membu'uh#&n *embe+&h&n un'u# menu'u* lub&n &n 'e$ben'u#. Sebelum melu#&n *embe+&h&n( +ilu#&n *enil&i&n *o'ensi b&i +en&n *eme$i#s&&n se8&$& len#&* +&n 'e*&' see$& se'el&h b&i l&hi$ un'u# menen'u#&n lu&sn& +ei+i' neu$oloi#( &+& 'i+n& hi+$ose&lus( lu&sn& +eo$mi'&s lub&n bel&n( +&n &+&n& #el&in&n #oneni'&l &n l&in. Se#sio C&es&$e& 'e$en8&n& sebelum mul&in& *e$s&lin&n *en'in +ilu#&n un'u# menu$&ni #e$us&n neu$oloi# &n 'e$&+i *&+& b&i +en&n +ee# me+ul& s*in&lis S&*u'$&(2014/. 3+ En#e2al!"el
1. Deinisi )nse&lo#el &+&l&h +ee# &'&u 8&8&' *&+& #$&nium &n +i'&n+&i +en&n &+&n& *enonol&n #elu&$ menines sel&*u' o'/ +&n o' &n bi&s&n& +i'u'u*i oleh #uli' mel&lui su&'u lub&n *&+& 'ul&n 'en#o$. )nse&lo#el +iseb&b#&n oleh #e&&&ln *enu'u*&n '&bun s&$& sel&m& *e$#emb&n&n &nin. Peneb&b *&s'i ense&lo#el belum +i#e'&hui( 'e'&*i #emun#in&n me$u*&n #ombin&si +&$i be$b&&i 'o$ se*e$'i nu'$isi *&& ibu( ene'i#( +&n *&*&$&n 'e$h&+&* 'o#sin &'&u ine#si *&+& '&h&* &-&l #ehi+u*&n &nin. Dee# '&bun s&$& '&m*n& be$hubun&n
+en&n #e#u$&n&n &s&m ol&' *&+& ibu( +&n *en&mb&h&n su*lemen &s&m ol&' *&+& ibu h&mil &'&u *&+& -&ni'& &n be$en8&n& h&mil +&*&' menu$un#&n $isi#o #el&in&n ini. 1. B&mb&$&n ,linis &. %i+$ose&lus b. ,elum*uh&n #eem*&' &no'& e$ #u&+$i*lei& *&s'i#/ 8. B&nu&n *e$#emb&n&n +. Mi#$ose&lus e. B&nu&n *enlih&'&n . ,e'e$bel&n&n men'&l +&n *e$'umbuh&n . A'si& h. ,e&ns&-&n 2. Pels&n&&n &.
&$in&n
&n
menonol
#e
+&l&m
'en#o$( membu&n #&n'un( +&n mem*e$b&i#i #el&in&n #$&nio&si&l &n 'e$&+i. 8. Sebelum *embe+&h&n( b&i +im&su##&n +e +&l&m in#ub&'o$ +en&n #on+isi '&n*& b&u. +. &i +en&n hi+$ose&lus mun#in *e$lu +ibu&'#&n su&'u *in'&s shun'/ 3. P$onosis P$onosis un'u# ense&lo#el 'e$&n'un *&+& 'i*e &$in&n o' &n 'e$#en&( lo#&si #&n'un( +&n m&lo$m&si o' &n mene$'&i. '+ H.r!#e2al(# 1. Deinisi Se8&$& umum(
hi+$ose&lus
me$u*&n
*enimbun&n
8&i$&n
se$eb$os*in&l &n be$lebih +i +&l&m o'. %i+$ose&lus &+&l&h #el&in&n *&'olois o' &n menib&'#&n be$'&mb&hn& 8&i$&n se$eb$os*in&l
CCS/
+en&n
&'&u
*e$n&h
+en&n
'e#&n&n
in'$$&ni&l &n menin#&'( sehin& 'e$+&*&' *eleb&$&n =en'$i#el D&$sono(2005/. 2. ,l&sii#&si &. e$+&s&$#&n sumb&'&nn& 1/ %i+$ose&lus obs'$u#s'i
o'
'e$&nu
#&$en&
+es&n
oleh
b&nn& 8&i$&n +&l&m #e*&l& +&n 'inin& 'e#&n&n in'$$&ni&l. 2/ %i+$ose&lus +i+&*&' Pe$'umbuh&n o' *&+& &-&ln& su+&h sem*u$n&( 'e'&*i #emu+i&n
'e$&+i
&nu&n
in'$$&ni&l &n 'ini 3. )'ioloi a. %i+$ose&lus 8oneni'&l 1/ S'enosis u&+u#'us sl=ii
#&$en&
:
&+&n&
*eneb&b
'e#&n&n
'e$b&n
hi+$ose&lus b&i +&n &n 60?0/. A#u&+u#'us +&*&' me$u*&n s&lu$&n bun'u &'&u lebih sem*i' +&$i bi&s&n&. Be&l& hi+$ose&lus umun& e$lih&' se l&hi$ &'&u *$o$esi +en&n 8e*&' *&+& bul&nbul& *e$'&m& #el&hi$&n. 2/ S*in& bii+& +&n #$&nium bii+& : be$hubun&n +en&n sin+$om A$nol+Chi&$i ib&' 'e$'&$i#n& me+ul& s*in&lis #e me+ul& oblon&'& +&n se$ebelum 'e$le'& lebih $en+&h +&n menu'u*i o$em&n m&num sehin& 'e$&+i *enumb&'&n seb&i&n &'&u 'o'&l. 3/ Sin+$om D&n+E&l#e$: &'$esi& #oneni'&l o$&men Lus8#& +&n M&en+hi &n meneb&b#&n hi+$ose&lus obs'$u#'i +en&n *eleb&$&n =en'$i#el'e$u'&m& =en'$i#el I&n +&*&' men&+i s&n&' bes&$ hin& men&+i su&'u #is'& bes&$ +i+&e$&h os& *os'e$io$. 4/ ,is'& &$noi+: +&*&' 'e$&+i se8&$& #oneni'&l &'&u '$&um& se#un+e$ su&'u hem&'om&.
4.
%i+$ose&lus +iseb&b#&n oleh : Ine#si : bi&s&n& 'e$&+i *&+& hi+$ose&lus *&s8& menini'is. !eo*l&sm& : +iseb&b#&n oleh &+&n& obs'$u#si me#&nisme
*&+& s&lu$&n &li$&n CSS Pe$+&$&h&n in'$$&ni&l : +&*&' meneb&b#&n hem&'om&
+i+&l&m o' sehin& +&*&' 'imbul *enumb&&n Sumb&'&n *&+& *eni' *enimbun&n(
mis&ln&
mu#o*olis&$i+& +&n his'iosi'osis F. In'o#si#&si =i'&min A. 5. B&mb&$&n ,linis &. &i mu+& 1/ ,e8e*&'&n *e$'umbuh&n #e*&l& 'i+ no$m&l 2/ Penonol&n on'&nel #hususn& &n'e$io$/ &n #&+&n '&n*& +ise$'&i *embes&$&n #e*&l& : 'e&n +&n 'i+ be$+enu' 3/ Dil&'&si =en& *&+& #uli' #e*&l& 4/
8. Peme$i#s&&n isi#( &mb&$&n #lini# &n s&m&$s&m&$ e. Pen&'&ls&n&&n P&+& seb&i&n bes&$ *en+e$i'&( *embes&$&n #e*&l& &n be$hen'i +en&n sen+i$in& &$$es'e+ h+$o8e*h&lus/. %&l ini mun#in +iseb&b#&n oleh $e#&n&lis&si $u&n sub&$noi+ &'&u #om*ens&si *emben'u#&n CSS &n be$#u$&n. i#& *eneb&b hi+$ose&lus &+&l&h 'umo$( 'in+&n be+&h un'# men&n#&' 'umo$ 'e$sebu' +&*&' +i*e$'imb&n#&n. Pen&'&ls&n&&n hi+$ose&lus &n'&$& l&in &+&l&h : 1. Lu#&n *e$&-&'&n umum( mis&ln& *en&-&s&n suhu( *en8e&h&n ine#si( *en&-&s&n &su*&n +&n h&lu&$&n( se$'& *e$&-&'&n se'el&h A, +&n A. 2. U#u$ lin#&$ #e*&l& se8&$& be$#&l& un'u# mene'&hui l&u *e$'&(b&h&n CSS. 3. Lu#&n *en&-&s&n +&n *en8e&h&n mun'&h. 4. Lu#&n *en&-&s&n #e&n. >i#& *e$lu( s*&'el li+&h +&*&' +i*&s&n un'u# men8e&h $e'$si li+&h &n +&*&' meneb&b#&n *e$+&$&h&n &'&u sumb&'&n *&+& s&lu$&n *e$n&*&s&n. 5. D&*&'#&n ino$me+ 8onsen' +&$i o$&n'u& un'u# me$uu# #e *us&' *el&&&n #eseh&'&&n &n lebih mem&+&i. P&+& +&s&$n& 'e$+&*&' 'i& *$insi* +&l&m *enob&'&n hi+$ose&lus( &i'u menu$&ni *$o+u#si CSS( memen&$uhi hubun&n &n'&$& 'em*&' *$o+u#si CSS +&n 'em*&' &bso$bsi( se$'& *enelu&$&n CSS #e +&l&m o$&n e#s'$$&ni&l. 4+ Ob#tr("#. B.l.ar.# 1. Deinisi Obs'$u#si bili&$is &+&l&h su&'u #el&in&n #oneni'&l be$u*& &+&n&
*enumb&'&n s&lu$&n em*e+u sehin& em*e+u 'i+ +&*&' men&li$ #e +&l&m usus un'u# +i#elu&$#&n +&l&m eses seb&&i s'e$#obilin. 2. )'ioloi Obs'$u#si bili&$is 'e$&+i #&$en& s&lu$&n em*e+u belum 'e$ben'u# +en&n sem*u$n& sehin& 'e$sumb&' *&+& s&&' &mnion 'e$'el&n m&su#. 3. B&mb&$&n ,linis
Be&l& mul&i 'e$lih&' *&+& hi$ minu *e$'&m&( &i'u b&i '&m* i#'e$us. eses be$-&$n& *u'ih #e&bu&bu&n( 'e$lih&' se*e$'i +em*ul( +&n -&$n& u$ine men&+i lebih 'u& #&$en& men&n+un u$obilin. 4. Pen&'&ls&n&&n &. e$i *e$&-&'&n l&n& b&i no$m&l &n l&in( mis&ln& *embe$i&n nu'$isi &n &+e#u&'( *en8e&h&n ine#si( +&n *en8e&h&n hi*o'e$mi&. b. e$i#&n #onselin *&+& o$&n'u& &&$ me$e#& mene$'i #e&+&&n b&i me$e#& +&n mene'&hui 'in+&n &*& &n *e$lu +ilu#&n. D&*&'#&n ino$me+ 8onsen' un'u# melu#&n $uu#&n #e *us&' *el&&n&n &n lebih mem&+&i &'&u un'u# melu#&n 'in+&n o*e$&si S&*u'$&(2014/ 5+ Atre#.a E#!2a(#+ 1. Deinisi A'$esi& )so&us &+&l&h #el&in&n #oneni'&l *&+& #on'iuni'&s
eso*h&us +en&n'&n*& hubun&n +en&n '$e& &'&u eso*h&us &n 'i+ 'e$ben'u# se8&$& sem*u$n&. A'$esi& eso*h&us se$in +ise$'&i +en&n #el&in&n b&-&&n l&in( se*e$'i #el&in&n &n'un( #el&in&n &s'$oin'es'in&l mis&ln& &'$esi& +uo+eni/( +&n #el&in&n 'ul&n S&*u'$&( D$. Ln+on. 2014/. 2. )'ioloi Umumn& *eneb&b &'$esi& eso*h&us 'i+ +i#e'&hui se8&$& *&s'i +&n #emun#in&n *eneb&bn& &+&l&h mul'i&8'o$. 'o$ #el&in&n ene'i8 se*e$'i sin+$om '$isom 21(13( +&n 1 #emun#in&n +&*&' menin#&'#&n #e&+i&n &'$esi& eso*h&us. 'o$ l&in 'e$&+i se8&$& s*o$&+i8 +&n $e#u$en *&+& s&u+&$& #&n+un 2 / S&*u'$&( D$. Ln+on. 2014/. 3. P&'oisioloi P&+& *emis&h&n &$in&n( 'e$&+i *emis&h&n &n'&$& '$e& +&n eso*h&us *&+& minu #e4 hin& minu #e6 #ehi+u*&n emb$ion&l S&*u'$&( D$. Ln+on. 2014/. 4. ,l&sii#&si &.
Semen eso*h&us *$o#sim&l be$hi$ *&+& #&n'un bun'u +&n semen +is'&l +i hubun#&n #e '$e& &'&u b$on#us *$ime$ +en&n is'ul& *en+e# *&+& &'&u +e#&' biu$#&si. +.
&nus.,on+isi ini me$u*&n #el&in&n m&lo$m&si #oneni'&l +im&n& 'e$&+i #e'i+len#&*&n *e$#emb&n&n emb$ioni# *&+& b&i&n &nus &'&u 'e$'u'u*n& &nus se8&$& &bno$m&l. Menu$u' Melbou$ne( &'$esi& &ni +ibe+&n men&+i 'i& enis( &i'u : &. A'$esi& &ni le' 'ini : $e8'um be$hi$ +i&'&s m. le=&'o$ &ni m. *ubo#o#sieus/( &$ &n&'&$& uun bun'u $e8'um +&n #uli' *e$ineum J 18m. b. A'$esi& &ni le' in'e$me+ie' : $e8'um be$hi$ +i m. le=&'o$ &ni( 'e'&*i 'i+ menembusn&. 8. A'$esi& &nus le' $en+&h *&+& &nus/ : $e8'um be$hi$ +ib&-&h m. le=&'o$ &ni( &$ &n'&$& #uli' +&n uun $e8'um *&lin &uh 1 8m S&*u'$&( D$. Ln+on. 2014/. 2. )'ioloi Peneb&b u'&m& &'$esi& &ni 'i+ +i#e'&hui se8&$& *&s'i.Se8&$& umum &'$esi& &ni +iseb&b#&n oleh mi$&si &n 'i+ sem*u$n& +&n *e$#emb&n&n s'$u#'u$ #olon &n 'i+ sem*u$n& &n 'e$&+i &n'&$& 710 minu sel&m& *e$#emb&n&n e'us S&*u'$&( D$. Ln+on. 2014/. 3. B&mb&$&n ,linis &. Sel&m& 244 &m se'el&h l&hi$( b&i men&l&mi mun'&hmun'&h +&n b. 8. +. e.
'i+ &+& +ee#&si me8onium. i#& &+& is'ul& $e#'o=es'ibul&$ +&n me8onium #elu&$ +&$i is'ul& 'e$sebu'(
be$&$'i 'e$&+i &'$esi& le' $en+&h S&*u'$&( D$. Ln+on. 2014/. 4. Pen&'&ls&n&&n a. e$i +u#un&n emosion&l +&n #ein&n *&+& ibu b. Pe$'olon&n *e$'&m& &+&l&h +en&n 'i+ membe$i#&n &*& *un mel&lui mulu'( menu'u* o$&n &n menonol +en&n #&ss& s'e$il &n +ib&s&hi s&line no$m&l( sehin& #&ss& 'e'&* b&s&h( mem&s'i#&n b&i 'e'&* h&n&'(
mem&s&n *i*& l&mbun un'u# membi&$#&n 8&i$&n l&mbun men&li$ beb&s. 8. B&n'i &su*&n m&n&n mel&lui mulu' +en&n *embe$i&n 8&i$&n in'$&=en& sesu&i +en&n #ebu'uh&n( mis&ln& lu#os& 56 &'&u !&bi#&$bon&'. +. Penob&'&n #&sus &'$esi& &ni &+&l&h +en&n *embe+&h&n un'u# membu&' lub&n &nus. Un'u# i'u( +&*&'#&n ino$me+ 8onsen' +&$i o$&n'u& un'u# me$uu# b&i #e *us&' *el&&n&n #eseh&'&n &n lebih mem&+&i. e. Pembe+&h&n *e$lu see$& +ilu#&n se'el&h 'ini &'$esi& +i'en'u#&n. P&+& &'$esi& &ni le' 'ini +&n in'e$me+ie'( +ilu#&n simoi+ #olos'omi( 612 minu #emu+i&n +ilu#&n 'in+&n +eini'i=e PSA"P/. P&+& &'$esi& &ni le' $en+&h( +ilu#&n 'es *$o=o#&si +en&n s'imul&'o$ o'o' un'u# meni+en'ii#&si b&'&s o'o' sin'e$ &ni se#i'&$ &nus +&n melu#&n *e$ine&l &no*l&s'i. P&+& &'$esi& &ni &n +ise$'&i is'ul&( +ilu#&n 8u' b&8# in8ision. P&+& s'enosis &ni +ilu#&n +il&'&si $u'in S&*u'$&( D$. Ln+on. 2014/. &&+ Hern.a D.a2ramat."a+ 1. Deinisi %e$ni& +i&$&m&'i#& &+&l&h m&su#n& o$&n &b+omen mel&lui +ee# lub&n/ *&+& +i&$&m& #e +&l&m $on& 'o$s.Lub&n ini h&n& +i'u'u* oleh l&*is&n *leu$& +&n *e$i'oniun. Se8&$& umum 'e$+&*&' 'i& 'i*e +&s&$ he$ni&
+i&$&m&'i#&(
&i'u
he$ni&
o8h+&le#
mel&lui
+ee#
*os'e$ol&'e$&l/( he$ni& mo$&ni mel&lui +ee# &n'e$io $e'os'e$n&l/ +&n hi&'us he$ni&( &i'u m&su#n& b&i&n &'&s l&mbun( &i'u #&$+i &s'e$ #e+&l&m $on& 'o$s mel&lui *eleb&$&n hi&'us eso*h&us. ,el&in&n &n *&lin se$in +i'emu#&n &+&l&h he$ni& o8h+&le# S&*u'$&( D$. Ln+on. 2014/. 2. )'ioloi Peneb&$&n *&s'i he$ni& +i&$&m&'i#& m&sih belum +i#e'&hui. %&l ini se$in +ihubun#&n +en&n *enun&&n 'h&li+omi+e( #uinin( ni'$oeni+e( &n'ie*ile*'i8( &'&u +eisiensi =i'&min A sel&m& #eh&mil&n.!eon&'us he$ni& ini +iseb&b#&n oleh &nu&n *emben'u#&n +i&$&m&. Di&$&m& 'e$ben'u# +&$i 'i& unsu$( &i'u memb$&ne *leu$o*e$i'onei( se*'um '$&ns=e$sum( +&n *e$'umbuh&n +&$i 'e*i &n be$&s&l +&$i o'o' +in+in +&+&.B&nu&n *emben'u#&n +i&$&m& +&*&' be$u*& #e&&l&n *emben'u#&n seb&i&n +i&$&m&( &nu&n usi #e'i& unsu$( +&n &nu&n *emben'u#&n o'o'. B&nu&n *emben'u#&n +&n usi 'e$sebu' &n meneb&b#&n 'e$ben'u#n& lub&n he$ni&( se+&n#&n &nu&n
*emben'u#&n o'o' &n meneb&b#&n +i&$&m& 'i*is +&n menimbul#&n e=en'&$&si S&*u'$&( D$. Ln+on. 2014/. 3. B&mb&$&n ,linis e$&' $in&nn& e&l& he$ni& +i&$&m&'i#& 'e$&n'u# *&+& b&nn& o$&n +ib&i&n &b+omen &n m&su# #e$on& 'o$s. P&+& #&sus he$ni& +i&$&m&'i#& be$&'( 'e$+&*&' &mb&$&n #linis seb&&i be$i#u' : &/ B&nu&n *e$n&*&s&n *&+& h&$ih&$i *e$'&m&. b/ Ses n&&s( 'e$u'&m& *&+& s&&' 'i+u$ 'e$len'&n. 8/ "e'$si sel& i& +&n subs'e$n&l. +/ Pe$u' #em*is +&n menunu##&n &mb&$&n s#&oi+ 8e#un/. e/ uni &n'un 'e$+en&$ +i +&e$&h &n be$l&-&n&n #&$en& 'e$+o$on oleh isi *e$u'. / i#& b&i mun'&h( 'e#&n b&i &&$ 'i+ 'e$&+i &s*i$&si. 5. &i 'i+ +ibe$i minum( h&n& +ibe$i#&n inus. 6. e$i#&n &n'ibio'i8 *$oilsis. 7. D&*&'#&n ino$me+ 8onsen' +&$i o$&n'u& un'u# me$uu# b&i #e *us&' *el&&n&n #eseh&'&n &n lebih mem&+&i. . O$&n *e$u' h&$us +i#emb&li#&n #e $on& &b+omen +&n lub&n *&+& +i&$&m& +i*e$b&i#i. %&l ini +ilu#&n +en&n 8&$& o*e$&si. S&*u'$&( D$. Ln+on. 2014/. 5. ,om*li#&si +&n P$onosis ,om*li#&si &n se$in 'e$&+i ib&' he$ni& +i&$&m&'i#& &+&l&h #om*li#&si #&$+ioloi ib&' h*o*l&si& *&$u.P$onosis 'e$&n'un *&+& #ebe$h&sil&n 'in+&n *embe+&h&n +&n &'&u 'i+ &+&n& #om*li#&si S&*u'$&( D$. Ln+on. 2014/. K!n#ep Keperawatan
Pen#&i&n ,e*e$&-&'&n a.
Lu#&n *en#&i&n isi# P&+& l&bio s#i;is: +is'o$si *&+& hi+un( '&m* seb&i&n &'&u #e+u&n&( &+&n& 8el&h *&+& bibi$.
b. P&+& *l&'os#i;is: '&m* &+& 8el& *&+& 'e# &'&u u=ul&( *&l&'o lun( +&n #e$&s +&n
&'&u o$&men in8isi=e( &+&n& $on& *&+& hi+un( +is'o$si hi+un( 'e$&b& &+&n& 8el&h &'&u 'e$bu#&n& l&ni'l&ni' s&&' +i*e$i#s& +en&n &$i( #esu#&$&n +&l&m menis&* &'&u m&n. 8. Ins*e#si *&l&'um( b&i# se8&$& =isus&l m&u*un +en&n menem*&'#&n &$i se8&$& l&nsun +i&'&s *&l&'um +. Obse$=&si *e$ilu m&n e. Obse$=&si in'e$si b&i#elu&$&. Di&nos& ,e*e$&-&'&n 1/ ,e'i+ee#'i&n *ol& m&n b&i b+ &bno$m&li'&s &n&'omi# ++ #e'i+m&m*u&n un'u# menoo$+in&si menis&*( menel&n( +&n be$n&*&s( #e'i+m&m*u&n un'u# memul&i menis&* &n ee#'i( #e'i+m&m*u&n un'u# mem*e$'&h&n#&n menis&* &n ee#'i 2/ ,e'i+seimb&n&n nu'$isi : #u$&n +&$i #ebu'uh&n 'ubuh b+ 'o$ biolois ++ #u$&n m&n&n( #e'i+m&m*u&n mem&n m&n&n. 3/ %&mb&'&n #omuni#&si =e$b&l b+ +ee# &n&'omis misl9 8el&h *&l&'um/ ++ #esuli'&n menun&n e#s*$esi -&&h +&n 'ubuh. 4/ B&nu&n 8i'$& 'ubuh b+ *eni' ++ *e$ub&h&n 'u&l *&+& unsi( *e$ub&h&n 'u&l *&+& s'$u#'u$. 5/ "isi#o &s*i$&si ++ &nu&n menel&n
Intervensi Keperawatan
DIAB!OSA 1. ,e'i+ee#'i&n
!OC Stat(# N(tr.#.
!IC Pember.an
*ol& m&n b&i Se'el&h +ilu#&n 'in+&n
B!t!l
b+ &bno$m&li'&s #e*e$&-&'&n sel&m& 3 K 24
1. Pe&n
&n&'omi#
++ &m(
+ih&$&*#&n
ne$i
,a"an
enan
b&i
sel&m&
menusui +en&n bo'ol
#e'i+m&m*u&n be$#u$&n ( +en&n #$i'e$i& un'u#
h&sil :
semi o-le$ *&+& s&&' b&i
menoo$+in&si
1. Asu*&n i;i
menis&*(
2. Asu*&n m&n&n
menel&n(
+&n
4. )ne$
#e'i+m&m*u&n
5. "&sio be$&' b&+&n
un'u#
6. %i+$&si
menis&*
menusu 3. Sen+&-&n b&i se$in se$in sel&m& +&n se'el&h
3. Asu*&n 8&i$&n
be$n&*&s(
memul&i
2. Posisi#&n b&i *&+& *osisi
menusu 4.
&n
u#u$&n
ee#'i(
#elembu'&n lub&n
u#u$&n bo'ol 6.
#e'i+m&m*u&n
'e$h&+&*
un'u#
+o'(
+&n
#e-&s*&+&&n b&i
+en&n
melon&$#&n *&i&n b&i(
mem*e$'&h&n#&n menis&*
+o'(
menoso# #i +&n '&n&n(
&n
&'&u bi8&$& *&+& b&i 7. Do$on un'u# menhis&*
ee#'i
+en&n mens'imul&si $ele# $oo'in( sesu&i #ebu'uh&n . Moni'o$ in'e 8&i$&n ?. Moni'o$ &'&u e=&lu&si $eleK menhis&* sel&m& menusu 10. Moni'o$ be$&' b&+&n b&i sesu&i #ebu'uh&n 2. ,e'i+seimb&n &n
Stat(# N(tr.#.
,ana)emen N(tr.#.
nu'$isi : Se'el&h +ilu#&n 'in+&n Moni'o$ #&lo$i +&n &su*&n m&n&n
#u$&n
+&$i #e*e$&-&'&n sel&m& 3 K 24
#ebu'uh&n 'ubuh &m( b+ biolois
+ih&$&*#&n
ne$i
'o$ be$#u$&n ( +en&n #$i'e$i& ++ h&sil :
1. Moni'o$ 'e$&+in&
#e8en+e$un&n *enu$un&n
+&n
#en&i#&n be$&' b&+&n 2. Ci*'&n lin#un&n &n
#e'i+m&m*u&n
7. Asu*&n i;i
o*'im&l
*&+&
s&&'
mem&n
. Asu*&n m&n&n
men#onsumsi m&n&n
m&n&n.
?. Asu*&n 8&i$&n
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Se'el&h +ilu#&n 'in+&n #e*e$&-&'&n sel&m& 3 K 24 &m(
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#onse*si +&n sel&m& +&l&m #&n+un&n. Di*e$#i$&n 10 20 +&$i #em&'i&n &nin +&l&m #&n+un&n +&n #em&'i&n neon&'&l +iseb&b#&n oleh #el&in&n #oneni'&l. ,hususn& *&+& b&i be$&' b&+&n +i*e$#i$&n #i$& #i$& 20 +i&n'&$&n& menin&l #&$en& #el&in&n #oneni'&l +&l&m minu *e$'&m& #ehi+u*&nn& Soi&( 2011 /. Peneb&b seben&$n& m&lo$m&si #oneni'&l 'i+ +i#e'&hui. Se8&$& umum *e$'umbuh&n emb$io +&n &nin +&l&m #&n+un&n +&*&' +i*en&$uhi oleh be$b&&i 'o$( &n'&$& l&in ene'i#( lin#un&n( &'&u #e+u&n& Soi&( 2011 /.
a.
b. 8. +.
Di b&-&h ini +i#emu#&n be$b&&i 'o$ : 'o$ ,$omosom 'o$ Me#&nis 'o$ Ine#si 'o$ Umu$
e. . . h. i. j.
'o$ ob&' 'o$ %o$mon&l 'o$ Pen&$uh "&+i&si 'o$ Bi;i 'o$ L&in l&in 'o$ &n 'i+ +i#e'&hui *eneb&bn&. L&bios#i;is &+&l&h su&'u #e'i+sem*u$n&&n *&+& *en&mbun&n bibi$ b&i&n &'&s( &n bi&s&n& be$lo#&si 'e*&' +i b&-&h hi+un Muslih&'un( 2010/. Cel&h bibi$ +&*&' 'e$&+i +en&n be$b&&i +e$&&' m&lo$m&si( +imul&i +&$i ''i# $in&n *&+& b&i&n 'e*i bibi$ +i #&n&n &'&u +i #i$i &$is 'en&h( s&m*&i 8el&h #om*le' &n melu&s hin& #e hi+un.
DA/TAR PUSTAKA
ule8he#(B. 2016. Nursing Interventions Classification, 6 th ed . )lse=ie$ :USA %e$+m&n( %. 2011. Diagnosa Keperawatan Definisi dan Klasifikasi 2012-201! >&$'& : )BC M&nu&b&( +##. 2007. "engantar Kuliah #$stetri! >&$'& : )BC M&$&n'i( D-i. 2011. %uku a&ar Neonatus dan $alita! >&$'& : C. <$&ns Inome+i& Moo$he&+( S. 2016. Nursing #utco'es Classifications (th ed! )lse=ie$ : USA Muslih&'un( E&'i !u$. 2010. )suhan Neonatus %a*i Dan %alita! Yo&$'& : i'$&m&& P$i8e Eilson. 2005. "atofisiologi. >&$'& : )BC S&*u'$&( D$. Ln+on. 2014. )suhan Neonatus, %a*i, dan %alita . <&ne$&n : in&$u*& A#s&$& Soi&n( D$. Am$u. 2011. +inopsis #$stetri! disi ! .ilid 1! >&$'& : )BC So+i#in. 2011. Keperawatan )nak! >&$'& : )BC
Eilli&n Eil#ins. 2011. Kapita +elekta "en*akit! disi 2. >&$&'& : )BC