Lp Chf Sulis Igd

STASE KEPERAWATAN GAWAT DARURAT LAPORAN PENDAHULUAN ASUHAN KEPERAWATAN PADA PASIEN DENGANCONGESTIF HEART FAILURE (CHF) DI INSTALASI GAWAT DARURAT (IGD) RSUD SLEMAN

Disusun Oleh : SULISTIARNI 3216099

PENDIDIKAN PROFESI NERS ANGKATAN XI SEKOLAH TINGGI ILMU KESEHATAN JENDERAL ACHMAD YANI YOGYAKARTA 2016

1

HALAMAN PENGESAHAN LAPORAN PENDAHULUAN ASUHAN KEPERAWATAN PADA PASIEN DENGANCONGESTIF HEART FAILURE (CHF) DI INSTALASI GAWAT DARURAT (IGD) RSUD SLEMAN

Disahan !a"a Ha#i$ #i$ %a %an&&al : Oleh

:

Pe'(i'(in& Aa"e'i 

Pe'(i'(in& .lini$/I

Mahasisa

Muha'a% N)*i+an%),-S,.e!,-Ns, M,.e!

Hen"#a A#i i(aa, AM. 

Sulis%ia#ni

2

CHF (CONGESTIVE HEART FAILURE)/GAGAL JANTUNG KONGESTIF A KONSEP DASAR CHF (CONGESTIVE HEART FAILURE) 1 D!"#$#%# /)n&es%ie Hea#% ailu#e 4/H5 a"alah sua%u )n"isi "i'ana

 an%un& 'en&ala'i e&a&alan "ala' 'e')'!a "a#ah &una 'en7uu!i e(u%uhan sel8sel %u(uh aan nu%#ien "an )si&en se7a#a a"eua%, Hal ini 'en&ai(a%an !e#e&an&an #uan& an%un& 4"ila%asi5 &una 'ena'!un& "a#ah le(ih (an+a un%u

"i!)'!aan

e

selu#uh %u(uh a%au

'en&ai(a%an )%)% an%un& au "an 'ene(al, an%un& han+a 'a'!u 'e')'!a "a#ah un%u a%u +an& sin&a% "an "in"in& )%)% an%un& +an& 'ele'ah %i"a 'a'!u 'e')'!a "en&an ua%, Se(a&ai ai(a%n+a- &inal se#in& 'e#es!)ns "en&an 'enahan ai# "an &a#a', Hal ini aan 'en&ai(a%an (en"un&an 7ai#an "ala' (e(e#a!a )#&an %u(uh se!e#%i %an&an- ai- !a#u- a%au )#&an lainn+a sehin&&a %u(uh lien 'ena"i  (en&a 4congestive5 4U"ian%i- 20105, Ga&al an%un& )n&es%i* 4/H5

a"alah

sua%u

ea"aan

 !a%)*isi)l)&is (e#u!a elainan *un&si an%un& sehin&&a an%un& %i"a  'a'!u 'e')'!a "a#ah un%u 'e'enuhi e(u%uhan 'e%a()lis'e  a#in&an "an e'a'!uann+a han+a a"a alau "ise#%ai !enin&&ian )lu'e "ias%)li se7a#a a(n)#'al 4Mans)e#- 2005, 2 K&'%#"#'%#  Ne ;)# Hea#% Ass)7ia%i)n 4N;HA5 'e'(ua% lasi*iasi

*un&si)nal "ala' < elas :4Mans)e# "an T#i+an%i- 2005, .elas 1 : =ila !asien "a!a% 'elauan a%i*i%as (e#a% %a'!a eluhan, .elas 2 :=ila !asien %i"a "a!a% 'elauan a%i*i%as le(ih (e#a% "a#i a%ii%as seha#i8ha#i %an!a eluhan, .elas 3 : =ila !asien %i"a "a!a% 'elauan a%i*i%as seha#i8ha#i %an!a eluhan, .elas < : =ila !asien sa'a seali %i"a "a!a% 'elauan a%i*i%as a!a!un "an ha#us %i#ah (a#in&,  E*#+&+,#

3

Menu#u%U"ian%i 420105 e%i)l)&i &a&al an%un& )n&es%i* 4/H5 "iel)'!)an (e#"asa#an *a%)# e%i)l&i es%e#na 'au!un in%e#na- +ai%u: a, a%)# eksterna 4"a#i lua# an%un&5> hi!e#%ensi #enal- hi!e#%i#)i"- "an ane'ia #)nis$(e#a%,  (, a%)# interna 4"a#i "ala' an%un&5 15 Dis*un&si a%u!: ?en%#i7ula# Se!%u' De*e7% 4?SD5- A%#ia Se!%u' De*e7% 4ASD5- s%en)sis 'i%#al- "an insu*isiensi 'i%#al, 25 Dis#i%'ia: a%#ial *i(#ilasi- en%#iel *i(#ilasi- "an hea#% (l)7, 35 .e#usaan 'i)a#": a#"i)'i)!a%i- 'i)a#"i%is "an in*a#  'i)a#", <5 In*esi: en")a#"i%is (a7%e#ial su(8au% - P'*+"#%#+&+,# Meanis'e +an& 'en"asa#i &a&al an%un& 'eli!u%i &an&&uan

e'a'!uan )n%#a%ili%as an%un& +an& 'en+e(a(an 7u#ah an%un& le(ih #en"ah "a#i n)#'al, Da!a% "ielasan "en&an !e#sa'aan /O @ HR   S? "i 'ana 7u#ah an%un& 4/O: Cardiac output 5 a"alah *un&si *#euensi an%un& 4HR:  Heart Rate5  ?)lu'e Seun7u! 4S?: Stroke Volume5, #euensi an%un& a"alah *un&si "a#i sis%e' sa#a* )%)n)', =ila 7u#ah an%un& (e#u#an&- sis%e' sa#a* si'!a%is aan 'e'!e#7e!a% *#euensi an%un& un%u 'e'!e#%ahanan 7u#ah an%un&, =ila 'eanis'e )'!ensasi ini &a&al un%u 'e'!e#%ahanan !e#*usi a#in&an +an& 'e'a"ai- 'aa )lu'e seun7u! an%un&lah +an& ha#us 'en+esuaian "i#i un%u 'e'!e#%ahanan 7u#ah an%un&, ?)lu'e seun7u! a"alah u'lah "a#ah +an& "i!)'!a !a"a se%ia! )n%#asi- +an& %e#&an%un& !a"a 3 *a%)#- +ai%u: 415  Preload   4+ai%u sin)ni' "en&an Huu' S%a#lin& !a"a an%un& +an& 'en+a%aan (aha  u'lah "a#ah +an& 'en&isi an%un& (e#(an"in& lan&sun& "en&an %eanan +an& "i%i'(ulan )leh !anan&n+a #e&an&an se#a(u% an%un&5> 425 .)n%#a%ili%as 4'en&a7u !a"a !e#u(ahan eua%an )n%#asi +an& %e#a"i  !a"a %in&a% sel "an (e#hu(un&an "en&an !e#u(ahan !anan& se#a(u%  an%un& "an a"a# alsiu'5> 435 A*%e#l)a" 4'en&a7u !a"a (esa#n+a %eanan en%#iel +an& ha#us "ihasilan un%u 'e')'!a "a#ah 'elaan  !e#(e"aan %eanan +an& "i%i'(ulan )leh %eanan a#%e#i)le5,

4

ia %e#a"i &a&al an%un&- %u(uh 'en&ala'i (e(e#a!a a"a!%asi +an& %e#a"i (ai !a"a an%un& "an se7a#a sis%e'i, ia )lu'e seun7u! e"ua en%#iel (e#u#an& ai(a% !eneanan )n%#a%ili%as a%au a*%e#l)a" +an& san&a% 'enin&a%- 'aa )lu'e "an %eanan !a"a ahi# "ias%)li "i "ala' e"ua #uan& an%un& aan 'enin&a%, Hal ini aan 'enin&a%an  !anan& se#a(u% 'i)a#"iu' !a"a ahi# "ias%)li "an 'en+e(a(an a%u sis%)li 'ena"i sin&a%, ia )n"isi ini (e#lan&sun& la'a- 'aa aan %e#a"i "ila%asi en%#iel, /a#"ia7 )u%!u% !a"a saa% is%i#aha% 'asih  (isa (e#*un&si "en&an (ai %a!i !enin&a%an %eanan "ias%)li +an&  (e#lan&sun& la'a 4#)ni5 aan "iala#an e e"ua a%#iu'- si#ulasi  !ul')ne# "an si#ulasi si%e'i, Ahi#n+a %eanan a!ile# aan 'enin&a% +an& aan 'en+e(a(an %#ansu"asi 7ai#an "an %i'(ul e"e'a  !a#u a%au e"e'a sis%e'i, Penu#unan cardiac output - %e#u%a'a ia (e#ai%an "en&an  !enu#unan %eanan a#%e#ial

a%au !enu#unan !e#*usi &inal- aan

'en&a%iasi (e(e#a!a sis%e' sa#a* "an hu')#al, Penin&a%an a%ii%as sis%e' sa#a* si'!a%is aan 'e'a7u )n%#asi 'i)a#"iu'- *#euensi "en+u% an%un& "an ena> +an& aan 'enin&a%an )lu'e "a#ah sen%#al +an& selanu%n+a 'enin&a%an  preload , Mesi!un a"a!%asi8a"a!%asi ini "i#an7an& un%u 'enin&a%an cardiac output - a"a!%asi i%u sen"i#i "a!a% 'en&&an&&u %u(uh, Oleh a#ena i%u- %aia#"i "an !enin&a%an )n%#a%ili%as 'i)a#"iu' "a!a% 'e'a7u %e#a"in+a ise'ia !a"a !asien "en&an !en+ai% a#%e#i )#)ne# se(elu'n+a "an !enin&a%an  preload  "a!a% 'e'!e#(u#u )n&es%i !ul')ne#, A%iasi si%e' sa#a* si'!a%is u&a aan 'enin&a%an #esis%ensi  !e#i*e#, A"a!%asi ini "i#an7an& un%u 'e'!e#%ahanan !e#*usi e )#&an8 )#&an i%al- %e%a!i ia a%iasi ini san&a% 'enin&a% 'alah aan 'enu#unan ali#an e &inal "an a#in&an, Salah sa%u e*e !en%in&  !enu#unan cardiac output  a"alah !enu#unan ali#an "a#ah &inal "an  !enu#unan e7e!a%an *il%#asi &l)'e#)lus- +an& aan 'eni'(ulan #e%ensi s)"iu' "an 7ai#an, Si%e' #ennin8an&i)%ensin8al")s%e#)n u&a aan %e#a%iasi-

'eni'(ulan

!enin&a%an

5

#esis%ensi

asule#

!e#i*e# 

selanu%n+a "an !eni&a%an afterload   en%#iel i#i se(a&ai'ana #e%ensi s)"iu' "an 7ai#an, Ga&al an%un& (e#hu(un&an "en&an !enin&a%an a"a# a#&inin as)!#esin "ala' si#ulasi- +an& u&a (e#si*a% as))n%#i%)# "an  !en&ha'(a% es#esi 7ai#an, Pa"a &a&al an%un& %e#a"i !enin&a%an  !e!%i"a na%#iu#e%i a%#ial ai(a% !enin&a%an %eanan a%#iu'- +an& 'enunuan (aha "isini %e#a"i #esis%ensi %e#ha"a! e*e na%#iu#e%i "an as)"ila%)#, . P'*'% Te#la'!i#  6 M'$#"!%*'%# K&#$#  a, Penin&a%an )lu'e in%#aasula#,  (, .)n&es%i a#in&an ai(a% %eanan a#%e#i "an ena +an& 'enin&a%

ai(a% %u#unn+a 7u#ah an%un&, 7, E"e'a !ul')nal ai(a% !enin&a%an %eanan ena !ul')nalis +an& 'en+e(a(an 7ai#an 'en&ali# "a#i a!ile# !a#u e ale)li> "i'ani*es%asian "en&an (a%u "an na*as !en"e, ", E"e'a !e#i*e# u'u' "an !ena'(ahan (e#a% (a"an

ai(a%

 !enin&a%an %eanan ena sis%e'i, e, Pusin&- ea7auan 'en%al 47)n*usi)n5- ele%ihan- in%)le#ansi an%un& %e#ha"a! la%ihan "an suhu !anas- es%#e'i%as "in&in- "an )li&u#ia ai(a% !e#*usi "a#ah "a#i an%un& e a#in&an "an )#&an +an& #en"ah, *, Se#esi al")s%e#)n- #e%ensi na%#iu' "an 7ai#an- se#%a !enin&a%an )lu'e in%#aasule# ai(a% %eanan !e#*usi &inal +an& 'enu#un 4!ele!asan #enin &inal5, Su'(e#: Mans)e#-42005,  P!3!4#%''$ D#',$+%*# CHF a, Hi%un& sel "a#ah len&a!: ane'ia (e#a% a%au ane'ia &#ais a%au

 !)lisi%e'ia e#a  (, Hi%un& sel "a#ah !u%ih: Le)si%)sis a%au ea"aan in*esi lain 7, Analisa &as "a#ah 4AGD5: 'enilai "e#aa% &an&&uan esei'(an&an asa' (asa (ai 'e%a()li 'au!un #es!i#a%)#i, ", #asi le'a: !enin&a%an a"a# )les%e#)l- %#i&lise#i"a- LDL +an& 'e#u!aan #esi) /AD "an !enu#unan !e#*usi a#in&an

6

e, Se#u' a%e)la'in: Pe'e#isaan un%u 'en&esa'!in&an !en+ai% a"#enal *, Se"i'en%asi 'enin&a% ai(a% a"an+a in*la'asi au%, &, Tes *un&si &inal "an ha%i: 'enilai e*e +an& %e#a"i ai(a% /H %e#ha"a! *un&si he!a# a%au &inal h, Ti#)i": 'enilai !enin&a%an a%ii%as %i#)i" i, E7h)7a#"i)&#a': 'enilai sen)sis$in)'!e%ensi- !e'(esa#an #uan&  an%un&- hi!e#%#)!i en%#iel  , /a#"ia7 s7an: 'enilai un"e#!e#*usi)n )%)% an%un&- +an& 'enunan&  !enu#unan e'a'!uan )n%#asi, , R)n%&en %)#as: un%u 'enilai !e'(esa#an an%un& "an e"e'a !a#u, l, .a%e%e#isasi an%un&: Menilai *#asi eesi en%#iel, ', E.G: 'enilai hi!e#%#)!i a%#iu'$en%#iel- ise'ia- in*a#- "an "is#i%'ia Su'(e#: U"ian%i 420105 5 P!$'*'&'%'$''$ Tuuan "asa# !ena%alasanaan !asien "en&an &a&al  an%un& a"alah: a, Menin&a%an )si&enasi "en&an %e#a!i O2 "an 'enu#unan

)nsu'si )si&en "en&an !e'(a%asan a%ii%as,  (, Menin&a%an )n%#asi 4)n%#a%ili%as5 )%)%

an%un&

"en&an

"i&i%alisasi, 7, Menu#unan (e(an an%un& "en&an "ie% #en"ah &a#a'- "iu#e%i- "an as)"ila%)#, Pena%alasanaan Me"is 15 Menin&a%an )si&enasi "en&an !e'(e#ian )si&en "an 'enu#unan )nsu'si O 2 'elalui is%i#aha%$ !e'(a%asan a%i*i%as 25 Me'!e#(aii )n%#a%ili%as )%)% an%un& a5 Men&a%asi ea"aan +an& #ee#si(le- %e#'asu %i#)%)si)sis'ise"e'a- "an a#i%'ia,  (5 Di&i%alisasi 415 D)sis "i&i%alis 4a5 Di&)sin )#al un%u "i&i%alisasi 7e!a% 0-B '& "ala' <86 ")sis sela'a 2< a' "an "ilanu%an 20-B '& sela'a 28< ha#i, 4(5 Di&)sin I? 0-B 8 1 '& "ala' < ")sis sela'a 2<  a', 475 /e"ilani" I? 1-281-6 '& "ala' 2< a',

7

425 D)sis !enunan& un%u &a&al an%un&: "i&)sin 0-2B '& seha#i, un%u !asien usia lanu% "an &a&al &inal ")sis "isesuaian, 435 D)sis !enunan& "i&)sin un%u *i(#ilasi a%#iu' 0-2B '&, 4<5 Di&i%alisasi 7e!a% "i(e#ian un%u 'en&a%asi e"e'a  !ul')nal au% +an& (e#a%: 4a5 Di&)sin: 181-B '& I? !e#lahan8lahan, 4(5 /e"ila'i" 0-<80-C I? !e#lahan8lahan, Su'(e#: Mans)e# 42005 a, Te#a!i Lain 15 .)#esi !en+e(a(8!en+e(a( u%a'a +an& "a!a% "i!e#(aii an%a#a lain: lesi a%u! an%un&- ise'ia 'i)a#"- a#i%'ia- "e!#esi 'i)a#"iu' "iin"usi al)h)l- !i#au in%#a#"ial- "an ea"aan 25 35 <5 B5

output  %in&&i, E"uasi %en%an& hu(un&an eluhan- &eala "en&an !en&)(a%an, P)sisi se%en&ah "u"u, Osi&enasi 4283 li%e#$'eni%5, Die%: !e'(a%asan na%#iu' 42 &# na%#iu' a%au B &# &a#a'5 "i%uuan un%u 'en7e&ah- 'en&a%u#- "an 'en&u#an&i e"e'ase!e#%i !a"a hi!e#%ensi "an &a&al an%un&, Ren"ah &a#a' 2 &#  "isa#anan !a"a &a&al an%un& #in&an "an 1 &# !a"a &a&al  an%un& (e#a%, u'lah 7ai#an 1 li%e# !a"a &a&al an%un& (e#a% "an

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DAFTAR PUSTAKA

A#"ini- D,N, 42005, Pe#(e"aaan E%i)l)&i Ga&al an%un& .)n&es%i* !a"a Usia Lanu% "en&an Usia Deasa Di Ru'ah Sai% D#, .a#ia"i anua#i8 Dese'(e# 2006, Se'a#an&: UNDIP Mans)e#- A- ", 42005,  Kapita Selekta Kedokteran, Jilid 1 edisi 3, aa#%a: Me"ia Aes7ula!ius San%)sa- =, 42005, Panduan Diagnosa Keperaatan !"!D" #$$%&#$$' , aa#%a: P#i'a Me"ia U"ian%i- , , 420105, Keperaatan Kardiovaskuler , aa#%a: Sale'(a 'e"ia, He#"'an- T- 4201B5, NANDA Diagnosis Keperaatan( definisi ) Klasifikasi, E" 10 201B8201, Pene#(i% (uu e")%e#an EG/ : aa#%a D)7h%e#- =ule7he, 4201B5  !ursing *nvention Classifications +!*C- E"i%i)n BUni%e" S%a%es O* A'e#i7a: M)s(+ Elseei# A7a"e'i7 P#ess- 200<, Maas- M)#hea"- h)ns)n "an Sans)n, !ursing -ut Comes +!-C, Uni%e" S%a%es O* A'e#i7a: M)s(+ Elseei# A7a"e'i7 P#ess- 200<,

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