LAPORAN PENDAHULUAN ASUHAN ASUH AN KEPERAW KEPE RAWA ATAN PADA KLIEN KLIE N DENGAN DENG AN GANGGUAN SISTEM MUSKULOSKELETAL (FRAKTUR)
OLEH : NAMA
: NI KADEK ITA ITA RAT RATNA DEWI DEWI
NIM
: P07120214081 P07120214081
KELA KELAS S
: II. II.3 3 D III III KEP KEPER ERA AWATAN
KEMENTERIAN KESEHATAN REPUBLIK INDONESIA POLITEKNIK POLITEKNI K KESEHAT KE SEHATAN AN DENPASAR JURUSAN KEPERAWATAN 2016 I. Kons Kons! ! D"s" D"s"## Pn$ Pn$"% "%&' &' A. Pn Pn# #'& '&"n "n
Frak Fraktu turr aa! aa!a" a" #$t%a #$t%a& & r$ta r$tak k atau atau &ata &ata" " &aa &aa tu!a tu!a'( '( )a'( a'( utu" utu".. K$*a')aka' +raktur %#$*a*ka' ,!$" trau-a %-a'a t$ra&at t$ka'a' )a'( *$r!$*%"a' &aa tu!a'( *a%k *$ru&a trau-a !a'(#u'( a' trau-a t%ak !a'(#u'( /Sa-#u"%aat ,'( 200. Fraktur Fraktur atau &ata" tu!a'( tu!a'( aa!a" t$r&utu#')a t$r&utu#')a k,'t%'u%t k,'t%'u%ta# a# ar%'(a' ar%'(a' tu!a'( tu!a'( atau atau tu!a'( tu!a'( ra5a' ra5a' )a'( )a'( u-u-' u-u-')a )a %#$*a %#$*a*ka *ka' ' ,!$" ,!$" rua&a rua&ak#a k#a /Ma'#,$r 2007. Fraktur aa!a" &ata" tu!a'( *%a#a')a %#$*a*ka' ,!$" trau-a atau t$'a(a +%#%k /Pr%6$ a' W%!#,' 200. Fraktur Fraktur atau &ata" tu!a'( tu!a'( aa!a" t$r&utu#')a t$r&utu#')a k,'t%'u%t k,'t%'u%ta# a# ar%'(a' ar%'(a' tu!a'(
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rua&ak#a.Fraktur a&at %*a(% -$'a% : 1.Fraktur 1.Fraktur k,-&!% k,-&!%tt aa!a" aa!a" &ata" &ata" &aa &aa #$!uru" #$!uru" (ar%# (ar%# t$'(a" t$'(a" tu!a'( tu!a'( a' *%a#a')a -$(a!a-% &$r($#$ra' /*$r($#$r ar% &,#%#% ',r-a!. 2.Frakt 2. Fraktur ur t%ak k,-&!%t k,-&!%t /%'k,-&!%t /%'k,-&!%t aa!a" &ata" )a'( "a')a t$ra% &aa #$*a(%a' ar% (ar%# t$'(a" tu!a'(. 3.Frakt 3. Fraktur ur t$rtutu& t$rtutu& /6!,#$ /6!,#$ aa!a" "%!a'(')a "%!a'(')a atau t$r&utu#')a t$r&utu#')a k,'t%'u%t k,'t%'u%ta# a# ar%'(a' tu!a'( %-a'a t%ak t$ra&at "u*u'(a' a'tara +ra(-$' tu!a'( $'(a' $'(a' u'%a u'%a !uar !uar atau *%!a *%!a ar%'(a ar%'(a' ' ku!%t ku!%t )a'( )a'( *$raa *$raa %ata#' %ata#')a )a #$k%tar &ata" tu!a'( -a#%" utu". 4.Frakt 4. Fraktur ur t$r*uka t$r*uka /,&$'6,-& /,&$'6,-&,u' ,u' aa!a" "%!a'(')a "%!a'(')a atau t$r&utu#') t$r&utu#')aa ar%'(a' tu!a'( %-a'a +ra(-$'9+ra(-$' tu!a'( &$r'a" atau #$a'( *$r"u*u'(a' $'(a' u'%a !uar.Fraktur !uar.Fraktur t$r*uka a&at %*a(% ata# t%(a $raat )a%tu : ". D#""' I
1 Luka 1 662 K$ru#aka' K$ru#aka' ar%'(a' ar%'(a' !u'ak #$%k%t #$%k%t tak aa ta'a ta'a !uka !uka r$-uk r$-uk 3 Fraktur Fraktur #$$r"a'a #$$r"a'a tra'#;$r# tra'#;$r#a! a! ,*!%k ,*!%k atau atau k,'t%'u% k,'t%'u%t%+ t%+ r%'(a' r%'(a' 4 K,'t K,'taa-%' %'a#% a#% -%'% -%'%-a -a!!
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1 La#$r a#$ra# a#%% < 1 662 K$ru#aka' K$ru#aka' ar%'(a' ar%'(a' !u'ak !u'ak t%ak !ua# +!a&a;u!#$ +!a&a;u!#$ 3 Fraktu Frakturr k,'t%' k,'t%'u%t u%t%+ %+ #$a'( #$a'(
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1 T$ra $ra%% k$ru#a k$ru#aka' ka' ar%'(a' ar%'(a' !u'ak !u'ak )a'( )a'( !ua# !ua# -$!%&u -$!%&ut% t% #truktur #truktur ku!%t ku!%t ,t,t a' '$ur,;a#6u! '$ur,;a#6u!ar ar #$rta k,'ta-%'a#% k,'ta-%'a#% $raat t%'((%. Fraktur $raat III t$r*a(% ata# : a) b)
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&$r*a%ka' a(ar *a(%a' %#ta! a&at %&$rt"a'ka' t$ra% k$ru#aka' ar%'(a' !u'ak "$*at. B. E'&o,o& Frak Fraktu turr %#$* %#$*a* a*ka ka' ' ,!$" ,!$" trautrau-aa % -a'a -a'a t$r t$ra& a&at at t$ka' t$ka'a' a' )a'( )a'(
*$r!$*%"a' &aa tu!a'( )a'( *%a#a')a % ak%*atka' #$6ara !a'(#u'( a' t%ak !a'(#u'( a' #$r%'( *$r"u*u'(a' $'(a' ,!a"ra(a &$k$raa' atau !uka )a'( % #$*a*ka' ,!$" k$'araa' *$r-,t,r. P$') P$')$* $*a* a* &ata &ata" " tu!a' tu!a'( ( &a!% &a!%'( '( #$r%' #$r%'( ( % #$*a #$*a*k *ka' a' ,!$" ,!$" trautrau-aa t$ruta-a &aa a'ak9a'ak a&a*%!a tu!a'( -$!$-a" atau t$ka'a' r%'(a'. M$'urut /D,$'($# 2000 aa&u' &$')$*a* +raktur a'tara !a%' : 1. Trau Trau-a -a La'( La'(#u #u'( '( )a%t )a%tu u +rakt +raktur ur t$ra t$ra%% % t$-&a t$-&att %-a %-a'a 'a *a(% *a(%a' a' t$r#$*ut -$'a&at rua &ak#a -%#a!')a *$'tura' atau &uku!a' &aa a't$r*ra6"% )a'( -$'(ak%*atka' +raktur. 2. Traurau-aa Tak La'(# La'(#u' u'( ( - )a%tu #uatu trau-a trau-a )a'( -$')$*a*ka' -$')$*a*ka' &ata" tu!a'( %t$-&at )a'( au" ar% t$-&at k$a%a' k$k$ra#a'. 3. Frak Fraktu turr Pat, Pat,!, !,(% (%k k Stuktur )a'( t$ra% &aa tu!a'( )a'(
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/k,'($'%ta!&$raa'(a' '$u&!a#t%k a' -$ta*,!%k M$'urut >ar&$'%t, /2000 aa&u' &$')$*a* +raktur a'tara !a%' : 1. K$k$ K$k$ra ra#a #a' ' !a'( !a'(#u #u'( '( K$k$ra#a' !a'(#u'( -$')$*a*ka' &ata" tu!a'( &aa t%t%k t$ra%')a k$k$ra#a'. Fraktur $-%k%a' $-%k%a' #$r%'( *$r#%+at +raktur t$r*uka $'(a' (ar%# &ata" -$!%'ta'( atau -%r%'(. 2. K$k$ K$k$ra ra#a' #a' t%ak t%ak !a' !a'(# (#u' u'( (
K$k$ra#a' t%ak !a'(#u'( -$')$*a*ka' &ata" tu!a'( %t$-&at )a'( au" ar% t$-&at t$ra%')a k$k$ra#a'. ?a'( &ata" *%a#a')a aa!a" *a(%a' )a'( &a!%'( !$-a" a!a- a!ur "a'tara' ;$kt,r k$k$ra#a'. 3. K$k$ K$k$ra ra#a' #a' ak% ak%*a *att tar%k tar%ka' a' ,t,t ,t,t Pata" tu!a'( ak%*at tar%ka' ,t,t #a'(at ara'( t$ra%. K$kuata' a&at *$ru&a &$-u't%ra' &$'$kuka' &$'$kuka' a' &$'$ka'a' k,-*%'a#% ar% k$t%(a')a a' &$'ar%ka'. Et%,!,(% ar% +raktur -$'urut Pr%6$ a' W%!#,' /200 aa 3 )a%tu : 1. >%$ra atau *$'tura' 2. Fraktur &at,!,(%k Frak Fraktu turr &at, &at,!, !,(% (%k k t$ra t$ra% % &aa &aa a$r a$ra" a"9 9a$r a$ra" a" tu!a tu!a'( '( )a'( )a'( t$!a" t$!a" -$'a% !$-a" ,!$" kar$'a tu-,r ka'k$r a' ,#t$,&,r,#%#. 3. Fraktur *$*a' Fraktur *$*a' atau +raktur k$!$!a"a' t$ra% &aa ,ra'(9 ,ra'( )a'( *aru #aa -$'a-*a" t%'(kat akt%;%ta# -$r$ka #$&$rt% *aru % t$r%-a a!a- a'(kata' *$r#$'ata atau ,ra'(9 ,ra'( )a'( *aru -u!a% !at%"a' !ar%. . M"n&/ M"n&/s' s'"s& "s& K,&n&s K,&n&s Ma'%+$#ta#% k!%'%k ar% +aktur -$'urut /=ru''$r a' Suart" 2002 : 1. N)$r N)$r%% t$ru t$ru#9 #9-$'$r $'$ru# u# a' *$rt *$rtaa-*a *a" " *$ra *$rat' t') )a #a#a-&a% &a% tu!a tu!a'( '(
%%-,*%!%#a#%. S&a#-$ ,t,t )a'( -$')$rta% +raktur -$ru&aka' *$'tuk *%a% a!-%a" )a'( % ra'6a'( utuk -$-%'%-a!ka' ($raka' a'tar 2.
+r$(-$' tu!a'(. S$t$ S$t$!a" !a" t$ra t$ra%% +rak +raktu tur r *a(%a' *a(%a'9* 9*a( a(%a %a' ' t%a t%ak k a&a a&att % (u'ak (u'aka' a' a' 6$'$ru'( *$r($rak #$6ara a!a-%a" /($rak !uar *%a#a *uka')a t$ta& r%(% r%(% #$&$rt% #$&$rt% ',r-a! ',r-a!') ')a. a. P$r($# P$r($#$ra' $ra' +ra(-$ +ra(-$' ' tu!a'( tu!a'( &aa &aa +raktur +raktur !$'(a !$'(a' ' a' a' tu'( tu'(ka ka%% -$') -$')$* $*a* a*ka ka' ' $+, $+,rr-%t %ta# a# /t$r! /t$r!%" %"at at -au& -au&u' u' t$ra*a $k#t$r-%ta# )a'( *%#a %k$ta"u% -$-*a'%'(ka' $k#t$r-%ta# )a'( ',r-a! $'(a' $k#t$r-%ta# )a'( t%ak a&at *$r+u'(#% *$r+u'(#% $'(a' $'(a' *a%k kar$'a +u'(#% ',r-a! ,t,t *$r(a'tu'( &aa %'t$(r%ta# tu!a'(
3.
t$-&at -$!$kat')a ,t,t. Paa Paa +raktu +rakturr &a' &a'a' a'( ( t$ra t$ra% % &$-$' &$-$'$k $ka' a' tu!a tu!a'( '( )a'( )a'( #$*$' #$*$'ar' ar') )a kar$' kar$'aa k,'t k,'tra rak# k#%% ,t,t ,t,t )a'( -$!$k -$!$kat at %ata %ata## a' a' %*a %*a5a 5a" " t$-&a t$-&att +raktur. Fra(-$' #$r%'( #a!%'( -$!%'(ku&% #atu #a-a!a%' #a-&a% 29 6- /192 %'6"%.
4.
Saat Saat $k#t$r$k#t$r-%ta %ta## %&$r%k %&$r%k#a #a $'(a' $'(a' ta'( ta'(a' a' t$ra*a t$ra*a aa') aa')aa $r%k tu!a tu!a'( '( %'a-aka' kr$&%tu# )a'( t$ra*a ak%*at ($#$ka' a'tara +ra(-$' #atu $'(a' !a%'')a /u% kr$&%tu# a&at -$'(a%*atka' k$ru#aka' ar%'(a'
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!u'ak )a'( !$*%" *$rat. P$-* P$-*$' $'(k (kak aka' a' a' &$ru &$ru*a *a"a "a' ' 5ar' 5ar'aa !,ka !,ka!! t$ra t$ra% % #$*a(a #$*a(a%% ak%* ak%*at at trau-a ar% &$'ara"a' )a'( -$'(%kut% +raktur. Ta'a %'% *aru *%#a t$ra% #$t$!a" *$*$ra&a a- atau "ar% #$t$!a" 6%$ra.
K,'%#%aa!a" &at,!,(%# TraM$'urut u-a !a'(Sa't,#, #u'( H$r-a' /2000:13 Trau-a tk-a'%+$#ta#% !a'(#u'( k!%'%k ar% +raktur
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=a%k %tu kar$'a trau-a !a'(#u'( -%#a!')a: tu!a'( kak% t$r*$'tur *$-&$r -,*%! atau t%ak !a'(#u'( -%#a!')a: #$#$,ra'( )a'( atu" $'(a' t$!a&ak ta'(a' -$')a'((a. u(a *%#a kar$'a trau-a ak%*at tar%ka' ,t,t -%#a!')a : &ata" tu!a'( &at$!a a' ,!$kra',' kar$'a ,t,t tr%#$& tr%#$ & a' *%#$& -$'aak *$rk,'trak#%. /D,$'($# 2000. S$5aktu tu!a'( &ata" &$rara"a' *%a#a')a t$ra% % #$k%tar t$-&at &ata" a' k$ a!a- ar%'(a' !u'ak #$k%tar tu!a'( t$r#$*ut ar%'(a' !u'ak u(a *%a#a')a -$'(a!a-% k$ru#aka'. R$ak#% &$raa'(a' *%a#a')a t%-*u! "$*at "$*at #$t$!a" #$t$!a" +raktur +raktur.. S$!9#$! S$!9#$! ara" ara" &ut%" &ut%" a' #$! -a#t -a#t *$raku *$raku-u! -u!a#% a#% -$')$*a*ka' &$'%'(kata' a!%ra' ara"k$t$-&at t$r#$*ut. Fa(,#%t,#%# a' &$-*$r#%"a' #%#a9#%#a #$! -at% %-u!a%. D% t$-&at &ata" t$r*$'tuk +%*r%' /"$-at,-a /"$-at,-a +raktur a' *$r+u'(#% *$r+u'(#% #$*a(a% #$*a(a% a!a9a!a u'tuk -$!$katka' -$!$katka' #$!9 #$! *aru. Akt%;%ta# ,#t$,*!a#t t$ra'(#a'( a' t$r*$'tuk tu!a'( *aru %-atur )a'( %#$*ut 6a!!u#. =$kua' +%*r%' %r$a*#,r*#% a' #$!9#$! tu!a'( *aru -$'(a!a-% r$-,$!%'( u'tuk -$-*$'tuk tu!a'( #$at% />ar&$'%t, 2000 . I'#u I'#u+%# +%#%$ %$'# '#%% &$-* &$-*u! u!u" u" ara ara" " atau atau &$'$ &$'$ka ka'a 'a' ' #$ra* #$ra*ut ut #ara+ #ara+ )a'( )a'( *$rka%ta' $'(a' &$-*$'(kaka' )( t%ak %ta'(a'% a&at -$'uru'ka' a#u&a' ara" k$ $k#tr$-%ta# a' -$'(ak%*atka' k$ru#aka' #ara+ &$r%+$r.
=%!a t%ak t$rk,'tr,! t$rk,'tr,! &$-*$'(ka &$-*$'(kaka' ka' a&at -$'(ak%*at -$'(ak%*atka' ka' &$'%'(kata &$'%'(kata' ' t$ka'a' ar%'(a' ,k!u#% ara" t,ta! a&at *$rak%*at a',k#%a ar%'(a')( -$'(ak%*atka' ru#ak')a #$ra*ut #ara+ -au&u' ar%'(a' ,t,t. K,-&!%ka#% %'% %'a-aka' #%'r,- k,-&art$-$' /=ru''$r #uart" 2002. F. P3# P3#&%s &%s""n ""n D&"no D&"nos'& s'&% % M$'urut /PERMENKES RI 2014 &$-$r%k#aa' %a(',#%k -$!%&ut% : 1. F,t, &,!,# -u-')a -u-')a %!akuka' %!akuka' &$-$r%k#aa' a!a- &r,)$k#% &r,)$k#% AP a' !at$ra! !at$ra!
u'tuk -$'$'tuka' !,ka#% !ua# a' $'%# $ '%# +raktur. 2. P$-$r% P$-$r%k#aa k#aa' ' ra% ra%,!, ,!,(% (% !a%'') !a%'')aa S$#ua% %'%ka#% %'%ka#% a&at %!akuka' %!akuka' &$-$r%k#aa' &$-$r%k#aa' *$r%kut a'tara !a%' : radioi radioisot sotope ope scanning scanning tu!a'( tu!a'( t,-,(ra+% t,-,(ra+% artr,(ra+% artr,(ra+% >T9#6 >T9#6a' a' a' MRI u'tuk -$-&$r!%"atka' +raktur a' -$'(%$'t%+%ka#% k$ru#aka' ar%'(a' !u'ak. 3. P$-$r% P$-$r%k#aa k#aa' ' ara" ara" rut%' rut%' a' a' (,!,'( (,!,'(a' a' ara" ara" Ht -u'(k%' -$'%'(kat /"$-,k,'#$'tra#% atau -$'uru' /&$rara"a' *$r-ak'a &aa #%#% +raktur atau ,r(a' au" &aa trau-a -u!t%&!$. P$'%'( P$'%'(kat kata' a' #$! ara" ara" &ut%" &ut%" aa!a" aa!a" r$#&,' r$#&,' #tr$## #tr$## ',r-a! ',r-a! #$t$!a" #$t$!a" trau-a. 4. Kr$at% Kr$at%'%' '%' : TrauTrau-aa ,t,t ,t,t -$'%'( -$'%'(katk katka' a' *$*a' kr$at%' kr$at%'%' %' u'tuk k!%r$' k!%r$'## (%'a!. . Pr,+%! k,a(u!a#% k,a(u!a#% : &$ru*a" &$ru*a"a' a' a&at a&at t$ra% t$ra% &aa k$"%!a' k$"%!a'(a' (a' ara". ara". G. M"n"3 M"n"3n n P#o!#"' P#o!#"'&/ &/ !"" P"s&n F#"%'# F#"%'# T%' T%'ak aka' a' k$&$ k$&$ra5 ra5ata ata' ' &r$ &r$ ,&$r$ ,&$r$t% t%++ -$ru -$ru&a &aka ka' '
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Kons! D"s"# As"n K!#"5"'"n A. Pn% Pn%"& "&"n "n K!# K!#"5" "5"'" '"n n 1. Data Data Su* Su*$k $kt% t%+ + P$'( P$'(ka ka% %a' a' -$ru -$ru&a &aka ka' ' ta"a ta"a& & a5a! a5a! a' a' !a' !a'a# a#a' a' a!a a!a- &r, &r,#$# #$#
k$&$ra5ata' u'tuk %tu %&$r!uka' k$6$r-ata' a' k$t$!%t%a' t$'ta'( -a#a!a -a#a!a"9"9-a#a! a#a!a" a" k!%$' k!%$' #$"%'(( #$"%'((aa a&at a&at -$-*$r% -$-*$r%ka' ka' ara" t$r"a t$r"aa& a& t%' t%'ak aka' a' k$&$ k$&$ra5 ra5at ata' a'.. K$*$ K$*$r" r"a#% a#%!a !a' ' &r,# &r,#$# $# k$&$ k$&$ra5 ra5at ata' a' #a'( #a'(at at *$r(a'tua'( &aa ta"a& %'%. Ta"a& Ta"a& %'% t$r*a(% ata# : a. P$'(u-&u!a' Da Data 1 A'a-'$#a a I$' I$'t% t%ta ta## K!%$ K!%$' ' * K$!u"a' ta-a Paa u-u-')a k$!u"a' uta-a &aa ka#u# +raktur aa!a" ra#a ')$r%. N)$r% t$r#$*ut *%#a akut atau kr,'%k t$r(a'tu'( a' !a-a')a #$ra'(a'. 'tuk -$-&$r,!$" &$'(ka%a' )a'( !$'(ka& t$'ta'( ra#a ')$r% k!%$' %(u'aka' : /1 Pr,;,k%'( Pr,;,k%'( I'6%$'t I'6%$'t : a&aka" aa &$r%#t%5a )a'( )a'( -$'a% )a'( -$'a% +akt,r &r$#%&%ta#% ')$r%. /2 Bua!%t Bua!%t) ) ,+ Pa%' : #$&$rt% #$&$rt% a&a ra#a ')$r% ')$r% )a'( %ra#aka %ra#aka' ' atau atau %(a %(a-* -*ark arka' a' k!%$ k!%$'. '. A&aka &aka" " #$&$r #$&$rt% t% t$r* t$r*ak akar ar *$r$')ut atau -$'u#uk. /3 R$(%,' R$(%,' : ra%at ra%at%,' %,' r$!%$+: r$!%$+: a&aka" a&aka" ra#a #ak%t *%#a r$a a&aka" ra#a #ak%t -$'a!ar atau -$')$*ar a' %-a'a ra#a #ak%t t$ra%. /4 S$;$r%t) S$;$r%t) /S6a!$ ,+ Pa%' : #$*$ra&a #$*$ra&a au" ra#a ')$r% ')$r% )a'( %ra#aka' k!%$' *%#a *$ra#arka' #ka!a ')$r% atau k!%$' -$'$ra'(ka' #$*$ra&a au" ra#a #ak%t -$-&$'(aru"% k$-a-&ua' +u'(#%')a. / T%-$ T%-$ : *$ra&a *$ra&a !a-a ')$r% ')$r% *$r!a' *$r!a'(#u (#u'( '( ka&a' ka&a' a&aka" a&aka" *$rta-*a" *uruk &aa -a!a- "ar% atau #%a'( "ar%. 6 R%5a)at R%5a)at P$') P$')ak%t ak%t S$kara'( S$kara'(
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!a-a
Paa k!%$' +raktur t%-*u! ra#a 6$-a# t$'ta'( k$aaa' %r%')a %r%')a )a%tu k$t%akuta' k$t%akuta' t%-*u! k$6a6ata' &aa %r% a'
+u'( +u'(#% #%
tu* tu*u"') u"')a. a. M$ka M$ka'% '%##-$$
%t$-&u" k!%$' *%#a t%ak $+$kt%+. /11 P,!a Tata Tata N%!a% a' K$)ak%'a' 'tu 'tuk k!%$ k!%$' ' +rak +raktu turr t% t%ak a&at a&at
k,& k,&%'( %'(
)a'( a'(
-$!ak $!ak#a #a' 'aka' aka'
k$*utu"a' k$*utu"a' *$r%*aa" $'(a' $'(a' *a%k t$ruta-a t$ruta-a +r$ku$'#% +r$ku$'#% a' k,'#$'tra#%. Ha! %'% *%#a %#$*a*ka' kar$'a ')$r% a' k$t$r*ata#a' ($rak k!%$'. 2. Data Data O*$ O*$k kt%+ t%+ a. P$-$ P$-$r%k r%k#aa #aa' ' F%#%k D%*a(% -$'a% ua )a%tu &$-$r%k#aa' &$-$r%k#aa' u-u- /#tatu# ($'$ra!%#ata ($'$ra!%#ata u'tuk -$'a&atka' -$'a&atka' (a-*ara' (a-*ara' u-u- a' &$-$r%k#aa' &$-$r%k#aa' #$t$-&at /!,ka!%#. 1 K$aaa' u-u- : *a%k *a%k atau *uruk')a *uruk')a )a'( %6atat aa!a" ta'a9 ta'a #$&$rt% : a K$#aara' K$#aara' &$'$r%ta &$'$r%ta : a&at%# a&at%# #,&,r #,&,r k,-a k,-a ($!%#a" ($!%#a" k,-&,# k,-&,# -$'t%# t$r(a'tu'( &aa k$aaa' k!%$'. * K$#ak%ta' k$aaa' &$')ak%t: akut kr,'%k r%'(a' #$a'( *$rat a' &aa ka#u# +raktur *%a#a')a akut. 6 Ta'a Ta'a9ta' 9ta'a a ;%ta! ;%ta! t%ak ',r-a! ',r-a! kar$'a kar$'a aa (a'((u (a'((ua' a' *a%k +u'(#% -au&u' *$'tuk. 2 P$-$ P$-$r% r%k# k#aa' aa' "$a "$a9t 9t,9 ,9t, t,$$ : a K$&a K$&a!a !a T%ak aa (a'((ua' )a%tu ',r-, 6$&"a!%k #%-$tr%# t%ak aa &$',',!a' t%ak aa ')$r% k$&a!a. * Mata T%a T%ak k aa aa (a'( (a'((u (ua' a' #$&$r #$&$rt% t% k,' k,'u' u'(t (t%; %;aa t%a t%ak k a'$a'$-%# %# /kar$'a t%ak t$ra% &$rara"a'. 6 H%u H%u'( '( T%ak aa $+,r-%ta# tak aa &$r'a+a#a' 6u&%'( "%u'(. T$!%' T$!%'(a (a T$# *%#%k atau 5$*$r -a#%" a!a- k$aaa' ',r-a!. T%ak aa !$#% atau ')$r% t$ka'. $ Mu!ut Mu!ut a' a' @%(% @%(% Tak aa &$-*$#ara' t,'#%! (u#% t%ak t$ra% &$rara"a' -uk,#a -u!ut t%ak &u6at. + L$"$r
T%ak aa (a'((ua' )a%tu #%-$tr%# t%ak aa &$',',!a' r$+!$k -$'$!a' aa. ( T",r T",rak ak## Tak Tak aa &$r($raka' ,t,t %'t$r6,#ta$ ($raka' aa #%-$tr%#. " Paru Paru /1 /1 I'#&$ #&$k#% P$r' P$r'a+ a+a# a#a' a' -$'%' $'%'(k (kat at r$( r$(u!$r u!$r atau atau t% t%ak') ak')aa t$r( t$r(a' a'tu tu' '(
&aa aa
r%5a r%5a) )at
&$') &$')ak ak%t %t
k!%$ k!%$' '
)a'( a'(
*$r"u*u'(a' $'(a' &aru. &aru. /2 Pa!&a#% P$r($raka' #a-a atau #%-$tr%# +$r-%tu# ra*a #a-a. /3 P$rku#% Suara k$t,k #,',r #,',r tak aa $ru& atau #uara ta-*a"a' ta-*a"a' !a%'')a. /4 /4 Au#ku u#ku!t !ta# a#%% Suara Suara 'a+a 'a+a## ',r',r-a! a! tak tak aa aa 5"$$C 5"$$C%' %'( ( atau atau #uara #uara ta-*a"a' !a%'')a #$&$rt% #tr%,r a' r,'6"%. % a'tu'( /1 I'#&$k#% T%ak ta-&ak %ktu# a'tu'(. /2 Pa!&a#% Na% -$'%'(kat %ktu# t%ak t$ra*a. /3 Au#ku!ta#% Suara S1 a' S2 tu'((a! tak aa -ur9-ur. A*,-$' A*,-$' /1 I'#&$k#% =$'tuk atar #%-$tr%# t%ak aa "$r'%a. /2 Pa!&a#% Tu(,r *a%k t%ak aa $+a'# -u#ku!$r "$&ar t%ak t$ra*a. k P$rku#% Suara t")-&a'% aa &a'tu!a' ($!,-*a'( 6a%ra'. ! Au#ku!ta#% P$r%#ta!t%k u#u# ',r-a! ± 20 ka!%-$'%t. - I'(u%'a!9@$'$ta!%a9A'u# Tak aa aa "$r' "$r'%a %a tak tak aa aa &$-* &$-*$# $#ara ara' ' !)-& !)-&"$ "$ tak aa aa k$#u!%ta' =A=. ' Ku!%t T$ra&at $r)t$-a #u"u #$k%tar a$ra" trau-a -$'%'(kat *$'(kak ,$$-a ')$r% ')$r% t$ka'. , Ek#t$r-%ta# K$kuata' ,t,t aa')a ,$$-a atau t%ak #u"u akra! a' ROM. *. P$-$r%k#aa' P$'u'a'(
1 P$-$ P$-$r% r%k# k#aa' aa' Ra Ra%, %,!, !,(% (% 2 P$-$r% P$-$r%k#a k#aa' a' La*,ra La*,rat,r t,r%u%ua Ka!#%uKa!#%u- S$ruS$ru- a' F,#+,r F,#+,r S$ru- -$'%'(ka -$'%'(katt &aa &aa ta"a& ta"a& &$')$-*u"a' tu!a'(. * A!ka!%' F,#+at -$'%'(kat &aa k$ru#aka' tu!a'( a' -$'u' -$'u'uk ukka' ka' k$(%ata k$(%ata' ' ,#t$,* ,#t$,*!a#t !a#t%k %k a!aa!a- -$-*$' -$-*$'tuk tuk tu!a'(. 6 E'C%- ,t,t ,t,t #$&$rt% Kr$at%'%' Kr$at%'%' K%'a#$ Laktat Laktat D$"%r,($' D$"%r,($'a#$ a#$ /LDH9 /LDH9 A#&ar A#&artat tat A-%', A-%', Tra'# Tra'#+$ra +$ra#$ #$ /AST /AST A!,! A!,!a#$ a#$ )a'( -$'%'(kat &aa ta"a& &$')$-*u"a' tu!a'(. 3 P$-$ P$-$r% r%k# k#aa' aa' !a%' !a%'9!a 9!a%' %' a P$-$r%k#aa' P$-$r%k#aa' -%kr,,r(a -%kr,,r(a'%#-$ '%#-$ ku!tur ku!tur a' t$#t #$'#%t%;%ta# : %a&atka' -%kr,,r(a'%#-$ &$')$*a* %'+$k#%. * =%,&#% tu!a'( a' ,t,t: &aa %'t%')a &$-$r%k#aa' %'% #a-a $'(a' $'(a' &$-$r%k &$-$r%k#aa' #aa' %ata# %ata# ta&% ta&% !$*%" !$*%" %'%k %'%ka#% a#%ka' ka' *%!a *%!a t$ra% %'+$k#%. 6 E!$ktr,-) E!$ktr,-),(ra+% ,(ra+% : t$ra&at k$ru#aka' k$ru#aka' k,'uk#% k,'uk#% #ara+ )a'( %ak%*atka' +raktur. Art"r, Art"r,#6, #6,&) &) : %a&a %a&atka tka' ' ar%'(a ar%'(a' ' %kat %kat )a'( )a'( ru#ak ru#ak atau #,*$k kar$'a trau-a )a'( *$r!$*%"a'. $ I'%uI'%u- I-a(%'(: &aa &$-$r%k#aa' &$-$r%k#aa' %'% %a&atka' %a&atka' aa')a aa')a %'+$k#% &aa tu!a'(. + MRI : -$'((a-*a -$'((a-*arka' rka' #$-ua #$-ua k$ru#aka' k$ru#aka' ak%*at ak%*at +raktur. +raktur. B. D&"no D&"nos" s" K K!# !#"5" "5"'"n '"n 1. N)$r% N)$r% akut akut *$r"u* *$r"u*u'( u'(a' a' $'(a $'(a' ' a($' 6%$ 6%$ra. ra. 2. Ha-*at Ha-*ata' a' -,*%! -,*%!%ta %ta## +%#%k +%#%k *$r"u* *$r"u*u'( u'(a' a' $'(a' $'(a' k$ru#aka k$ru#aka' ' %'t$(r %'t$(r%ta# %ta#
#truktur tu!a'( &r,(ra- &$-*ata#a' ($rak. 3. R$#% R$#%k, k, %'+$ %'+$k# k#%. %. 4. R$#%k R$#%k, , #),k #),k "%&, "%&,;, ;,!$!$-%k %k.. . K$t%a K$t%ak$+ k$+$kt $kt%+a' %+a' &$r+u#% &$r+u#% ar%'(a ar%'(a' ' &$r%+$ &$r%+$rr *$r"u *$r"u*u' *u'(a' (a' $'(a' $'(a' ')$r% ')$r% $k#t$r-%ta#. . K$ru#aka' K$ru#aka' %'t$(r%t %'t$(r%ta# a# ku!%t ku!%t *$r"u*u'( *$r"u*u'(a' a' $'(a' $'(a' %-,*%!%# %-,*%!%#a#% a#% +%#%k. +%#%k. . P#n+"n""n K!#"5"'"n No.
D&"nos"
1.
K!#"5"'"n N)$r% akut
T"n "n K#&'#&" K#&'#&" In'#4ns&
H"s&, NO Pain level *$r"u*u'(a' Pain control $'(a' a($' Comfort level K#&'#&" H"s&,
NI P"&n 3"n"3n' a. Lakuka' &$'(ka%a'
')$r%
#$ 6 a r a
6%$ra
a. Ma-&u
k,-&r$"$'#%+
-$'( -$'(,' ,'tr tr,! ,!
')$r% ')$r%
/ta"u
&$')$*a*
')$r%
-a-&u
-$'((u'aka'
u'tuk u'tuk -$'(ur -$'(ura'( a'(%%
k,-u'%ka k,-u'%ka#% #% t$ra&$ut%k t$ra&$ut%k u'tuk
')$r%
&a#%$' . Ka% ku!tur
)a'(
-$'((u'aka'
-$-&$'(aru -$-&$'(aru"% "% r$#&,' r$#&,'
-a'a($-$' ')$r% 6. Ma-&u -$'($'a!%
')$r% $. E;a!u a!ua#%
/#ka!a
%'t$'#%ta#
+.
+r$ku$'#% a' ta'a
')a-a'
-$'($ta"u%
&$'(a!a-a'
*$rk $rkura' ura'( (
$'(a'
ar%
k$t%ak')a-a'a' 6. @u'aka' t$"'%k
*a'tua' *. M$!a&,rka' *a"5a
')$r% . M$')ataka'
ura# ura#% %
',';$r*a!
-$'6ar%
')$r%
karak karakt$ t$r%# r%#t% t%k k
+r$ku$'#% kua!%ta# a'
','+ar-ak,!,(%
')$r ')$r%%
!,ka#%
+akt,r &r$#%&%ta#% *. O*#$r;a#% r$ak#%
t$"'%k
')$r%
t$r-a#uk
&$'(a!a-a' a-a'
')$r% -a#a !a-&au E;a!ua#% *$r#a-a &a#%$'
a'
t%-
k$#$"ata' !a%' t$'ta'( ra#a
k$t%ak$+$kt%+a'
#$t$!a"
')$r% *$rkura'(
k,'tr ,'tr,! ,!
')$r% $r%
!a-&au (. =a'tu &a#%$'
-a#a a#a a'
k$!uar(a
u'tuk
-$'6ar%
a'
-$'$-uka' uku'(a' ". K,'tr,! !%'(ku'(a' )a'(
a&at
-$-& -$-&$' $'(ar (aru" u"%%
')$r% ')$r%
#$&$rt #$&$rt%% #u"u #u"u rua'(a rua'(a' ' &$'6a"a)aa' %.
k$*%#%'(a' Kura'(%
a' +akt,r
&r$#%&%ta#% ')$r% . P%!%" a' !akuka' &$'a'(a'a'
')$r%
/+ar-ak,!,(% ','+ ','+arar-ak ak,! ,!,( ,(%%
a' a'
%'t$r&$r#,'a! k. Ka% t%&$ a' #u-*$r ')$r% !.
u'tuk
-$'$'tuka' %'t$r;$'#% Aar Aarka ka' ' t$'t t$'ta' a'( ( t$k t$k'% '%k k
','+ar-ak,!,(% -. =$r%ka' a'a!($t%k u'tuk
-$'(ura'( a'(%
')$r% '. E;a!u a!ua#%
k$$+$ $+$kt%+a' +a'
k,'tr,! ')$r% ,. T%'(k %'(katk atka' a' %#tr% %#tr%"a "att &. K,!a*,ra#%ka' $'(a' ,kt$r
%ka
aa
k$!u"a k$!u"a' ' a' t%'ak t%'aka' a' ')$r% t%ak *$r"a#%! . M,'%t,r &$'$r%-aa' &a#%$'
t$'ta'(
-a'a$-$' ')$r% An",s&+ "3&n&s'#"'&on a. T$'tuka' !,ka#% karakt$r karakt$r kua!%ta# kua!%ta# a' $raat $raat ')$r% ')$r% #$*$!u#$*$!u &$-*$r%a' ,*at *. >$k %'truk#% ,kt$r t$'ta'( a'(
$'% $'%#
,*at
,#% a' +r$ku$'#% 6. >$k >$k r%5a r%5a) )at a!$r a!$r(% (% . P%!%" a'a!($#%6 )a'( %&$r!uka'
atau
k,-*%'a#%
ar%
a'a!($#%6
k$t%ka
&$-*$r%a' !$*%" ar% #atu $. T$'tuka'
&%!%"a'
a'a!( a'a!($#% $#%66
t$r( t$r(a' a'tu tu'( '(
+.
t%&$ a' *$rat')a ')$r% T$'tuka' a'a!($#%6 &%!%"a'
rut$
&$-*$r%a' a' ,#%# ,&t%-a! (. P%!%" rut$ &$-*$r% $r%a' #$6ar #$6araa I I IM u'tu u'tuk k &$'(,*ata'
')$r%
#$6ara t$ratur ". M,'%t,r ;%ta!
#%('
#$*$!u #$*$!u- a' #$#ua" #$#ua" &$-*$r%a'
a'!($#%k
&$rta-a ka!% %. =$r%ka' a'a!($#%6 t$&at t$&at 5aktu 5aktu t$rutat$ruta-aa .
#aat ')$r% "$*at E;a!u#% $+$kt%;%ta# a'a!( a'a!($#% $#%6 6 ta' ta'aa a' a'
2.
Ha-*ata' -,*% -,*%!% !%ta ta##
+%#% +%#%k k
NO Joint
movement
:
($a!a NI E7#+&s
'#"!$
active "3*,"'&on Mobility level a. M,'%t ,'%t,r ,r%' %'( ( ;%ta! %ta! #%( #%(' $'(a' $'(a' k$kuata' k$kuata' Self care : ADs #$*$!u-#$#ua" !ransfer !ransfer perfoormance a' ta"a'a' K#&'#&" "s&, !at%"a !at%"a' ' r$#&,' r$#&,' &a#%$' &a#%$' #$ku' #$ku'$r $r ak%*at ak%*at a. K!%$' -$'%'(kat #aat !at%"a' +raktur a!aakt%;%ta# *. K,'#u!ta#%ka' $'(a'
*$r"u*u'(a'
+%#%k *. M$'($rt% ar% ar%
t$ra t$ra& &% tuua'
&$'% &$'%'( '(ka kata ta' '
-,*%!%ta# 6. M$M$-;$r* ;$r*a! a!%# %#a# a#%k %ka' a'
r$' r$'6a' 6a'a
+%#% +%#%k k
t$'t t$'ta' a'( (
a-*u a-*u!a !a'# '#%%
#$#ua% k$*utu"a' 6. =a'tu k!%$'
$'(a' u'tuk
&$ra#aa'
-$'((u'ak -$'((u'aka' a' t,'(kat t,'(kat
a!a--$'%'(katka
#aat
'
k$kuata'
a'
k$-a-&ua'
*a'tu
a'
6$(a" t$r"aa& 6%$ra . Aarka' &a#%$' atau t$'a(a t$'a(a k$#$"at k$#$"ata' a' !a%' !a%'
*$r&%'a" . M$M$-&$ra &$ra(a (aka ka' ' &$'((u'aa'
*$ra!a'
t$'ta'( a!at
u'tuk
-,*%!%#a#% /5a!k$r
t$k'%k
a-*u!a'#% $. Ka% k$-a-&ua' &a#%$'
a!a-
-,*%!%#a#% +. Lat%" &a#%$'
a!a-
&$-$'u"a' k$*utu"a' ADL# ADL# #$6ara #$6ara -a'%r -a'%r%% #$#ua% k$-a-&ua' (. Da-&%'( a' *a'tu &a#%$' #aat -,*%!%#a#% a'
*a'tu
k$*utu"a'
&$'u"% ADL#
&a#%$' ". =$r% =$r%ka ka' ' a!at a!at *a't *a'tu u %ka %ka &a#%$' -$-$r!uka' &a#%$' i. Aarka' *a(a%-a'a &,#%#%
a'
*a'tua' 8.
R$#%k, %'+$k#%
NO "mmune status #nowledge : infection
control $is% control K#&'#&" "s&, a. K!%$' *$*a# ta' ta'a
a'
*$r%ka' %ka
%&$r!uka' NI In/+'&on on'#o, a. =$r# =$r#%" %"ka ka' ' !%' !%'(ku' (ku'(a (a' ' #$t$!a" %&aka% &a#%$'
ar% ($a! $a!aa
%'+$k#% *. M$'$#kr%&#%ka' &r,#$#
-$ru*a"
&$'u!ara''
!a%' *. P$rta"a'ka'
t$k'%k
%#,!a#% 6. =ata =ata#% #% &$'( &$'(u' u'u u'( '( *%! *%!aa &$r!u . I'#truk#%ka'
&aa
&$')ak%t
+a6t,r
&$'(u'u'(
u'tuk
)a'(
-$'6 -$'6u6 u6%% ta'( ta'(a' a' #aat #aat
-$-&$'(aru"%
*$rku'u'(
&$'u!ara'
#$rta
&$'ata!ak#a'aa'')a 6. M$'u $'u'uk ukka' k$-a-& k$-a-&ua' ua' u'tuk u'tuk -$'6$(a" t%-*u!')a %'+$k#% . u-!a" !$uk,#%t a!a- *ata# ',r-a! $. M$'u $'u'uk ukka' &$r%!aku #$"at
"%u&
-$'%'((a!ka' &a#%$' $. @u'aka' #a*u' a't%-%kr,*a u'tuk 6u6% ta'(a' +. >u6% ta'(a'
#$t%a&
#$*$!u #$*$!u- a' #$#ua #$#ua" " t%'aka' k$&$ra5ata' (. @u'ak u'aka' a' *au *au #aru #aru' '( ta'( ta'(a' a'
#$* #$*a(a% a(a%
a!at a!at
&$'!%'u'( ". P$rt P$rta" a"a' a'ka ka' ' !%' !%'(k (ku' u'a' a' a#$&t%6
#$!a-a
&$-a#a'(a' a!at %. @a't% !$t !$tak I &$r &$r%+$r a' a' !%'$ !%'$ 6$'t 6$'tra ra!! a' a' r$##%'( #$#ua% $'(a' &$tu'uk u-u . @u'aka' kat$t$r %'t$r-%t$' -$'u -$'uru ru'k 'ka' a'
u'tuk %'+$ %'+$k# k#%%
ka'u'( k$'6%'( k. T%'(katka' %'tak$ !.
'utr%#% =$r%ka'
t$ra&%
a't%*%,t%6 *%!a &$r!u In/+'&on !#o'+'&on a. M,'%t,r ta'a
a'
($a!a %'+$k#% #%#t$-%k a' !,6a! *. M,'%t,r
"%tu'(
(ra'u!,#%t W=> 6. M,'%t,r k$r$'ta'a' t$r"aa& %'+$k#%
. =ata =ata#% #% &$' &$'(u (u' 'u' u'( ( $. P$rta"a'ka' t$k'%k a#&$ a#&$#% #%##
&aa &aa
&a#% &a#%$' $'
)a'( *$r$#%k, +. P$rta"a'ka' %#,!a#% k& (. =$r%ka' ku!%t $&%$-a ". I'#&$k#% %.
t$k'%k
&$ra5ata'
&aa
a r$ a
ku!%t
a'
-$-*ra'$ -uk,#a T$r"aa aa& k$-$ra" ra"a'
&a'a# a' ra%'a#$ . I'#&$k#% k,'%#% !uka%'#%#% *$a" k. D,r,'( -a#ukka' !.
'utr%#% )a'( 6uku& D,r,'( -a#uka'
6a%ra' -. D,r, D,r,'( '( %#t%r %#t%ra" a"at at '. I'#truk#%ka' &a#%$' u'tuk
-%'u-
a't%*%,t%6 #$#ua% r$#$& ,. Aarka' &a#%$' a' k$!u k$!uar ar( (a
ta' ta'aa
($a!a %'+$k#% &. Aarka'
a' 6ara
-$'("%'ar% %'+$k#% . La&,r a&,rk ka' k$6u k$6ur% r%(a (aa' a'
9.
R$#%k,
#),k NO Syo% prevention "%&,;,!$-%k Syo% management K#&'#&" "s&, a. Na% a!a- *ata#
%'+$k#% r. La&, La&,rk rka' a' ku! ku!tu turr &,#% &,#%t% t%+ + NI S$o% !#4n'&on a. M,'%t,r #tatu# #%rk #%rku! u!a# a#%% ku!%t
=P =P #u"u
5ar' 5ar'aa ku!%t
)a'( %"ara&ka' *. Ira-a a'tu'(
$') $')ut ut a'tu a'tu'( '( HR HR
a!a a!a- *ata *ata## )a'( a'(
a' r%t-$ 'a% &$r%+$r
%"ara&ka' 6. Fr$ku'#%
a' ka&%!$r r$+%!! 'a&a# *. M,'%t,r ta'a
a!a a!a- *ata *ata## )a'( a'(
%'a$k %'a$kuat uat
%"ara&ka' ar%'(a' . Ira-a &$r'a&a#a' 6. M,'%t,r a!a a!a- *ata *ata## )a'( a'(
,k#%( ,k#%($'a $'a#% #% #u"u
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>ar&$' >ar&$'%t, %t, /2000 /2000 Diagnosa #eperawatan.Apli%asi pada Pra%ti% #linis #linis E. E@> akarta >,r5%' E!%Ca*$t" . 2010. )u%u 2010. )u%u Sa%u Patofisiologi Patofisiologi . akarta : E@>. D,$'($# at a! /2000 $encana /2000 $encana Asuhan #eperawatan #eperawatan E.3. akartaG E@> E'(ra- =ar*ara.18. $encana =ar*ara.18. $encana Asuhan #eperawatan Medi%al.)edah, /olume /olume 0 . akarta : E@>. H$at"$r H$r-a'. 2012. Diagnosis 2012. Diagnosis #eperawatan: Definisi dan #lasifi%asi 1231. 1234. 1234. akarta: E@>. Ku#uKu#u-a a Har"% Har"%.. 201. 201. Apli%asi Asuhan #eperawatan )erdasar%an Diagnosa Medis 5A5DA 5"C.5*C5"C.5*C- ?,()akarta : M$%A6t%,'. W%!k%'#,' u%t" M. 200. )u%u 200. )u%u Sa%u Diagnosis #eperawatan, edisi . akarta: E@>. Sa't,# Sa't,#a a =u%. =u%. 2007. 2007. Panduan Panduan Diagnosa #eperawatan 5A5DA 1226.1227 . 1226.1227 . akarta:
Pr%-a M$%ka
Ma'#,$r A kk. 2007. #apita 2007. #apita Sele%ta #edo%teran, Jilid 3 edisi 0. akarta: M$%a A$#6u!a&%u#
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