tag:blogger.com,1999:blog-25566526568987512442024-03-05T18:18:47.116+07:00ASUHAN KEPERAWATAN STIKES BORROMEUSIan zkate pakpahanhttp://www.blogger.com/profile/10259135788220046244noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-2556652656898751244.post-89850254755874050652010-10-17T12:28:00.003+07:002010-10-17T20:35:55.735+07:00ASKEP MORBUS HENSEN<div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-size: 24pt; line-height: 115%;">ASKEP MORBUS HENSEN</span><span style="font-size: 24pt; line-height: 115%;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 115%;">MAKALAH<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 115%;">disusun untuk memenuhi tugas mata </span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 115%;">ajaran Keperawatan Medikal Bedah III</span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 115%;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas> <v:path gradientshapeok="t" o:connecttype="rect" o:extrusionok="f"> <o:lock aspectratio="t" v:ext="edit"> </o:lock></v:path></v:stroke></v:shapetype><v:shape id="Picture_x0020_1" o:spid="_x0000_s1030" style="height: 222.75pt; left: 0; margin-left: 93pt; margin-top: 9.95pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.5pt; z-index: 5;" type="#_x0000_t75"> <v:imagedata o:title="Logo STIKes ku Don't open,please call me again" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image002.jpg"> <w:wrap type="square"> </w:wrap></v:imagedata></v:shape><v:shape id="Picture_x0020_1" o:spid="_x0000_s1030" style="height: 222.75pt; left: 0; margin-left: 93pt; margin-top: 9.95pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.5pt; z-index: 5;" type="#_x0000_t75"><br />
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</div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14pt; line-height: 115%;"><o:p>KELAS SANTA TERESA</o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
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</div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #00b0f0; font-family: Algerian; font-size: 14pt; line-height: 115%;">PROGRAM STUDI D III KEPERAWATAN<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #00b0f0; font-family: Algerian; font-size: 14pt; line-height: 115%;">Sekolah tinggi ilmu kesehatan santo borromeus<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #00b0f0; font-family: Algerian; font-size: 14pt; line-height: 115%;">bandung<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #00b0f0; font-family: Algerian; font-size: 14pt; line-height: 115%;"><br />
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</span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 14pt; line-height: 150%;">BAB I<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: Arial, sans-serif;">PENDAHULUAN</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l22 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">A.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Latar belakang<o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><span style="color: black;">Kusta telah menyerang manusia sejak 300 sm, dan telah dikenal oleh peradaban </span><a href="http://id.wikipedia.org/wiki/Tiongkok_kuna" title="Tiongkok kuna"><span style="color: black;">tiongkok kuna</span></a><span style="color: black;">, </span><a href="http://id.wikipedia.org/wiki/Mesir_kuno" title="Mesir kuno"><span style="color: black;">mesir kuna</span></a><span style="color: black;">, dan </span><a href="http://id.wikipedia.org/wiki/India" title="India"><span style="color: black;">india</span></a><span style="color: black;">. Pada </span><a href="http://id.wikipedia.org/wiki/1995" title="1995"><span style="color: black;">1995</span></a><span style="color: black;">, </span><a href="http://id.wikipedia.org/wiki/Organisasi_Kesehatan_Dunia" title="Organisasi Kesehatan Dunia"><span style="color: black;">organisasi kesehatan dunia</span></a><span style="color: black;"> (who) memperkirakan terdapat dua hingga tiga juta jiwa yang cacat permanen karena kusta. walaupun pengisolasian atau pemisahan penderita dengan masyarakat dirasakan kurang perlu dan tidak </span><a href="http://id.wikipedia.org/wiki/Etika" title="Etika"><span style="color: black;">etis</span></a><span style="color: black;">, beberapa kelompok penderita masih dapat ditemukan di berbagai belahan dunia, seperti </span><a href="http://id.wikipedia.org/wiki/India" title="India"><span style="color: black;">india</span></a><span style="color: black;"> dan </span><a href="http://id.wikipedia.org/wiki/Vietnam" title="Vietnam"><span style="color: black;">vietnam</span></a><span style="color: black;">.<o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><span style="color: black;">Pengobatan yang efektif terhadap penyakit kusta ditemukan pada akir </span>1940<span style="color: black;"> dengan diperkenalkannya </span><a href="http://id.wikipedia.org/w/index.php?title=Dapson&action=edit&redlink=1" title="Dapson (halaman belum tersedia)"><span style="color: black;">dapson</span></a><span style="color: black;"> dan derivatnya. Bagaimanapun juga, bakteri penyebab lepra secara bertahap menjadi kebal terhadap dapson dan menjadi kian menyebar. Hal ini terjadi hingga ditemukannya pengobatan multiobat pada awal </span><a href="http://id.wikipedia.org/wiki/1980-an" title="1980-an"><span style="color: black; text-decoration: none;">1980</span></a><span style="color: black;"> penyakit ini pun mampu ditangani kembali.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 22.5pt;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penyakit kusta ialah sebuah </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Penyakit_infeksi" title="Penyakit infeksi"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">penyakit infeksi</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Kronis" title="Kronis"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">kronis</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> yang disebabkan oleh </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Bakteri" title="Bakteri"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">bakteri</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Mycobacterium_leprae" title="Mycobacterium leprae"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">mycobacterium leprae</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">.</span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Kusta#cite_note-Sasaki_2001-0"></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Penyakit ini adalah tipe penyakit </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Granulomatosa" title="Granulomatosa"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">granulomatosa</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> pada </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Saraf_tepi" title="Saraf tepi"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">saraf tepi</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> dan </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Mukosa" title="Mukosa"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">mukosa</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> dari </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Saluran_pernapasan_atas" title="Saluran pernapasan atas"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">saluran pernapasan atas</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> dan </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Lesi" title="Lesi"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">lesi</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> pada </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Kulit" title="Kulit"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">kulit</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> adalah tanda yang bisa diamati dari luar. Bila tidak ditangani, kusta dapat sangat progresif, menyebabkan kerusakan pada kulit, saraf-saraf, anggota gerak, dan </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Mata" title="Mata"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">mata</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">. Tidak seperti </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Mitos" title="Mitos"><span style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%; text-decoration: none;">mitos</span></a></span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> yang beredar di masyarakat, kusta tidak menyebabkan pelepasan anggota tubuh yang begitu mudah. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 22.5pt;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Oleh karena itu penulis membuat makalah tentang asuhan keperawatan pada klien dengan Morbus Hansen. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 22.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l22 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">B.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 42.55pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo55; text-align: justify; text-indent: -7.1pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Tujuan umum:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Agar mahasiswa STIKes St. Borromeus D III Keperawatan tingkat 2 semester 4 dapat memahami askep pada klien dengan gangguan Morbus Hansen<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
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</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo55; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan khusus.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l15 level1 lfo53; text-align: justify; text-indent: 22.5pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dapat memahami anatomi dan fisiologi dari system integument.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l15 level1 lfo53; text-align: justify; text-indent: 22.5pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dapat memahami pengertian Morbus hansen<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l15 level1 lfo53; text-align: justify; text-indent: 22.5pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dapat memahami penyebab terjadinya Morbus Hansen<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l15 level1 lfo53; text-align: justify; text-indent: 22.5pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dapat memahami proses terjadinya Morbus Hansen<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l15 level1 lfo53; text-align: justify; text-indent: 22.5pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dapat memahami gejala dari Morbus Hansen<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l15 level1 lfo53; text-align: justify; text-indent: 22.5pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dapat memahami asuhan keperawatan Morbus Hansen<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l22 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">C.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Metode penulisan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: 20.7pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kami menggunakan metode diskusi, konsultasi serta mengambil beberapa teori yang yang bersangkutan dari beberapa buku dan mengumpulkan beberapa teori yang kami ambil dari internet untuk dapat menyusun makalah ini.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l22 level2 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sistematika penulisan <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: .5in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Adapun sistematika penulisan makalah ini terdiri dari 4 bab yaitu : bab I Pendahuluan yang meliputi Latar Belakang Masalah, Tujuan Penulisan, Metode Penulisan, dan Sistematika Penulisan. Bab II Tinjauan Teortis yang berisi mengemukakan teori dan konsep dasar Morbus Hansen yang meliputi : Anatomi dan fisiolog, Pengertian, Penyebab, Proses Terjadinya, Gejala, Pemeriksaan diagnostik, dan Asuhan Keperawatan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><br />
</div><div class="MsoNormal"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: 48.55pt; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 150%;">BAB II<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">TINJAUAN TEORETIS<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo40; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">A.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">ANATOMI FISIOLOGI INTEGUMEN<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sistem integument merupakan bagian dari tubuh manusia, khususnya organ yang menutupi permukaan atau bagian luar tubuh manusia yang sering disebut kulit. Kulit merupakan organ yang paling besar pada tubuh manusia dan terletak paling luar sehingga mudah mengalami trauma atau terkontaminasi oleh mikroorganisme serta mudah dilihat individu maupun orang lain. Kulit merupakan jalinan pembuluh darah, saraf, dan kelenjar yang tidak berujung, semuanya memiliki potensi untuk terserang penyakit. Luas kulit orang dewasa 1,5 m<sup>2 </sup>dengan berat kira-kira 15% dari berat badan. Secara mikroskopis, struktur kulit terdiri dari tiga lapisan, yaitu lapisan epidermis, lapisan dermis, dan lapisan subkutis.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><o:wrapblock><v:shape id="Picture_x0020_2" o:spid="_x0000_s1029" style="height: 228pt; left: 0; margin-left: 70.5pt; margin-top: 27.65pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 330pt; z-index: 1;" type="#_x0000_t75"> <v:imagedata o:title="image002" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image003.jpg"> <w:wrap type="topAndBottom"> </w:wrap></v:imagedata></v:shape></o:wrapblock><br />
<span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l28 level1 lfo35; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">LAPISAN EPIDERMIR<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lapisan epidermis adalah lapisan paling atas dari kulit serta tidak mengandung pembuluh darah dan saraf. </span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tebalnya di kulit biasa 0, 3 mm, Ditelapak tangan dan kaki tebalnya 1.5 mm. Waktu yang diperlukan dari lapisan yang paling bawah menjadi paling luar 30 hari.</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><o:wrapblock><v:shape id="Picture_x0020_3" o:spid="_x0000_s1028" style="height: 224.25pt; left: 0; margin-left: 72.75pt; margin-top: 0; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 321pt; z-index: 2;" type="#_x0000_t75"> <v:imagedata o:title="Main Picture" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image004.gif"> <w:wrap type="topAndBottom"> </w:wrap></v:imagedata></v:shape></o:wrapblock><br />
<span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bagian-bagian lapisan epidermis:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: 14.2pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1. Stratum corneum <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.8pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Adalah lapisan tanduk yang berada paling luar, terdiri atas beberapa lapis sel gepeng yang mati dan tidak berinti dan mengandung zat keratin.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l28 level1 lfo35; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Stratum lucidum <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: .25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Adalah lapisan yang terdapat langsung dibawah laisan korneum, merupakan lapisan selgepeng tanpa inti dengan protoplasma yang berubah menjadi protein yang disebut eleidin. <o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l28 level1 lfo35; tab-stops: 35.45pt; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Stratum Granulosum<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; tab-stops: 35.45pt; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Merupakan lapisan epidermis yang mempunyai fungsi penting dalam pembentukan protein dan ikatan kimia stratum korneum. selnya gepeng,berinti dan protoplasma berbutir besar.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l28 level1 lfo35; tab-stops: 35.45pt; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Stratum Spinosum<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; tab-stops: 35.45pt; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Adalah lapisan yang mengalami prose mitosis. Protoplasmanya jernih karena mengandung glikogen dan inti selnya di tengah-tengah. Sel bentuk dan besarnya berbeda karena proses mitosis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l28 level1 lfo35; tab-stops: 35.45pt; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Stratum basale<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; tab-stops: 35.45pt; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">merupakan lapisan epidermis yang paling bawah. Terdiri atas sel-sel berbentuk kubus (kolumnar) yang berbaris seperti pagar (palisade). Didalam lapisan ini terdapat melanosit, sel pembentuk melanin (melanosit) merupakan sel-sel berwarna muda mengandung pigmen-pigmen melanosom.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; tab-stops: 35.45pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2. LAPISAN DERMIS<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: 10.0pt; margin-left: 14.2pt; margin-right: 0in; margin-top: 12.0pt; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Adalah lapisan kulit di bawah epidermis yang terbagi menjadi dua bagian, yaitu:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: 10.0pt; margin-left: 14.2pt; margin-right: 0in; margin-top: 12.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: 10.0pt; margin-left: 1.0in; margin-right: 0in; margin-top: 12.0pt; mso-add-space: auto; mso-list: l34 level1 lfo36; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pars Papilaris (Stratum Papilar)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: 10.0pt; margin-left: 1.0in; margin-right: 0in; margin-top: 12.0pt; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">yaitu bagian yang menonjol ke epidermis. Bagian ini berisi ujung serabut saraf dan pembuluh darah yang menyokong dan member nutrisi pada epidermis.</span><span lang="IN" style="color: #41484d; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> </span><span class="apple-style-span"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lapisan papila hampir tidak mengandung jaringan ikat, memiliki serabut kolagen yang tipis. Lapisan ini dikenal dengan lapisan subepitel karena dibawah lapisan epitel epidermis. Lapisan ini disebut juga lapisan papila karena terdapat papila (kecil, seperti jari-jari) yang berikatan dengan epidermis. Kebanyakan papila mengandung kapiler untuk memberi nutrisi pada epidermis. Papila dengan serabut dobel ditelapak tangan dan kaki membentuk sidik jari.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l34 level1 lfo36; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pars Retikularis (Stratum Retikularis),<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> </span><span class="apple-style-span"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lapisan retikuler terdiri dari jaringan ikat, memiliki serabut kolagen yang kasar dan berkas serabut yang saling bersilangan membentuk seperti jaring. Garis-garis serabut tersebut membentuk Cleavage yang penting dalam proses pembedahan. Sayatan bedah yang memotong garis cleavage lebih sulit sembuh daripada yang paralel dengan garis ini. Lapisan reticular sangat banyak mengandung pembuluh darah, syaraf, ujung-ujung syaraf bebas, sel-sel adiposa(lemak), kelenjar minyak dan akar rambut, reseptor untuk tekanan dalam. Bagian terbawah lapisan ini mengandung serabut otot polos (khususnya didada dan putting susu genital) dan folikel rambut.</span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><br style="mso-special-character: line-break;" /> <br style="mso-special-character: line-break;" /> </span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Disekitar pembuluh darah yang kecil terdapat limfosit, histiosit, sel mast, dan leukosit yang melindungi tubuh dari infeksi dan invasi benda-benda asing. di samping itu, di dalam lapisan dermis juga terdapat akar rambut dan kelenjar keringat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ada dua macam kelenjar keringat, yaitu:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l36 level1 lfo37; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">w<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kelenjar ekrin, yang berukuran kecil, terletak di bagian dangkal dermis dengan secret yang encer. Kelenjat ini langsung bermuara di permukaan kulit. kelenjat ini terdapat di seluruh permukaan kulit, terbanyak pada bagian dahi, tangan, kaki, dan aksila.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l36 level1 lfo37; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">w<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">kelenjar apokrin, yang lebih besar, terletak lebih dalam dan sekretnya lebih kental. kelenjar apokrin dipengaruhi oleh saraf adrenargi, terdapat di aksila, aerola mammae, pubis, labia minora dan saluran telinga luar.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Manusia memiliki dua jenis rambut, yaitu:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l5 level1 lfo38; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">w<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rambut lanugo, denagn ciri pendek, tidak berpigmen, halus, dan akarnya di dalam dermis. Contohnya, rambut yang ada di pipi, rambut yang ada pada tubuh bayi (biasnya akan hilang setelah lahir).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l5 level1 lfo38; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">w<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rambut terminal, dengan cirri lebih panjang, lebih kasar, berpigmen, berkumpul di daerah tertentu, dan akarnya di dalam subkutis. rambut ini memiliki siklus pertumbuhan yang lebih cepat, kurang lebih 1 cm per bulan (mis, rambut kepala).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3. LAPISAN SUBKUTIS<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><span class="apple-style-span"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lapisan hypodermis atau lapisan subkutan terdiri dari jaringan adipose, banyak mengandung pembuluh darah, pembuluh limfe dan syaraf juga terdapat gulungan kelenjar keringat dan dasar dari folikel rambut. Tidak seperti epidermis dan dermis, batas dermis dengan lapisan ini tidak jelas.Pada bagian yang banyak bergerak jaringan hipodermis kurang, pada bagian yan melapisi otot atau tulang mengandung anyaman serabut yang kuat. Pada area tertentu yng berfungsi sebagai bantalan (payudara dan tumit) terdapat lapisan sel-sel lemak yang tipis. Distribusi lemak pada lapisan ini banyak berperan dalam pembentukan bentuk tubuh terutama pada wanita.</span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l43 level1 lfo39; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">FUNGSI KULIT<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kulit memiliki banyak fungsi diantaranya dalah:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a. Menutupi dan melindungi organ-organ dibawahnya<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b. Melindungi tubuh dari masuknya mikroorganisme dan benda asing yang dapat membahayakan tubuh. Fungsi ini merupakan fungsi perlindungan pasif. Selain fungsi perlindungan pasif, lapisan dermis berperan dalam proses menyiapkan limfosit yang di produksi oleh sumsum tulang sebelum benar-benar dipakai untuk menyerang berbagai mikroorganisme penyebab penyakit. Peran kulit dalam hal ini merupakan peran aktif dalam perlindungan tubuh.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c. Pengaturan suhu. Kulit, jaringan sub kutan dan lemak merupakan penyekat panas dari tubuh. Lemak menyalurkan panas sepertiga kecepatan jaringan lain atau dalam kata lain lemak menghambat pengeluaran panas dari tubuh. . Kecepatan aliran darah ke kulit menyebabkan konduksi panas sangat efisien. Konduksi panas ke kulit diatur oleh sistem syaraf simpatis. Syaraf simpatis mengatur kecepatan lairan darah dengan menstimulasi vaso konstriksi dan vaso dilatasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d. Ekskresi: Melalui perspirasi/berkeringat, membuang sejumah kecil urea.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e. Sintesis: Konversi 7-dehydrocholesterol menjadi Vit D3(cholecalciferol) dengan bantuan sinar U.V. Kekurangan UV dan Vit D mengakibatkan absorpsi Ca dari intestinal ke darah menurun.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f. Sensori persepsi: mengandung reseptor terhadap panas, dingin, nyeri, sentuhan /raba, tekanan. Juga mengandung ujung-ujung syaraf bebas yang berfungsi sebagai homeostatis.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo40; tab-stops: 28.35pt; text-align: justify; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">B.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PENGERTIAN<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l56 level1 lfo29; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Morbus Hansen (lepra atau morbus Hansen) adalah penyakit kronis yang disebabkan oleh infeksi mycobacterium leprae (Kapita Selekta Kedokteran UI, 2000)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l56 level1 lfo29; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penyakit Morbus Hansen adalah penyakit menular yang menahun dan disebabkan oleh kuman kusta (Mycobacterium leprae) yang menyerang saraf tepi, kulit dan jaringan tubuh lainnya (Departeman Kesehatan, Dit. Jen PPM & PL, 2002)<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l56 level1 lfo29; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jadi, Morbus Hansen adalah penyakit kronis yang disebabkan oleh Myrobacterium Lepra yang menyerang saraf tepi, kulit dan jaringan tubuh lainnya.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo40; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">C.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">ETIOLOGI<o:p></o:p></span></b></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><span lang="IN"><a href="http://id.wikipedia.org/wiki/Berkas:M_leprae_ziehl_nielsen2.jpg"><span lang="EN-US" style="color: black; text-decoration: none;"><v:shape alt="180px-M_leprae_ziehl_nielsen2" href="http://id.wikipedia.org/wiki/Berkas:M_leprae_ziehl_nielsen2.jpg" id="Picture_x0020_4" o:button="t" o:spid="_x0000_i1025" style="height: 90.75pt; mso-wrap-style: square; visibility: visible; width: 135pt;" type="#_x0000_t75"> <v:fill o:detectmouseclick="t"> <v:imagedata o:title="180px-M_leprae_ziehl_nielsen2" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image005.jpg"> </v:imagedata></v:fill></v:shape></span></a></span><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 14.7pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mycrobacterium Lepra yang merupakan bakteri tahan asam, bersifat obligat intraseluler yang ditemukan oleh G. A. Hansen. Masa membelah diri Mycrobacterium leprae memerlukan waktu yang cukup lama dibandingkan dengan kuman lain, yaitu 12-21 hari masa tunasnya antara 40 hari sampai dengan 40 tahun. Penyakit kusta dapat ditularkan dari penderita kusta Multibasiler (MB) kepada orang lain dengan cara penularan langsung, melalui saluran pennapasan (inhalasi) dan kulit (kontak langsung dengan penderita yang lama dan erat). Kuman tersebut dapat ditemukan di folikel rambut, kelenjar keringat,septum dan air susu ibu<o:p></o:p></span></div><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 115%;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span> <br />
<div class="MsoNormal"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo40; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">D.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">FAKTOR YANG MENYEBABKAN TIMBULNYA PENYAKIT<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Timbulnya penyakit kusta pada seseorang tidak mudah sehingga tidak perlu ditakuti, namun hal ini tergantung pada beberapa faktor, yaitu<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-align: justify; text-indent: -11.45pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Patogenesis kuman Mycobacterium leprae, </span><span lang="IN" style="color: black;">kuman Kusta tersebut masih utuh bentuknya </span><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">maka memiliki kemungkinan penularan lebih besar daripada bentuk kuman yang telah hancur ak</span><span lang="IN" style="color: black;">ibat pengobatan.</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-align: justify; text-indent: -11.45pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Cara penularan, melalui kontak langsung dengan daerah yang terdapat lesi basah, berganti-gantian baju, handuk, melalui sekret serta udara.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-align: justify; text-indent: -11.45pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Keadaan sosial ekonomi yang terbatas sehingga dalam memenuhi kebutuhan hidup seperti makanan yang bergizi, tempat tinggal yang kumuh.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-align: justify; text-indent: -11.45pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Higiene dan sanitasi berhubungan dengan keadaan sosial juga dimana orang-orang yang mengalami keadaan sosial rendah tidak bisa memenuhi kebutuhan hygienenya seperti membeli sabun, kebersihan air tidak terjamin akibat permukiman padat penduduk, ventilasi rumah yang tidak bagus, pencahayaan yang <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-align: justify; text-indent: -11.45pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Daya tahan tubuh, imun tubuh juga mempengaruhi dalam masuk dan berkembangnya virus M.Leprae.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo40; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">E.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><o:wrapblock><v:shape alt="kusta4_2" id="Picture_x0020_4" o:allowoverlap="f" o:spid="_x0000_s1027" style="height: 104.25pt; left: 0; margin-left: 36pt; margin-top: 45.75pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: line; mso-position-vertical: absolute; mso-wrap-distance-bottom: 3.75pt; mso-wrap-distance-left: 3.75pt; mso-wrap-distance-right: 3.75pt; mso-wrap-distance-top: 3.75pt; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 117pt; z-index: 3;" type="#_x0000_t75"> <v:imagedata o:title="kusta4_2" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image006.jpg"> <w:wrap anchory="line" type="topAndBottom"> </w:wrap></v:imagedata></v:shape></o:wrapblock><br />
<b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">MANIFESTASI KLINIS<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l29 level1 lfo30; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kulit dengan bercak putih atau kemerahan dengan mati rasa<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l29 level1 lfo30; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><o:wrapblock><v:shape alt="kusta2_0" id="Picture_x0020_5" o:allowoverlap="f" o:spid="_x0000_s1026" style="height: 102.75pt; left: 0; margin-left: 36pt; margin-top: 45.3pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: line; mso-position-vertical: absolute; mso-wrap-distance-bottom: 3.75pt; mso-wrap-distance-left: 3.75pt; mso-wrap-distance-right: 3.75pt; mso-wrap-distance-top: 3.75pt; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 125.35pt; z-index: 4;" type="#_x0000_t75"> <v:imagedata o:title="kusta2_0" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image007.jpg"> <w:wrap anchory="line" type="topAndBottom"> </w:wrap></v:imagedata></v:shape></o:wrapblock><br />
<span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penebalan pada saraf tepi disertai kelainan fungsinya berupa mati rasa dan kelemahan pada otot tangan, kaki dan mata.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l29 level1 lfo30; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Adanya kuman tahan asam (BTA positif) pada pemeriksaan kerokan kulit <b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo40; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">F.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PATOFISIOLOGI<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: 21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mekanisme penularan penyakit <i style="mso-bidi-font-style: normal;">Morbus Hansen</i> diawali dari </span><span lang="FI" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">kuman <em><b style="mso-bidi-font-weight: normal;">Mycobacterium Leprea</b></em><em><span style="font-style: normal;">. </span></em></span><span lang="SV" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kuman ini biasanya berkelompok dan hidup dalam sel serta mempunyai sifat tahan asam (<strong><span style="font-weight: normal;">BTA) . </span></strong>Kuman Morbus Hansen ini pertama kali menyerang saraf tepi, yang selanjutnya dapat menyerang kulit, mukosa mulut, saluran nafas bagian atas, sistem retikuloendotelial, mata, otot, tulang, dan testis kecuali susunan saraf pusat</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">.</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> </span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mekanisme penularan yang tepat belum diketahui. Beberapa hipotesis telah dikemukakan seperti adanya kontak dekat dan penularan dari udara. Terdapat bukti bahwa tidak semua orang yang terinfeksi oleh kuman M. leprae menderita kusta, dan diduga faktor genetika juga ikut berperan. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: 21.3pt;"><strong><span lang="IN" style="font-size: 12pt; font-weight: normal; line-height: 150%;">Kerusakan saraf pada pasien <i style="mso-bidi-font-style: normal;">Morbus Hansen</i></span></strong><span lang="IT" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> diakibatkan </span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">M.Leprae</span></i><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> yang memiliki bagian <em><span style="font-style: normal;">G domain of extracellular matriks protein laminin 2 </span></em>yang akan berikatan dengan sel schwaan melalui reseptor dystroglikan lalu akan mengaktifkan MHC (Major Histocompatibility Complex) kelas II setelah itu mengaktifkan CD4+. CD4+ akan mengaktifkan Th1 dan Th2 dimana Th1 dan Th2 akan mengaktifkan makrofag. Makrofag gagal memakan M. Leprae akibat adanya fenolat glikolipid I yang melindungi di dalam makrofag. Ketidakmampuan makrofag akan merangsang makrofag bekerja terus-menerus untuk menghasilkan sitokin dan GF(Growht Factor) yang lebih banyak lagi. Sitokin dan GF tidak mengenal bagian self atau nonself sehingga akan merusak saraf dan saraf yang rusak akan diganti dengan jaringan fibrous sehingga terjadilah penebalan saraf tepi. Sel schwann merupakan APC non professional. Akibatnya akan </span><span lang="FI" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">mengalami gangguan fungsi saraf tepi seperti sensorik, motorik dan otonom. Serangan terhadap fungsi sensorik akan menyebabkan terjadinya luka pada tangan atau kaki, yang selanjutnya akan mati rasa (</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a</span><em><span lang="FI" style="font-size: 12pt; font-style: normal; line-height: 150%;">nestasi</span></em><span lang="FI" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">). Kerusakan fungsi motorik akan mengakibatkan lemah</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> atau </span><span lang="FI" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">lumpuhnya otot kaki</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> atau </span><span lang="FI" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">tangan, jari-jari tangan</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> atau </span><span lang="FI" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">kaki menjadi bengkok. Rusaknya fungsi otonom berakibat terjadinya gangguan pada kelenjar keringat, kelenjar minyak dan gangguan sirkulasi darah sehingga kulit menjadi kering, menebal, mengeras, dan pecah-pecah yang pada akhirnya akan membuat si penderita cacat seumur hidup.</span><span lang="IT" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: 21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kelainan juga terjadi pada kulit, dalam hal ini dapat berupa <em>hipopigmentasi</em> (semacam panu) bercak-bercak merah, infiltrat (penebalan kulit) dan nodul (benjolan). Infiltrasi granuloma ke dalam adneksa kulit yang terdiri atas jaringan keringat, kelenjar palit, dan folikel rambut dapat mengakibatkan kulit kering dan alopesia. </span><span lang="FI" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: 21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penyakit ini dapat menimbulkan <i style="mso-bidi-font-style: normal;">ginekomastia</i> akibat gangguan keseimbangan hormonal dan oleh karena infiltrasi granuloma pada tubulus seminiferus testis. Penderita lepra lepromatosa dapat menjadi impoten dan mandul, karena infeksi ini dapat menurunkan kadar testosteron dan jumlah sperma yang dihasilkan oleh testis</span><span lang="FI" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .25in;"><span lang="FI" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pada kornea mata akan terjadi kelumpuhan pada otot mata mengakibatkan kurang</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> atau </span><span lang="FI" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">hilangnya reflek kedip, sehingga mata akan mudah kemasukan kotoran dan benda-benda asing yang dapat menimbulkan kebutaan. </span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kerusakan mata pada kusta dapat primer dan sekunder. Primer mengakibatkan alopesia pada alis mata dan bulu mata, juga dapat mendesak jaringan mata lainnya. Sekunder disebabkan oleh rusaknya N.fasialis yang dapat membuat paralisis N.orbitkularis palpebrarum sebagian atau seluruhnya, mengakibatkan lagoftalmus yang selanjutnya, menyebabkan kerusakan bagian – bagian mata lainnya. Secara sendirian atau bersama – sama akan menyebabkan kebutaan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .25in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="color: black;">G. KLASIFIKASI LEPRA<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1. Tipe Tuberkuloid (TT)</span><span lang="FI" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .45in;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lesi ini mengenai baik kulit maupun syaraf, jumlah lesi bisa satu atau beberapa, dapat berupa makula atau plakat yang berbatas jelas dan pada bagian tengah dapat ditemukan lesi yang regresi atau central healing. Permukaan lesi dapat bersisik dengan tepi yang meninggi, bahkan dapat menyerupai gambaran psoriasis atau tinea sirsinata. Dapat disertai penebalan saraf perifer yang biasanya teraba, kelemahan otot, dan sedikit rasa gatal. Tidak adanya kuman merupakan tanda terdapatnya respon imun pejamu yang adekuat terhadap kuman kusta.</span><span lang="SV" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2. Tipe Borderline Tuberkuloid (BT)</span><span lang="SV" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .45in;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lesi pada tipe ini menyerupai tipe TT, yakni berupa makula atau plakat yang sering disertai lesi satelit di tepinya. Jumlah lesi dapat satu atau beberapa, tetapi gambaran hipopigmentasi, kekeringan kulit atau skuama tidak sejelas tipe TT. Adanya gangguan saraf tidak seberat tipe TT dan biasanya asimetris. Lesi satelit biasanya ada dan terletak dekat saraf perifer yang menebal.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3. Tipe Mid Borderline (BB)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .45in;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Merupakan tipe yang paling tidak stabil, disebut juga sebagai bentuk dismorfik dan jarang dijumpai. Lesi sangat bervariasi, dapat berbentuk makula infiltratif, permukaan lesi dapat mengkilap dan batas lesi kurang jelas. Ciri khasnya adalah lesi punched out, yaitu, suatu lesi hipopigmentasi dengan bagian tengah oval dan berbatas jelas.</span><span lang="ES" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4. Tipe Borderline Lepromatosus (BL)</span><span lang="ES" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .45in;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Secara klasik lesi dimulai dengan makula, awalnya sedikit dan dengan cepat menyebar ke seluruh badan. Walaupun masih kecil, papul dan nodul lebih tegas dengan distribusi lesi yang hampir simetris dan beberapa nodul nampaknya melekuk pada bagian tengah. Lesi bagian tengah sering tampak normal dengan infiltrasi di pinggir dan beberapa tampak seperti punched out. Tanda-tanda kerusakan saraf lebih cepat muncul dibandingkan dengan tipe LL.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5. Tipe Lepromatous Leprosy<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .45in;"><span lang="IN" style="color: black; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jumlah lesi pada tipe ini sangat banyak, simetris, permukaan halus, lebih eritematus, berkilap, berbatas tidak tegas, dan pada stadium dini tidak ditemukan anestesi dan anhidrosis. Distribusi lesi khas, yakni di daerah wajah, mengenai dahi, pelipis, dagu, cuping telinga; sedangkan di badan mengenai bagian badan yang dingin, seperti lengan, punggung tangan, dan ekstensor tungkai. Pada stadium lanjut, tampak penebalan kulit yang progresif, cuping telinga menebal, facies leonina, madarosis, iritis, keratitis, deformitas pada hidung, pembesaran kelenjar limfe, dan orkitis yang selanjutnya dapat menjadi atrofi testis.Kerusakan saraf yang luas menyebabkan gejala stocking and glove anesthesia dan pada stadium lanjut serabut-serabut saraf perifer mengalami degenerasi hialin atau fibrosis yang menyebabkan anastesi dan pengecilan otot tangan dan kaki.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .25in;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo40; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">G.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PEMERIKSAAN DIAGNOSTIK <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level1 lfo31; tab-stops: 132.3pt; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Inspeksi. Pasien diminta memejamkan mata, menggerakan mulut, bersiul, dan tertawa untuk mengetahui fungsi saraf wajah. Semua kelainan kulit di seluruh tubuh diperhatikan, seperti adanya makula, nodul, jaringan parut, kulit yang keriput, penebalan kulit, dan kehilangan rambut tubuh (alopesia dan madarosis).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level1 lfo31; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan sensibilitas pada lesi kulit dengan menggunakan kapas (rasa raba), jarum pentul yang tajam dan tumpul (rasa nyeri), serta air panas dan dingin dalam tabung reaksi (rasa suhu).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level1 lfo31; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan saraf tepi dan fungsinya dilakukan pada : n. auricularis magnus, n. ulanaris, n. radialis, n. medianus, n. peroneus, dan n. tibialis posterior. Hasil pemeriksaan yang perlu dicatat adalah pembesaran, konsistensi, penebalan, dan adanya nyeri tekan. Perhatikan raut muka pasien apakah ia kesakitan atau tidak saat saraf diraba.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level1 lfo31; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan fungsi saraf otonom, yaitu memeriksa ada tidaknya kekeringan pada lesi akibat tidak berfungsinya kelenjar keringat dengan menggunakan pensil tinta.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klasifikasi Pause Basiler dan Multi Basiler menurut P2MPLP<o:p></o:p></span></b></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: .5in; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 154.0pt;" valign="top" width="205"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kelainan kulit dan hasil pemeriksaan bakteriologis<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 154.05pt;" valign="top" width="205"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tipe Pause Basiler<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 154.05pt;" valign="top" width="205"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tipe Multi Basiler<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 154.0pt;" valign="top" width="205"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo49; text-align: justify; text-indent: -13.65pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bercak (makula)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo50; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jumlah<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo50; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ukuran <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo50; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Distribusi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l30 level1 lfo50; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Permukaan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l30 level1 lfo50; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Batas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l30 level1 lfo50; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan sensitibilitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l30 level1 lfo50; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kehilangan kemampuan berkeringat, bulu rontok pada bercak<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo49; text-align: justify; text-indent: -13.65pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Infiltrat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l14 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kulit<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l14 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Membrana mukosa (hidung tersumbat pendarahan di hidung)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo49; text-align: justify; text-indent: -13.65pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Nodulus<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo49; text-align: justify; text-indent: -13.65pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penebalan syaraf tepi<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo49; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Deformitas (cacat)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo49; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sediaan apus<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo49; text-align: justify; text-indent: -13.65pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">ciri-ciri khusus<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 154.05pt;" valign="top" width="205"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1-5<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kecil dan besar<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Unilateral atau bilateral asimetris<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kering dan kasar<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tegas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selalu ada dan jelas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bertcak tidak berkeringat, ada bulu rontok pada bercak<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tidak ada<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tidak pernah ada<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tidak ada<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lebih sering terjadi dini, asimetris<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Biasanya asimetris terjadi dini<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">BTA negatif<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Central healing penyembuhan di tengah<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 154.05pt;" valign="top" width="205"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Banyak<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kecil-kecil<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bilateral, simetris<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Halus, berkilat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kurang tegas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Biasanya tidak jelas, jika ada, terjadi pada yang sudah lanjut<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bercak masih berkeringat, bulu tidak rontok<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ada, kadang-kadang tidak ada<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ada, kadang-kadang tidak ada<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kadang-kadang ada<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Terjadi pada yang lanjut, biasanya lebih dari satu dan simetris<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Terjadi pada usia lanjut<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">BTA positif<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">punched <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
</tbody></table><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dikutip dan dimodifikasi dari Buku Panduan Pemberantasan Kusta Depkes (1999)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klasifikasi Pause Basiler dan Multi Basiler berdasarkan WHO (1995)<o:p></o:p></span></b></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: .5in; mso-border-alt: solid black .5pt; mso-border-insideh: .5pt solid black; mso-border-insidev: .5pt solid black; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 154.0pt;" valign="top" width="205"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 154.05pt;" valign="top" width="205"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tipe Pause Basiler<o:p></o:p></span></b></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 154.05pt;" valign="top" width="205"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tipe Multi Basiler<o:p></o:p></span></b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 154.0pt;" valign="top" width="205"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level1 lfo18; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lesi kulit<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(macula datar, papul yang meninggi, nodus)<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level1 lfo18; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kerusakan saraf <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(menyebabkan hilangnya sensasi/kelemahan otot yang dipersarafi oleh saraf yang terkena)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; tab-stops: 51.05pt 111.35pt; text-align: justify; text-indent: 34.9pt;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 154.05pt;" valign="top" width="205"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo19; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1-5 lesi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo19; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hipopigmentasi/eritema<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo19; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Distribusi tidak simetris<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo19; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hilangnya sensasi yang jelas<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo19; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hanya satu cabang saraf<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 154.05pt;" valign="top" width="205"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo19; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">> 5<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo19; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Distribusi lebih simetris<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo19; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hilangnya sensasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo19; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Banyak cabang saraf<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dikutip dan dimodifikasi dari WHO (1995)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level1 lfo31; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan Bakteriologis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 57.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo32; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ketentuan pengambilan sediaan adalah sebagai berikut :<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 57.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo32; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sediaan diambil dari kelainan kulit yang paling aktif<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 57.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo32; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kulit muka sebaiknya dihindari karena lalasan kosmetik, kecuali tidak ditemukan lesi di tempat lain<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 57.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo32; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan ulangan dilakukan pada lesi kulit yang sama dan bila perluditambah dengan lesi kulit yang baru timbul<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 57.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo32; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lokasi pengambilan sediaan apus untuk pemeriksaan M. leprae ialah :<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo20; text-align: justify; text-indent: 13.05pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Cuping telinga kiri/kanan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo20; text-align: justify; text-indent: 13.05pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dua sampai empat lesi kulit yang aktif di tempat lain<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo33; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sediaan dari selaput lender hidung sebaiknya dihindari karena :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 106.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level3 lfo34; text-align: justify; text-indent: -21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tidak menyenangkan pasien<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 106.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level3 lfo34; text-align: justify; text-indent: -21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Positif palsu karena ada mikobakterium lain<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 106.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level3 lfo34; text-align: justify; text-indent: -21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tidak pernah ditemukan M. leprae pada selaput lendir hidung apabila sediaan apus kulit negative<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 106.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level3 lfo34; text-align: justify; text-indent: -21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pada pengobatan, pemeriksaan bakterioskopis selaput lender hidung lebih dahulu negative daripada sediaan kulit ditempat lain<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l52 level1 lfo21; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Indikasi pengambilan sediaan apus kulit :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo22; text-align: justify; text-indent: 13.05pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Semua orang yang dicurigai menderita kusta<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo22; text-align: justify; text-indent: 13.05pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Semua pasien baru yang didiagnosis secara klinis sebagai pasien kusta<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 106.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo22; text-align: justify; text-indent: -21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Semua pasien kusta yang diduga kambuh (relaps) atau karena tersangka kuman resisten terhadap obat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo22; text-align: justify; text-indent: 13.05pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Semua pasien Multi Basiler setiap satu tahun sekali<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l52 level1 lfo21; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan bakteriologis dilakukan dengan pewarnaan tahan asam, yaitu Ziehl Neelsen atau Kinyoun-gabett.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l52 level1 lfo21; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Cara menghitung BTA dalam lapangan mikroskop ada 3 metode, yaitu cara zig zag, huruf z, dan setengah/ seperempat lingkaran. Bentuk kuman yang mungkin ditemukan adalah bentuk utuh (solid), pecah-pecah (fragmented), granular (granulates), globus, dan clamps.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level1 lfo31; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Indeks Bakteri (IB)</span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Merupakan ukuran semikuantitatif kepadatan BTA dalam sediaan hapus, IB digunakan untuk menentukan tipe kusta dan mengevaluasi hasil pengobatan. Penilaian dilakukan menurut skala logaritma Ridley sebagai berikut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> 0 bila tidak ada BTA dalam 100 lapangan pandang <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> +1 Bila 1-10 BTA dalam 100 lapangan pandang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> +2 Bila 1-10 BTA dalam 10 lapangan pandang <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> +3 Bila 1-10 BTA dalam rata-rata 1 lapangan pandang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> +4 Bila 11-100 BTA dalam rata-rata 1 lapangan pandang <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> +5 Bila 101-1000 BTA dalam rata-rata 1 lapangan pandang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> +6 Bila > 1000 BTA dalam rata-rata 1 lapangan pandang <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 115%;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span> <br />
<div class="MsoNormal"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level1 lfo31; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Indeks Morfologi (IM)<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Merupakan persentase BTA bentuk utuh terhadap seluruh BTA. IM digunakan untuk mengetahui daya penularan kuman, mengevaluasi hasil pengobatan, dan membantu menentukan resistensi terhadap obat. Contoh menghitung IB dan IM sebagai berikut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 4.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 27.65pt; mso-border-alt: solid black .5pt; mso-border-insideh: .5pt solid black; mso-border-insidev: .5pt solid black; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 153.9pt;" valign="top" width="205"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lokasi pengambilan<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 75.0pt;" valign="top" width="100"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kepadatan<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 46.5pt;" valign="top" width="62"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Solid<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 122.1pt;" valign="top" width="163"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Fragmented/granulated<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 153.9pt;" valign="top" width="205"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l53 level1 lfo23; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Daun telinga kiri<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l53 level1 lfo23; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Daun telinga kanan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l53 level1 lfo23; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Paha kiri<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l53 level1 lfo23; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bokong kanan<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 75.0pt;" valign="top" width="100"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5 +<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4 +<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4 +<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4+<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 46.5pt;" valign="top" width="62"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 122.1pt;" valign="top" width="163"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">95<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">94<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">97<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">96<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 2; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 153.9pt;" valign="top" width="205"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 75.0pt;" valign="top" width="100"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">17 +<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 46.5pt;" valign="top" width="62"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">18<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 122.1pt;" valign="top" width="163"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">382<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo40; text-align: justify; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">H.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PENATALAKSANAAN<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: 21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan utama program pemberantasan kusta adalah menyembuhkan pasien kusta dan mencegah timbulnya cacat serta memutuskan mata rantai penularan dari pasien kusta terutama tipe yang menular kepada orang lain untuk menurunkan insidens penyakit.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Program Multi Drug Therapy (MDT) dengan kombinasi rifampisin, klofazimin dan DDs dmluai tahun 1981. Program ini bertujuan untuk mengatasi resistensi dapson yang semakin meningkat, mengurangi ketidaktaatan pasien, menurunkan angka putus obat, dan mengeliminasi persistensi kuman kusta dalam jaringan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify; text-indent: 14.2pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rejimen pengobatan MDT di Indonesia sesuai rekomendasi WHO (1995) sebagai berikut <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo33; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tipe PB</span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jenis obat dan dosis untuki orang dewasa :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 37.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l31 level1 lfo24; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rifampisin 600 mg/bulan diminum di depan petugas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 37.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l31 level1 lfo24; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klofazimin 300 mg/bulan diminum di depan petugas dilanjutkan dengan klofazimin 50 mg/hari diminum di rumah<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 37.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l31 level1 lfo24; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DDS 100 mg/hari diminum di rumah<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengobatan 24 dosis diselesaikan dalam wktu maksimal 36 bulan. Sesudah selesai minum 24 dosis dinyatakan RFT (Released From Treatment = berhenti minum obat kusta) meskipun secara klinis lesinya masih aktif dan pemeriksaan bakteti positif. Menurut WHO (1998) pengobatan MB diberikan untuk dosis yang diselesaikan dalam 12-18 bulan dan pasien langsung dinyatakan RFT.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo33; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dosis untuk anak</span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify; text-indent: 14.2pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klofazimin : umur di bawah 10 tahun : bulanan 100 mg/bulan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Harian 50 mg/2 kali/minggu<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Umur 11-14 tahun bulanan 100 mg/bulan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Harian 50 mg/3 kali/minggu<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> DDS : 1-2 mg/jkg berat badan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Rifampisin : 10-15 mg/kg berat badan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo33; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengobatan MDT terbaru <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify; text-indent: 14.2pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Metode ROM adalah pengobatan MDT terbaru. Menurut WHO (1998), pasien kusta tipe Pause Basiler dengan lesi hanya satu cukup diberikan dosis tunggal rifampisin 600 mg, ofloksasin 400 mg, dan minosiklin 100 mg dan pasien langsung dinyatakan RFT, sedangkan untuk tipe Pause Basiler dengan lesi 2-5 lesi diberikan 6 dosis dalam 6 bulan. Untuk tipe Multi Basiler diberikan sebagai obat alternative dan dianjurkan digunakan sebanyak 24 dosis dalam 24 bulan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo33; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Putus Obat</span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify; text-indent: 14.2pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pada pasien kusta tipe Pause Basiler yang tidak minum obat sebanyak 4 dosis dari yang seharusnya maka dinyatakan DO, sedangkan pasien kusta tipe Multi Basiler dinyatakan DO bila tidak minum obat 12 dosis dari yang seharusnya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo40; text-align: justify; text-indent: -21.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">I.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Indikasi Rujukan</span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memastikan diagnosis penyakit kusta <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Neuritis akut dan subakut<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Reaksi reversal berat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Reaksi ENL berat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Komplikasi pada mata<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Reaksi terhadap antikusta<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tersangka resisten terhadap antikusta<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">h.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasien cacat yang memerlukan rehabilitasi medic<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">i.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasien dengan keadaan umum buruk atau darurat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">j.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasien kusta yang membutuhkan latihan fisioterapi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">k.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasien kusta yang membutuhkan terapi okupasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">l.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Luka lebar dan dalam pada anggota gerak<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">m.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasien kusta yang menbutuhkan tindakan bedah septic<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">n.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasien yang memerlukan protese<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo27; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">o.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Indikasi social<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level4 lfo34; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">J.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">KOMPLIKASI<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Cacat merupakan komplikasi yang dapat terjadi pada pasien kusta baik akibat kerusakan fungsi saraf tepi maupun neuritis sewaktu terjadi reaksi kusta.<o:p></o:p></span></div><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 115%;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span> <br />
<div class="MsoNormal"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level4 lfo34; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">K.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PENATALAKSANAAN MEDIS<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l4 level1 lfo12; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Prinsip pengobatan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l49 level1 lfo13; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemberiaan obat antireaksi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Obat yang dapat digunakan adalah aspirin, klorukuin, prednisolon sebagai anti inflamasi. Dosis obat yang digunakan sebagai berikut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 74.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo14; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Aspirin 600-1200 mg yang diberikan tiap 4 jam, 4-6 kali sehari<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 74.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo14; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klorukuin 3 x 150 mg/hari<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 74.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo14; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Prednisone 30-80 mg/hari, dosis tunggal pada pagi hari sesudah makan atau dapat juga diberikan secara dosis terbagi misalnya: 4 x 2 tablet/hari, berangsur-angsur diturunkan 5-10 mg/2 minggu setelah terjadi respons maksimal. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 15.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Untuk melepaskan ketergantungan pada kortikosteroid pada reaksi tipe II digunakan talidomid. Dosis talidomoid 400 mg/hari yang berangsur-angsur diturunkan sampai 50 mg/hari. Tidak dianjurkan untuk wanita usia subur karena talidomoid bersifat teratogenik.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: .25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Setiap 2 minggu pasien harus diperiksa ulang untuk melihat keadaan klinis. Bila tidak ada perbaikan maka dosis prednisone yang diberikan dapat dilanjutkan 3-4 minggu atau dapat ditingkatkan (misalnya dari 15 mg jadi 20 mg sehari). Setelah ada perbvaikan dosis diturunkan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: .25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Untuk mencegah ketergantungan terhadap steroid, dapat diberikan klofazimin. Klofazimin hanya diberikan pada reaksi tipe II (ENL kronis). Dosis klofazimin ditinggikan dari dosis pengobatan kusta. Untuk orang dewasa 3 x 100 mg/hari selama 1 bulan. Bila reaksi sudah berkurang maka dosis klofazimin itu diturunkan menjadi 2 x 100 mg/ hari, selama 1 bulan diturunkan lagi menjadi 1 x 100 mg/hari selama 1 bulan. Setelah reaksi hilang pengobatan kembali ke dosis semula, yaitu 50 mg/hari.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l49 level1 lfo13; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Istirahat/imobilisasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l49 level1 lfo13; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemberian analgetik dan sedative.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 15.3pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Obat yang digunakan sebagai analgetik adalah aspirin, parasetamol, dan antimony. Aspirin masih merupakan obat yang terbaik dan termurah untuk mengatasi nyeri (aspirin digunakan sebagai antiinflamasi dan analgetik). Menurut WHO (1998), parastamo juga dapay digunakan sebagai analgetik. Sedangkan antimony yang digunakan pada reaksi tipe II ringan untuk mengatasi rasa nyeri sendi dan tulang kini jarang dipakai karena kurang efektif dan toksik. Dosis obat yang digunakan sebagai berikut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 74.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l54 level1 lfo15; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Aspirin 600-1200 mg yang diberikan tiap 4 jam, 4-6 kali sehari.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 74.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l54 level1 lfo15; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Parasetamol 300-1000 mg yang diberikan 4-6 kali sehari (dewasa).<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 74.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l54 level1 lfo15; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Antimony 2-3 ml diberikan secara selang-seling, maksimum 30 ml.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -18.55pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d. Obat-obatan kusta diteruskan dengan dosis tidak diubah.untuk semua tipe reaksi, bila tidak ada kontraindikasi, semua obat antikusta dosis penuh harus tretap diberikan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l4 level1 lfo12; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengobatan reaksi ringan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l55 level1 lfo16; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemberian obat antireaksi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Aspirin dan talidomid biasa digunakan untuk reaksi ringan. Bila dianggap perlu dapat diberikan klorokuin selama 3-5 hari.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l55 level1 lfo16; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Istirahat/imobilisasi <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berobat jalan dan istirahat di rumah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l55 level1 lfo16; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemberian analgetik dan sedative<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemberian analgetik dan obat penenang bila perlu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l55 level1 lfo16; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Obat-obat kusta diteruskan dengan dosis tidak diubah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l4 level1 lfo12; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengobatan reaksi berat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo17; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemberian obat antireaksi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pada reaksi berat diberikan prednisone dalam dosis tunggal atau terbagi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo17; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Istirahat/imobilisasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Imobilisasi local pada anggota tubuh yang mengalami neuritis. Bila memungkinkan pasien dirawat inap di rumah sakit.]<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo17; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemberian analgetik dan sedative<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo17; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Obat-obat kusta diteruskan dengan dosis tidak diubah.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rehabilitasi </span></b><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: 28.35pt; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Usaha-usaha rehabilisasi meliputi medis, okupasi, kejiwaan, dan social. Usaha medis yang dapat dilakukan untuk cacat tubuh antara lain operasi dan fisioterapi. Terapi kejiwaan berupa bimbingan mental diupayakan sedini mungkin pada setiap pasien, keluarga, dan masyarakat sekitarnya untuk memberikan dorongan dan semangat agar dapat menerima kenyataan dan menjalani pengobatan dengan teratur dan benar sampai dinyatakan sembuh secara medis. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: 28.35pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rehabilitasi social bertujuan memulihkan fungsi social ekonomi pasien sehingga menunjang kemandiriannya dengan memberikan bimbingan social dan peralatan kerja, serta membantu pemasaran hasil usaha pasien. <o:p></o:p></span></div><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span> <br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">ASUHAN KEPERAWATAN<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">A.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengkajian <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji biodata pasien untuk melengkapi rekamedis pasien dan untuk memudahkan dalam melakukan asuhan keperawatan. Usia dan jenis kelamin merupakan data dasar yang penting. Tempat tinggal pasien sangat penting karena kusta paling sering terjadi daerah dengan tingkat sosial-ekonomi yang rendah dan insidennya meningkat pada daerah tropis / sub tropis. Kaji pula secara lengkap jenis pekerjaan klien untuk mengetahui tingkat sosial – ekonomi, resiko trauma pekerjaan, dan kemungkinan kontak dengan penderita kusta.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Keluhan utama. Pasien sering datang ke tempat pelayanan kesehatan dengan keluhan adanya bercak putih yang tidak terasa, atau datang dengan keluhan kontraktur pada jari – jari<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Riwayat penyakit sekarang. Pada saat melakukan anamnesis pada pasien, kaji kapan timbulnya, dan bagaimana proses perubahannya, baik warna kulit maupun keluhan lainnya. Pada beberapa kasus ditemukan keluhan lainnya gatal, nyeri, panas, atau rasa tebal. Kaji juga apakah klien pernah mengalami pemeriksaan laboratorium. Ini penting untuk mengetahui apakah klien pernah mengalami penyakit tertentu sebelumnya. Pernahkah klien memakai obat kulit yang dioles atau diminum? Pada beberapa kasus, reaksi obat juga dapat menimbulkan perubahan warna kulit dan reaksi alergi yang lain. Perlu juga ditanyakan apakah keluhan ini pertama kali dirasakan. Jika sudah pernah obat apa yang pernah diminum? Teratur atau tidak?<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Riwayat penyakit dahulu. Salah satufaktor penyebabpenyakit kusta adalah daya tahan tubuh yang menurun. Akibatny M leprae dapat masuk kedalam tubuh. Oleh karena itu perlu dikaji adakah riwayat penyakit kronis atau penyakit lain .<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Riwayat penyakit keluarga. Penyakit kusta bukan penyakit turunan, tetapi jika anggota keluarga atau tetangga menderita penyakit kusta. Resiko tinggi kkusta bisa terjadi. Kaji juga apakah ada anggota keluarga lain yang menderita keluhan yang sama? Baik yang masih hidup atau yang sudah meninggal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Riwayat psikososial, kusta terkenal sebagai penyakit yang menakutkan dan menjijikan. Ini disebabkan adanya deformitas atau kecacatan yang ditimbulkan. Oleh karena itu perlu dikaji juga konsep diri serta respon masyarakat terhadap klien.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kebiasaan sehari hari. Pada saat melakukan anamnesis tentang pola kebiasaan sehari hari.perawat perlu mengkaji status gizi pola makan / nutrisi klien karena mempengaruhi sistem imun. Jika sudah ada deformitas atau kecacatan, maka aktivitas akan terganggu. Kaji juga terhadap adanya dampak anstesi/<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">8.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan fisik, harus diperiksa kelenjar regional karena dapat ditemukannya pembesaran dari beberapa limfe. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Inspeksi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji adanya ruam, hipo pigmentasi atau hiprpigmentasi sert eritematosa.dengan permukaan yang kasar atau licin dengan batas yang kurang jelas. Pada tipe tuberkuloid dapat ditemukan gangguan saraf kulit. Yang disrtai dengan penebalan syaraf, adanya nyeri tekan akibat adanya jarinagn fibrosa, anhidrisi, dan kerontokan rambut.pada tipe lepromatus , dijumpai hidung pelana dan wajah singa.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selain itu kaji juga adanya kelainan otot berupa artrofi disuse otot yang ditandai dengan kelumpuhan otot otot.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diikutui adanya kekakuan sendi atau kontraktur sehingga terjadi clow hand, drop foot, dan drop hand. Kaji juga adanya osteomilitis serta pemendekan kerusakan tulang. Kaji pula kelainan mata akibat kelumpuhan. Inspeksi mata kering kereatitis ulkus kornea iritis iridoksiklitik dan berakhir dengan kebutaan. Kaji adanya ginekomastia. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Palpasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Temukan adanya penebalan serabut syaraf, makula anastetika, pada tipe T, dan makula non anastetika pada tipe L. Serta permukaan yang kering dan kasar. Lakukan pemeriksaan sederhana, untuk menunjang kepastian diagnosis penyakit kusta serta untuk mengetahui adanyaanastesia pada lesi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l17 level1 lfo5; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Uji kulit. Uji ini paling sering dilakukan dan cara mudahnya sehingga semua petugas dapat melakukannya, penggunaan jarum untuk untuk mengetahui adanya asa sakitdilakukan dengan meminta pasien menyebutkan area yang lbih terasa nyeri. Serta kaji adanya rasa pada kulit dengan adanya rasa jika disentuh kapas atau bulu ayam. Jika tidak bisa, gunakan juga reaksi suhu, <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l17 level1 lfo5; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Uji keringat, biasanya akan ditemukan anhidrosis karena rusaknya kelenjar keringat, uji ini dilakukan dengan menggores lesi dengan pinsil tinta mulai dari beberapa cm dari arah dalam keluar. Hasilnya akan terjadi perubahan warna ungu sedangkan di area lesi tidak.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l17 level1 lfo5; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Uji lepromin, untuk menentukan diagnosis dan klasifikasi penyakit kusta. Tipe 1,T dan BT: uji lepromin positif. Tipe BB, BL, LL: uji lepromin negatif.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosis dan intervensi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosis keperawatan yang mungkin mungkin muncul adalah:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan citra tubuh bd lesi pada kulit, perubahn bentuk wajah, kerontokan rambut.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Resiko cedera bd anastesia atau hilang rasa akibat neuritis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penatalaksanaan program terapetik: ketidak efektifan bd rumitnya program pengobatan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan persepsi pengelihatan bd dengan kelumpuhan m orbicularis,<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan peran bd terbatasnya aktivitas sebagai dampak dari mutilasi ansorpsi tulang dan otot.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">B.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa Medis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 53.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo41; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Resiko cedera b.d anestesi atau hilang rasa sakit akibat neuritis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 53.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo41; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kerusakan intergritas kulit b.d adanya lesi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 53.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo41; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan gangguan persepsi visual b.d penurunan penglihatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 53.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo41; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Isolasi sosial b.d perubahan bentuk tubuh<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 53.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo41; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan aktivitas b.d kelumpuhan otot<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 53.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo41; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan konsep diri b.d perubahan penampilan fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 53.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DK : Resiko cedera berhubungan dengan anestesi atau hilang rasa akibat neuritis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hasil yang diharapkan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l46 level1 lfo2; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dapat menidentifikasi faktor faktor yang dapat meningkatkan resiko cedcera pada dirinya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l46 level1 lfo2; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dapat menjelaskan tujuan tindakan keamanan untuk mencegah cedera.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rencana keperawatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l57 level1 lfo6; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Beri penjelasan pada klien dan keluarga tentang tentang penyebab ansietas atau hilang rasa serta akibat yang ditimbulkan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l57 level1 lfo6; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji faktor penyebab atau pendukung terjadinya cedera.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l57 level1 lfo6; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kurangi atau hilangkan faktor penyebab jika mungkin.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l57 level1 lfo6; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ajari cara pencegahan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo7; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gunakan selalu alas kaki.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo7; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jika merokok, gunakan pipa rokok dan jangan merokok sambil tiduran<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo7; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji suhu air mandi.jika menggunakan air hangat gunakan termometer mandi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo7; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gunakan pelindung tangan saat mengangkat kompor,.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo7; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jangan gunakan baju panjang ketika sedang memasak.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo7; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hati hati dan waspada selau jika beraktifitas di dapur.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l57 level1 lfo6; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diskusikan dengan keluarga tentang cara pencegahan di rumah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DK penatalaksanaan aturan terapetik: ketidak efektifan bd rumitnya program pengobatan,<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hasil yang diharapkan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo8; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dan keluarga menyatakan pemahaman tentang perilaku sehat yang diperlukan untuk mempercepat proses penyembuhannya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo8; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien atau keluarga dapat menjelaskan proses terjadinya penyakit.penyebab, faktor penyebab, serta pendukungnya,juga aturan dalam pengobatannya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rencana keperawatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.5in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo9; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Courier New'; font-size: 12pt; line-height: 150%;"><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Identifikasi faktor penyebab ketidak efektifan penatalaksanaan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo10; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kurang percaya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo10; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kurang pengetahuan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo10; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kurangnya sumber – sumber pendukung<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.5in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo9; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Courier New'; font-size: 12pt; line-height: 150%;"><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bina hubungan saling percaya dengan klien dan keluarga.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.5in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo9; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Courier New'; font-size: 12pt; line-height: 150%;"><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jelaskan tentang penyakit proses penyakit dan resiko yang terjadi jika tidak diobati<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.5in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo9; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: 'Courier New'; font-size: 12pt; line-height: 150%;"><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Beri penyuluhan tentamng perawatan tentang penderira kusta tentang penyakit, sebelum pengobatan selam pengobatan, setelah pengobatan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo11; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perlunya pengobatan yang teratur,.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo11; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Cara makan obat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo11; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lam pengobatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo11; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hal hal yang timbul sama pengobatan seperti efek sampin dan reaksi yang ditimbulkan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo11; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Program tindak lanjut setelah RFT<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo11; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perawatan luka dirumah<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo11; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan gaya hidup <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo11; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pentingnya nutrisi.<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 90.45pt;" valign="top" width="121"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa <o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 85.05pt;" valign="top" width="113"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kriteria Hasil<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 148.85pt;" valign="top" width="198"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 137.75pt;" valign="top" width="184"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">R</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">asional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-bottom: solid black 1.0pt; border-left: solid black 1.0pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 90.45pt;" valign="top" width="121"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kerusakan intergritas kulit b.d adanya lesi<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 85.05pt;" valign="top" width="113"><div align="left" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: left;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lesi tidak menyebar<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: left;"><br />
</div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: left;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasien merasa nyaman<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 148.85pt;" valign="top" width="198"><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji/catat ukuran warna, kedalaman luka, perhatikan jaringan nekrotik dan kondisi sekitar luka.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">berikan perawatan luka yang tepat dan tindakan control infeksi.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: left;"><br />
</div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: left;"><br />
</div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">evaluasi warna sisi luka perhatikan ada atau tidak adanya penyembuhan.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: left;"><br />
</div><div align="left" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">lakukan advis dokter untuk memberikan obat sesuai dosis.<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">lakukan kolaborasi dengan ahli gizi untuk pemberian nitrisi TKTP.<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">ajarkan pasien dan keluarga mengenai perawatan luka. serta cara mencegah penularan.<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 137.75pt;" valign="top" width="184"><div align="left" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">memberikan informasi dasar tentang kebutuhan penanaman kulit dan kemungkinan petunjuk tentang sirkulasi pada area graft.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">menyiapkan jaringan untuk penanaman dan menurunkan resiko infeksi.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: left;"><br />
</div><div align="left" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">mengevaluasi keefektifan sirkulasi dan mengidentifikasi terjadinya komplikasi.<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">terapi dibutuhkan pasien dalam proses penyembuhan.<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">diet TKTP dapat membantu dalam proses pembentukan jaringan dan sel baru.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo56; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">membantu mempermudah serta mengarahkan keluarga dan pasien dalam perawatan luka, juga dalam mencegah terjadinya penularan ke jaringan lain atau pada keluraga.<o:p></o:p></span></div></td> </tr>
</tbody></table><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span> <br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><table align="left" border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-anchor-horizontal: margin; mso-table-anchor-vertical: margin; mso-table-left: left; mso-table-lspace: 9.0pt; mso-table-rspace: 9.0pt; mso-table-top: -13.5pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 25.5pt;" valign="top" width="34"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><b><span style="color: white; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">No<o:p></o:p></span></b></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 93.45pt;" valign="top" width="125"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa Keperawatan<o:p></o:p></span></b></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 120.9pt;" valign="top" width="161"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kriteria Hasil<o:p></o:p></span></b></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 99.2pt;" valign="top" width="132"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi<o:p></o:p></span></b></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 123.05pt;" valign="top" width="164"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rasional<o:p></o:p></span></b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 25.5pt;" valign="top" width="34"><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><b><span style="color: white; font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1<o:p></o:p></span></b></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 93.45pt;" valign="top" width="125"><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan sensori</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> </span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">perceptual : penglihatan b/d hilangnya reflex berkedip<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 120.9pt;" valign="top" width="161"><div align="left" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l26 level1 lfo58; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien berpartisipasi dalam program pengobatan<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l26 level1 lfo58; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mempertahankan penglihatan tanpa kehilangan leih lanjut.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l26 level1 lfo58; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien bisa mengenal gangguan sensori dan berkompensasi terhadap perubahan<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l26 level1 lfo58; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien bisa mengidentifikasi /memperbaiki potensial bahaya dalam lingkingan<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 99.2pt;" valign="top" width="132"><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tentukan ketajaman penglihatan, catat apakah satu atau kedua mata terlibat<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pastikan drajat/tipe kehilangan penglihatan klien<o:p></o:p></span></div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dorong klien untuk mengekspresikan perasaan tentang kehilangan/ kemungkinan kehilangan penglihatan<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tunjukan cara pemberian tetes mata, contoh menghitung tetesan, mengikuti jadwal.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Orientasikan pasien terhadap lingkungan, staf, orang lain diareanya. <o:p></o:p></span></div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Observasi tanda-tanda dan gejala-gejala disorientasi : pertahankan pagar tempat tidur.<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Letakan barang yang dibutuhkan/posisi bel pemanggil dalam jangkauan <o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan obat sesuai indikasi<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 123.05pt;" valign="top" width="164"><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kebutuhan individu dan pilihan intervensi bervariasi . bila bilateral, tiap mata dapat berlanjut pada laju yang berbeda. <o:p></o:p></span></div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mempengaruhi harapan masa depan pasien dan pilihan intervensi<o:p></o:p></span></div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sementara intervensi dini mencegah kebutaan, pasien menghadapi kemungkinan atau mengalami pengalaman kehilangan penglihatan sebagian atau total. Meskipun kehilangan pengelihatan telah terjadi tak dapat di perbaiki (meskipun dengan pengobatan), kehilangan lanjut dapat dicegah<o:p></o:p></span></div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah kehilangan penglihatan lebih lanjut.<o:p></o:p></span></div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memberi peningkatan kenyamanan dan kekeluargaan, menurunkan cemas.<o:p></o:p></span></div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Terbangun dalam lingkungan yang tak dikenal dan mengalami keterbatasan penglihatan dapat mengakibatkan bingung. Menurnkan resiko jatuh pada saat terbangun.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memungkinkan pasien menggapai objek yang lebih mudah dan memudahkan panggilan untuk pertolongan bila diperlukan<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: -13.5pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l16 level1 lfo47; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Untuk membantu/mencegah ke keadaan kehilangan penglihatan lebih lanjut. <o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; width: 631px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 83.4pt;" valign="top" width="111"><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;">Diagnosa Keperawatan<o:p></o:p></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 127.55pt;" valign="top" width="170"><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;">Kriteria Hasil<o:p></o:p></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 155.95pt;" valign="top" width="208"><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;">Intervensi<o:p></o:p></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 106.3pt;" valign="top" width="142"><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;">Rasional<o:p></o:p></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 83.4pt;" valign="top" width="111"><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Isolasi sosial b.d perubahan bentuk tubuh<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 127.55pt;" valign="top" width="170"><div align="left" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 10.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo42; text-align: left; text-indent: -14.15pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menunjukkan peningkatan perasaan harga diri<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 12.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo42; text-align: left; text-indent: -16.3pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berpartisipasi dalam aktivitas/progam pada tingkat kemampuan <o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 155.95pt;" valign="top" width="208"><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.95pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l37 level1 lfo43; text-align: left; text-indent: -16.95pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tentukan presepsi pasien tentang situasi<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l37 level1 lfo43; text-align: left; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan waktu untuk berbicara dengan pasien selama dan diantara aktivitas perawatan. Tetap memberi dukungan, mengusahakan verbalisasi. Perlakukan dengan penuh penghargaan dan menghormati perasan pasien.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 46.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: left;"><br />
</div><div align="left" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l37 level1 lfo43; text-align: left; text-indent: -17.1pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Batasi atau hindari penggunaan master, baju dan sarung tangan jika memungkinkan, misalnya jika berbicara dengan pasien<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4. Identifikasi sistem pendukung yang tersedia bagi pasien, termasuk adanya/hubungan dengan keluarga kecil dan besar<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.Dorong kunjungan terbuka, hubungan telepon dan aktivitas sosial dalam tingkat yang memungkinkan<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;">6.<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dorong adanya hubungan yang aktif dengan orang terdekat<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.Kembangkan perencanaan tindakan dengan pasien<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: left; text-indent: -7.1pt;">8.<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Rujuk pada sumber – sumber pelayanan sosial, konselor dan organisasi <o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 106.3pt;" valign="top" width="142"><div align="left" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: left; text-indent: -.8pt;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Isolasi sebagian dapat mempengaruhi diri saat pasien takut penolakan atau reaksi orang lain<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: left; text-indent: -.8pt;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasien mungkin akan mengalami isolasi fisik<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengurangi perasaan pasien akan isolasi fisik dan menciptakan hubungan sosial yang positif, yang dapat meningkatkan rasa percaya diri<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jika pasien mendapatkan bantuan dari orang terdekat, perasaan kesepian dan ditolak akan berkurang<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Partisipasi orang lain dapat meningkatkan rasa kebersamaan<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Membantu memantapkan partisipasi pada hubungan sosial. Dapat mengurangi kemungkinan upaya bunuh diri<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: left;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memiliki rencana yang dapat meningkatkan kontrol terhadap kehidupan sendiri dan beri pasien sesuatu untuk memandang kedepan/melakukan penyelesain.<o:p></o:p></span></div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">8.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Adanya sistem pendukung yang dapat mengurangi perasaan terisolasi <o:p></o:p></span></div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 42.55pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: left; text-indent: -14.2pt;"><br />
</div><div align="left" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: left;"><br />
</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span> <br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 78.9pt;" valign="top" width="105"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa <o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 98.8pt;" valign="top" width="132"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kriteria Hasil<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 132.85pt;" valign="top" width="177"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">intervensi<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 146.15pt;" valign="top" width="195"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rasional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 78.9pt;" valign="top" width="105"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan aktivitas b.d kelumpuhan otot</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 98.8pt;" valign="top" width="132"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">m</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">emepertahankan dan bila mungkin meningkatkan kekuatan dan ketahanan pada ekstremitas.</span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 132.85pt;" valign="top" width="177"><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pantau TTV klien<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div align="left" class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lakukan latihan rentang gerak secara konsisten, diawali denagn pasif kemudian aktif.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div align="left" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jadwalkan penobatan dan aktivitas perawtan untuk memberikan periode istirahat tak terganggu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Instruksikan dan bantu dalam mobilitas, contoh tongkat, walker, secara tepat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: left;"><br />
</div><div align="left" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dorong dukungan dan bantuan keluarga/orang terdekat pada latihan tentang gerak.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div align="left" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dorong partisipasi pasien dalam semua aktivitas sesuai dengan kemampuan individual.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 146.15pt;" valign="top" width="195"><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Toleransi terhadap peningkatan aktivitas tergantung pada kemammpuan klien untuk beradaptasi pada kebutuhan fisiologis dari peningkatan aktivitas.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Adaptasi memerlukan fungsi kardiovaskular, neurologis dan muskuloskleal optimal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div align="left" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meningkatkan pemeliharaan fungsi otot/sendi dan menurunkan kehilangan kalsium dari tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meningkatkan toleransi pasien terhadap aktivitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meningkatkan keamanan ambulasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div align="left" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l33 level1 lfo59; text-align: left; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memampukan keluarga/orang terdekat untuk aktif dalam perawatan pasien dan memberikan terapi lebih konstan/konsisten.<o:p></o:p></span></div><div align="left" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: left;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">meningkatkan kemandirian, meningkatkan harga diri, dan membantu proses perbaikan.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid black .5pt; mso-border-insideh: .5pt solid black; mso-border-insidev: .5pt solid black; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 119.7pt;" valign="top" width="160"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa Keperawatan<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 119.7pt;" valign="top" width="160"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kriteria yang diharapkan<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 119.7pt;" valign="top" width="160"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi Keperawatan<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 119.7pt;" valign="top" width="160"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rasional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 119.7pt;" valign="top" width="160"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan konsep diri B.d perubahan penampilan fisik<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 119.7pt;" valign="top" width="160"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .15in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -.15in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien mengatakan dan menunjukan peneimaan atas penampilanNya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .15in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -.15in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menunjukan keinginan dan kemampuan untuk melakukan perawatan diri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .15in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -.15in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dapat mengidentifikasi aspek positif diri<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .15in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-align: justify; text-indent: -.15in;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien menilai keadaan dirinya terhadap hal-hal yang realistic tanpa menyimpang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 119.7pt;" valign="top" width="160"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bina hubungan saling percaya antara perawat-klien.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dorong klien untuk mengajukan pertanyaan mengenai masalah kesehatan, pengobatan, dan kemajuan pengobatan dan kemungkinan hasilnya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-align: justify; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dorong klien untuk menyatakan perasaannya, terutama tentang cara ia merasakan, berfikir dan memandang dirinya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-align: justify; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hindari mengkritik.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jaga privasi dan lingkungan individu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tingkatkan interaksi social klien.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan informasi yang dapat dipercaya dan kejelasan informasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-align: justify; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dorong klien dan keluarga untuk menerima keadaan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 119.7pt;" valign="top" width="160"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Untuk menjalin rasa percaya.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"><br />
</div><div class="MsoListParagraphCxSpFirst"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-align: justify; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Agar pasien merasa ada harapan yang kuat untuk sembuh.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-align: justify; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Supaya pasien tidak terbebani sendiri dengan keadaan yang dialaminya.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Agar pasien tidak minder sewaktu bersosialisasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-align: justify; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Agar pasien merasa nyaman.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Agar pasien merasa nyaman ketika berhubungan social dengan orang lain.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Agar klien mengerti tidakan untuk menanggulangi masalah kesehatanya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo48; text-indent: -9.0pt;"><span lang="IN" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Agar pasien merasa nyaman dan tidak terbebani karna masalah kesehatanya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 9.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
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</div><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 14pt; line-height: 115%;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span></b> <br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 14pt; line-height: 150%;">BAB III<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 150%;">KESIMPULAN DAN SARAN<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l47 level1 lfo60; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif;">A.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif;"> Kesimpulan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -22.5pt;"><span lang="IN" style="font-family: Arial, sans-serif;"> <span style="color: black;">Penyakit kusta ialah </span></span><span lang="IN" style="color: black;">sebuah </span><span lang="IN"><a href="http://id.wikipedia.org/wiki/Penyakit_infeksi" title="Penyakit infeksi"><span style="color: black; text-decoration: none;">penyakit infeksi</span></a><span style="color: black;"> </span><a href="http://id.wikipedia.org/wiki/Kronis" title="Kronis"><span style="color: black; text-decoration: none;">kronis</span></a><span style="color: black;"> yang disebabkan oleh </span><a href="http://id.wikipedia.org/wiki/Bakteri" title="Bakteri"><span style="color: black; text-decoration: none;">bakteri</span></a><span style="color: black;"> </span><a href="http://id.wikipedia.org/wiki/Mycobacterium_leprae" title="Mycobacterium leprae"><span style="color: black; text-decoration: none;">Mycobacterium leprae</span></a><span style="color: black;">. Penyakit ini adalah tipe penyakit </span><a href="http://id.wikipedia.org/wiki/Granulomatosa" title="Granulomatosa"><span style="color: black; text-decoration: none;">granulomatosa</span></a><span style="color: black;"> pada </span><a href="http://id.wikipedia.org/wiki/Saraf_tepi" title="Saraf tepi"><span style="color: black; text-decoration: none;">saraf tepi</span></a><span style="color: black;"> dan </span><a href="http://id.wikipedia.org/wiki/Mukosa" title="Mukosa"><span style="color: black; text-decoration: none;">mukosa</span></a><span style="color: black;"> dari </span><a href="http://id.wikipedia.org/wiki/Saluran_pernapasan_atas" title="Saluran pernapasan atas"><span style="color: black; text-decoration: none;">saluran pernapasan atas</span></a><span style="color: black;">, dan </span><a href="http://id.wikipedia.org/wiki/Lesi" title="Lesi"><span style="color: black; text-decoration: none;">lesi</span></a><span style="color: black;"> pada </span><a href="http://id.wikipedia.org/wiki/Kulit" title="Kulit"><span style="color: black; text-decoration: none;">kulit</span></a><span style="color: black;"> adalah tanda yang bisa diamati dari luar. Bila tidak ditangani, kusta dapat sangat progresif, menyebabkan kerusakan pada kulit, saraf-saraf, anggota gerak, dan </span><a href="http://id.wikipedia.org/wiki/Mata" title="Mata"><span style="color: black; text-decoration: none;">mata</span></a><span style="color: black;">. Tidak seperti </span><a href="http://id.wikipedia.org/wiki/Mitos" title="Mitos"><span style="color: black; text-decoration: none;">mitos</span></a><span style="color: black;"> yang beredar di masyarakat, kusta tidak menyebabkan pelepasan anggota tubuh yang begitu mudah.</span></span><span lang="IN" style="color: black; font-family: Arial, sans-serif;"><o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l47 level1 lfo60; text-align: justify; text-indent: -.25in;"><span lang="IN" style="color: black; font-family: Arial, sans-serif;">B.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="color: black; font-family: Arial, sans-serif;">Saran <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 13.5pt;"><span lang="IN" style="font-family: Arial, sans-serif;"> Penyusun menyadari bahwa masih terdapat banyak kesalahan dalam penyusunan makalah ini, oleh karena itu penyusun mengharapkan kritik dan saran dari pembaca demi penyempurnaan mkalah ini.</span></div><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span> <br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DAFTAR PUSTAKA<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 0in; mso-add-space: auto;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Djuanda, adhi. 2000. <i style="mso-bidi-font-style: normal;">Ilmu Penyakit Kulit dan Kelamin Cet. 2, Ed.3</i> . Jakarta : FKUI. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Price, Sylvia Anderson.2005. <i style="mso-bidi-font-style: normal;">Patofisiologis : Konsep Klinis Proses-Proses Penyakit.</i></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jakarta : EGC.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 0in; mso-add-space: auto;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Rahariyani, Loetfia Dwi. 2008. <i style="mso-bidi-font-style: normal;">Buku Ajar Asuhan Keperawatan Klien Dengan Gangguan Sistem Integumen Cet. 1.</i> Jakarta : EGC. <i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Syaifuddin. 2006. <i style="mso-bidi-font-style: normal;">Anatomi Fisiologi untuk Mahasiswa Keperawatan Edisi 3</i>. Jakarta : EGC.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><cite><span lang="IN" style="font-family: Calibri, sans-serif;">hidayat2.wordpress.com/2009/05/26/<b>askep</b>-<b>lepra </b>kuliah+<b>keperawatan</b>+kebidanan+<b>asuhan</b>+<b>keperawatan</b>+<b>lepra</b></span></cite><span class="f"><span lang="IN"> <i><o:p></o:p></i></span></span></div><div class="MsoNormal" style="line-height: 150%;"><cite><span lang="IN" style="font-family: Calibri, sans-serif;">ads.masbuchin.com/search/<b>askep</b>%20<b>lepra</b></span></cite><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div>Ian zkate pakpahanhttp://www.blogger.com/profile/10259135788220046244noreply@blogger.com2tag:blogger.com,1999:blog-2556652656898751244.post-88522201712518439732010-10-17T12:21:00.001+07:002010-10-17T20:38:08.358+07:00ASKEP HERPES DAN TINEA<div align="center" class="MsoNormal" style="text-align: center;"><span style="font-size: 24pt; line-height: 115%;">ASKEP HERPES DAN TINEA<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 115%;">MAKALAH<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 115%;"><br />
</span></b></div><div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 115%;"></span></b></div><b style="mso-bidi-font-weight: normal;"></b><br />
<b style="mso-bidi-font-weight: normal;"><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font-size: medium; font-weight: normal; line-height: normal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; text-align: center;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 14px;">disusun untuk memenuhi tugas mata ajaran Keperawatan Medikal Bedah III<o:p></o:p></span></div><div><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 14px;"><br />
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</span></b></div><div align="center" class="MsoNormal" style="text-align: center;"><v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas> <v:path gradientshapeok="t" o:connecttype="rect" o:extrusionok="f"> <o:lock aspectratio="t" v:ext="edit"> </o:lock></v:path></v:stroke></v:shapetype><v:shape id="Picture_x0020_1" o:spid="_x0000_s1026" style="height: 207.75pt; left: 0; margin-left: 92.7pt; margin-top: 33.45pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.5pt; z-index: 1;" type="#_x0000_t75"> <v:imagedata o:title="Logo STIKes ku Don't open,please call me again" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image002.jpg"> <w:wrap type="square"> </w:wrap></v:imagedata></v:shape><v:shape id="Picture_x0020_1" o:spid="_x0000_s1026" style="height: 207.75pt; left: 0; margin-left: 92.7pt; margin-top: 33.45pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.5pt; z-index: 1;" type="#_x0000_t75"><br />
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</v:shape></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhV4QL2pIY2UHBSEAZr4vU8Dfk4UKWza9n6rLPNyxNfRol7yf8l8ZqhyopbCI2QdV7GEn04M6dnOMNhUJbkCPwKRKgWuHCmpuXXT1YTfvDeU2bo2kDuubtgpYmoRkK6PjNgXL72FFjAtGY/s1600/DAH+AH+CAPE.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhV4QL2pIY2UHBSEAZr4vU8Dfk4UKWza9n6rLPNyxNfRol7yf8l8ZqhyopbCI2QdV7GEn04M6dnOMNhUJbkCPwKRKgWuHCmpuXXT1YTfvDeU2bo2kDuubtgpYmoRkK6PjNgXL72FFjAtGY/s320/DAH+AH+CAPE.jpg" width="320" /></a></div><br />
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</div><div align="center" class="MsoNormal" style="line-height: normal; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;"><o:p> </o:p></span><span class="Apple-style-span" style="font-family: Arial, sans-serif; font-size: 13px; line-height: 14px;">oleh :</span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14pt; line-height: 115%;"><o:p> KELAS SANTA TERESA</o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
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</div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14pt; line-height: 115%;">PROGRAM STUDI D III KEPERAWATAN<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14pt; line-height: 115%;">Sekolah tinggi ilmu kesehatan santo borromeus<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14pt; line-height: 115%;">bandung<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 14pt; line-height: 150%;">BAB I<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 14pt; line-height: 150%;">PENDAHULUAN<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l54 level1 lfo1; text-indent: -21.8pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">A.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Latar Belakang<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: 27.8pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kulit adalah organ yang sangat penting untuk mengetahui tingkat kesehatan seseorang. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kecantikan seseorang secara fisik dapat dilihat dari kesehatan kulitnya. Kulit yang sehat mencerminkan kebersihan, status gizi, status emosi/psikologis, juga kepribadian seseorang. Oleh karena itu, kesehatan kulit/integumen perlu mendapat perhatian yang cukup besar.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: 27.8pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Apabila kulit mengalami kelainan atau gangguan akan membawa dampak baik fisik maupun psikologis pada penderita. Oleh karena itu, pemberian asuhan keperawatan yang tepat sangat diperlukan. Dalam makalah ini kami akan memaparkan beberapa contoh kelainan kulit yaitu Herpes dan Tinea serta bagaimana penatalaksanaan kita sebagai perawat dalam merawat pasien dengan kelainan kulit tersebut.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: 27.8pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l54 level1 lfo1; text-indent: -21.8pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">B.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tujuan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo4; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tujuan Umum<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Agar mahasiswa-mahasiswi STIKes St. Borromeus memahami asuhan keperawatan pada klien dengan herpes dan tinea.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo4; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tujuan Khusus<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 58.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-indent: 28.35pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Agar mahasiswa-mahasiswi STIKes St. Borromeus mengerti, mengetahui, dan memahami isi tentang:</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l56 level1 lfo63; text-indent: -21.3pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Anatomi fisiologi kulit<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l56 level1 lfo63; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Asuhan keperawatan pada klien dengan herpes simpleks<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l56 level1 lfo63; text-indent: -21.3pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Asuhan keperawatan pada klien dengan herpes zoster<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l56 level1 lfo63; text-indent: -21.3pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Asuhan keperawatan pada klien dengan tinea<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p> </o:p></span><span class="Apple-style-span" style="font-family: Arial, sans-serif; font-size: 13px; line-height: 19px;"> </span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l54 level1 lfo1; text-indent: -21.8pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">C.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Metode Penulisan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: .5in;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Adapun metode penulisan yang kami gunakan dalam penyusunan makalah ini yakni melalui studi literature, browsing internet, dan diskusi kelompok.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l54 level1 lfo1; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">D.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Sistematika Penulisan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Makalah ini disusun dengan sistematika sebagai berikut : BAB I PENDAHULUAN meliputi latar belakang, tujuan, metode penulisan dan sistematika penulisan. BAB II TINJAUAN TEORITIS meliputi Anatomi Fisiologi Kulit, A</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">s</span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">uhan Keperawatan pada Klien dengan Herpes, Asuhan keperawatan pada klien dengan Tinea. BAB III PENUTUP meliputi simpulan dan saran.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p> </o:p></span><span class="Apple-style-span" style="font-family: Arial, sans-serif; font-size: 13px; line-height: 19px;"> </span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 14pt; line-height: 150%;">BAB II<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 14pt; line-height: 150%;">TINJAUAN TEORETIS<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l39 level1 lfo3; text-indent: -21.8pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">A.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">ANATOMI FISIOLOGI KULIT<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 21.25pt;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kulit merupakan pembungkus yang elastik yang melindungi tubuh dari pengaruh lingkungan. Kulit juga merupakan alat tubuh yang terberat dan terluas ukurunya, yaitu 15 persen dari berat tubuh dan luasnya 1,50-1,75m². </span><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Rata-rata tebal kulit 1-2 mm. Paling tebal (6mm) terdapat di telapak tangan dan kaki dan yang paling tipis (0,5 mm) terdapat di penis.<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: center; text-autospace: none; text-indent: .25in;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><v:shape alt="http://www.virtualmedicalcentre.com/uploads/VMC/DiseaseImages/767_skin_section.jpg" id="Picture_x0020_1" o:spid="_x0000_i1034" style="height: 208.5pt; mso-wrap-style: square; visibility: visible; width: 273.75pt;" type="#_x0000_t75"> <v:imagedata o:title="767_skin_section" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image003.jpg"> </v:imagedata></v:shape></span><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: center; text-autospace: none;"><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Gambar struktur anatomi kulit<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-autospace: none;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><b><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bagian-bagian Kulit Manusia<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kulit terbagi atas tiga lapisan pokok, yaitu epidermis, dermis atau korium, dan jaringan subkutan atau</span><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">subkutis.</span><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l47 level1 lfo71; text-align: justify; text-autospace: none; text-indent: -21.25pt;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Epidermis</span></i><i style="mso-bidi-font-style: normal;"><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></i></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Epidermis terbagi atas empat lapisan.:</span><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.05pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -28.35pt;"><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.</span><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Lapisan basal atau stratum germinativium.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.05pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -28.35pt;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2. Lapisan malpighi atau stratum spinosum.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.05pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -28.35pt;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3. Lapisan granular atau stratum granulosum.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.05pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: -28.35pt;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">4. Lapisan tanduk atau stratum korneum.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Epidermis mengandung juga : Kelenjar ekrin, kelenjar apokrin, kelenjar sebaseus, rambut dan kuku. Kelenjar keringat ada dua jenis, ekrin dan apokrin. Fungsinya mengatur suhu, menyebabkan panas dilepaskan dengan cara penguapan. Kelanjar ekrin terdapat disemua daerah kulit, tetapi tidak terdapat di selaput lendir. Seluruhnya berjumlah antara 2 sampai 5 juta yang terbanyak ditelapak tangan. Sektretnya cairan jernih kira-kira 99 persen mengandung klorida,asam laktat,nitrogen dan zat lain. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kelenjar apokrin adalah kelenjar keringat besar yang bermuara ke folikel rambut, terdapat di ketiak, daerah anogenital, putting susu dan areola. Kelenjar sebaseus terdapat diseluruh tubuh, kecuali di tapak tangan, tapak kaki dan pungung kaki. Terdapat banyak di kulit kepala, muka, kening, dan dagu. Sekretnya berupa sebum dan mengandung asam lemak, kolestrol dan zat lain.</span><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l47 level1 lfo71; text-align: justify; text-autospace: none; text-indent: -21.8pt;"><i style="mso-bidi-font-style: normal;"><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dermis<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dermis atau korium merupakan lapisan bawah epidermis dan diatas jaringan subkutan. Dermis terdiri dari jaringan ikat yang dilapisan atas terjalin rapat (pars papillaris), sedangkan dibagian bawah terjalin lebih lebih longgar (pars reticularis). Lapisan pars retucularis mengandung pembuluh darah, saraf, rambut, kelenjar keringat dan kelenjar sebaseus.</span><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l47 level1 lfo71; text-align: justify; text-autospace: none; text-indent: -21.8pt;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jaringan Subkutan (Subkutis atau Hipodermis)<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jaringan subkutan merupakan lapisan yang langsung dibawah dermis. Batas antara jaringan subkutan dan dermis tidak tegas. Sel-sel yang tyerbanyak adalah liposit yang menghasilkan banyak lemak. Jaringan subkutan mengandung saraf, pembuluh darah dan limfe, kandungan rambut dan di lapisan atas jaringan subkutan terdapat kelenjar keringan. Fungsi dari jaringan subkutan adalah penyekat panas, bantalan terhadap trauma dan tempat penumpukan energi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><b><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Fungsi-fungsi Dari Kulit<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kulit mempunyai fungsi bermacam-macam untuk menyesuaikan tubuh dengan lingkungan. </span><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Fungsi</span><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">kulit adalah sebagai berikut :</span><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a) </span><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">fungsi proteksi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b) </span><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">fungsi absorpsi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c)</span><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> fungsi ekskresi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d) </span><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">fungsi persepsi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">e)</span><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> fungsi pengaturan suhu tubuh<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><span lang="IN" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">f) fungsi pembentukan pigmen<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><b><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Saraf pada Jaringan Kulit<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jika kulit diberi rangsangan listrik maka elemen-elemen kontraktil akan memendek atau kulit akanberinteraksi. Rangsangan ini berasal dari pusat kesadaran (otak) dan disalurkan melalui serabut sarafpengerak menuju serabut-serabut kulit. Seperti diketahui kulit berkontraksi menurut rangsangan yang datang, bila tidak ada rangsangan unit pengerak dalam keadaan istirahat (<i>relax</i>) dan otot dalam keadaan lemas (<i>flaccid</i>). Pengiriman rangsangan dari saraf ke serabut kulit dilakukan melalui sambungan yang dinamakan <i>junction neuromuscular. </i>Pada akhir ujung saraf ini masih terletak diluar selaput tipis pembungkus serabut kulit. </span><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dibagian akhir ini ditemukan butiran-butiran halus yang disebut kuhme atau<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-indent: 28.35pt;"><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">gelembung-gelembung asetilkolin. Asetilkolin merupakan hormon yang dikeluarkan oleh bagian saraf akhir dengan tujuan untuk merangsang serabut kulit. </span><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Karena rangsangan ini membuat permeabilitas sel-sel kulit berubah sehingga ia dapat meneruskan rangsangan tadi keseluruh bagain kulit. </span><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Akibatnya kulit</span><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">berkontraksi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-autospace: none; text-indent: 28.35pt;"><br />
</div><div align="center" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l39 level1 lfo3; text-indent: -21.8pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">B.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">ASUHAN KEPERAWATAN PADA KLIEN DENGAN HERPES ZOOSTER DAN HERPES SIMPLEKS<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo15; text-indent: -20.7pt;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">HERPES SIMPLEKS<o:p></o:p></span></i></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level2 lfo3; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengertian <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-indent: -21.3pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo4; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes simpleks adalah infeksi akut oleh virus herpes simpleks (virus herpes hominis) tipe I atau tipe II yang ditandai adanya vesikel berkelompok di atas kulit yang eritematosa di daerah mukokutan. Herpes simpleks disebut juga fever blister, cold score, herpes febrilis, herpes labialis, herpes progenitalis. (Kapita Selekta Kedokteran ed.III, 2000:151)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo4; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes simpleks adalah infeksi akut yang disebabkan oleh virus herpes simpleks (virus herpes hominis) tipe I atau tipe II yang ditandai oleh adanya vesikel yang berkelompok di atas kulit yang sembab dan eritematosa pada daerah dekat mukokutan, sedangkan infeksi dapat berlangsung baik primer maupun rekurens. (Adhi DJuanda, Ilmu penyakit kulit dan kelamin,2000:355)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo4; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes simpleks adalah penyakit yang mengenai kulit dan mukosa, bersifat kronis dan residif , disebabkan oleh virus herpes simpleks/herpes virus hominis. (FK Unair, 1993 dalam Loetfia Dwi Rahariyani tahun 2008 : 45)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo4; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kesimpulan: herpes simpleks adalah penyakit pada kulit dan mukosa yang disebabkan oleh virus herpes simpleks tipe I dan II ditandai oleh adanya vesikel yang berkelompok dan ertitematosa, ditularkan melalui udara dan sebagian kecil melalui kontak kulit langsung.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level2 lfo3; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Etiologi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Berdasarkan struktur antigeniknya dikenal 2 tipe virus herpes simpleks:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l67 level1 lfo32; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Virus herpes simpleks tipe I (HSV I)</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">. Penyakit kulit/selaput lendir yang ditimbulkan biasanya disebut <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">herpes simpleks </i></b>saja, atau dengan nama lain <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">herpes labialis, herpes febrilis</i></b>. Biasanya penderita terinfeksi virus ini pada usia kanak-kanak melalui udara dan sebagian kecil melalui kontak langsung seperti ciuman, sentuhan atau memakai baju/handuk mandi bersama. Lesi umumnya dijumpai pada tubuh bagian atas. Termasuk mata dengan rongga mulut, hidung dan pipi; selain itu, dapat juga dijumpai di daerah genitalia, yang penularannya lewat koitus orogenital (<i style="mso-bidi-font-style: normal;">oral sex</i>).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l67 level1 lfo32; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Virus herpes simpleks tipe II (HSV II, “virus of love”)</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">. Penyakit ditularkan melalui hubungan seksual. Tetapi dapat juga terjadi tanpa koitus, misalnya dapat terjadi pada dokter/dokter gigi dan tenaga medik. Lokalisasi lesi umumnya adalah bagian tubuh di bawah pusar, terutama daerah genitalia lesi ekstra-genital dapat pula terjadi akibat hubungan seksual orogenital.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level2 lfo3; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Patofisiologi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">HSV disebarkan melalui kontak langsung antara virus dengan mukosa atau setiap kerusakan di kulit. Virus herpes tidak dapat hidup di luar lingkungan yang lembab dan penyebaran infeksi melalui cara selain kontak langsung kecil kemungkinannya terjadi. HSV memiliki kemmpuan untuk menginvasi beragam sel melalui fusi langsung dengan membrane sel. pada infeksi aktif primer, virus menginvasi sel pejamu dan cepat berkembang dengan biak, menghancurkan sel pejamu dan melepaskan lebih banyak virion untuk menginfeksi sel-sel disekitarnya. Pada infeksi aktif primer, virus menyebar melalui saluran limfe ke kelenjar limfe regional dan menyebabkan limfadenopati. Tubuh melakukan respon imun seluler dan humoral yang menahan infeksi tetapi tidak dapat mencegah kekambuhan infeksi aktif. Setelah in feksi awal timbul fase laten. Selama masa ini virus masuk ke dalam sel-sel sensorik yang mempersarafi daerah yang terinfeksi dan bermigrasi disepanjang akson untuk bersembunyi di dalam ganglion radiksdorsalis tempat virus berdiam tanpa menimbulkan sitotoksisitas atau gejala pada manusia. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 67.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level2 lfo3; tab-stops: 175.5pt; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tingkatan infeksi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 175.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l72 level1 lfo33; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Infeksi primer<o:p></o:p></span></i></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tempat predileksi VHS <b style="mso-bidi-font-weight: normal;">tipe I</b> di daerah pinggang ke atas terutama di daerah mulut dan hidung, biasanya dimulai pada usia anak-anak. Inokulasi dapat terjadi secara kebetulan, misalnya kontak kulit pada perawat, dokter gigi, atau pada orang yang sering menggigiti jari (<i style="mso-bidi-font-style: normal;">herpetic Whit-low</i>). Virus ini juga sebagai penyebab herpes enfalitis. Infeksi primer oleh VHS <b style="mso-bidi-font-weight: normal;">tipe II</b> mempunyai tempat predileksi di daerah genital, juga dapat menyebabkan herpes meningitis dan infeksi neonatus.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Daerah predileksi ini sering kacau karena adanya cara hubungan seksual seperti oro-genital, sehingga herpes yang terdapat di daerah genital kadang-kadang disebabkan oleh VHS tipe I sedangkan di daerah mulut dan rongga mulut dapat disebabkan oleh VHS tipe II.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Infeksi primer berlangsung lebih lama dan lebih berat, kira-kira 2-6 minggu dan sering disertai gejala sistemik, misalnya demam, malese dan anoreksia, dan dapat ditemukan pembengkakan kelenjar getah bening regional hingga terjadi penyembuhan secara spontan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kelainan klinis yang dijumpai berupa rasa sakit serta vesikel yang berkelompok di atas kulit yang sembab dan eritematosa, berisi cairan jernih dan kemudian menjadi seropurulen, dapat menjadi kusta dan kadang-kadang menagalami ulserasi yang dangkal, biasanya sembuh tanpa sikatriks. Pada perabaan tidak terdapat indurasi. Kadang-kadang dapat timbul infeksi sekunder sehingga memberi gambaran yang tidak jelas. Umumnya didapati pada orang yang kekurangan antibodi virus herpes simpleks. Pada wanita ada laporan yang mengatakan bahwa 80% infeksi VHS pada genitalia eksterna disertai infeksi pada serviks.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l72 level1 lfo33; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Fase laten<o:p></o:p></span></i></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Fase ini berarti pada penderita tidak ditemukan gejala klinis, tetapi VHS dapat ditemukan dalam keadaan tidak aktif pada ganglion dorsalis. Penularan dapat tejadi pada fase ini, akibat pelepasan virus terus berlangsung meskipun dalam jumlah sedikit.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l72 level1 lfo33; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Infeksi rekurens (infeksi kambuhan)<o:p></o:p></span></i></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bila penderita sebelumnya telah pernah berkontak dengan virus ini sebagai infeksi primer, kebanyakan penderita akan mengalami infeksi kambuhan (rekurens). Infeksi ini berarti VHS pada ganglion dorsalis yang dalam keadaaan tidak aktif, dengan mekanisme pacu menjadi aktif dan mencapai kulit sehingga menimbulkan gejala klinis. Mekanisme pacu itu dapat berupa trauma fisik (demam, infeksi, kurang tidur, hubungan seksual, dll), trauma psikis (gangguan emosional, menstruasi), dan dapat pula timbul akibat jenis makanan yang merangsang (pedas, daging kambing) dan minuman yang merangsang (alkohol).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Lesi pada infeksi kambuhan ini biasanya lebih kecil dan lebih sedikit, tidak begitu terasa sakit. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Gejala klinis yang timbul lebih ringan dari pada infeksi primer dan berlangsung kira-kira 7-10 hari. Sering ditemukan gejala prodromal lokal sebelum timbul vesikel berupa rasa panas, gatal, dan nyeri. Infeksi rekurens ini dapat timbul pada tempat yang sama (loco) atau tempat lain/tempat di sekitarnya (non loco).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penderita yang mengabaikan penyakitnya dapat mengalami infeksi sekunder oleh kuman-kuman lain, sehingga gambaran klinisnya berubah menjadi luka yang kotor, berbau, dan disertai pembesaran getah bening regional. Infeksi sekunder dapat pula disertai oleh gejala sistemik, seperti demam, sakit kepala, badan lemas, dan muntah-muntah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 175.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level2 lfo3; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Manifestasi Klinis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l33 level1 lfo34; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Inokulasi kompleks primer</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> (<i style="mso-bidi-font-style: normal;">primary inoculation complex</i>). Infeksi primer herpes simpleks pada penderita usia muda yang baru pertama kali terinfeksi virus ini dapat menyebabkan reaksi lokal dan sistemik yang hebat. Manifestasinya dapat berupa herpes labialis. Dalam waktu 24 jam saja, penderita sudah mengalami panas tinggi (39-40<sup>o</sup>C), disusul oleh pembesaran kelenjar limfe submentalis, pembengkakan bibir, dan lekositosis di atas 12.000/mm<sup>3</sup>, yang 75-80%nya berupa sel polimorfonuklear. Terakhir, bentuk ini diikuti rasa sakit pada tenggorokan. Insidens tertinggi terjadi pada usia antara 1-5 tahun. Waktu inkubasinya 3-10 hari. Kelainan akan sembuh spontan setelah 2-6 minggu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l33 level1 lfo34; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes gingivostomatitis. </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kebanyakan bentuk ini terjadi pada anak-anak dan orang dewasa muda. Manifestasi klinis berupa panas tinggi, limfadenopati regional dan malaise. Lesi berupa vesikel yang memecah dan terlihat sebagai bercak putih atau ulkus. Kelainan ini dapat meluas ke mukosa bukal, lidah, dan tonsil, sehingga mengakibatkan rasa sakit, bau nafas yang busuk, dan penurunan nafsu makan. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pada anak-anak dapat terjadi dehidrasi dan asidosis. Kelainan ini berlangsung antara 2-4 minggu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 99.25pt; mso-add-space: auto; text-indent: -21.25pt;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><v:shape id="Bild_x0020_4" o:spid="_x0000_i1033" style="height: 165pt; mso-wrap-style: square; visibility: visible; width: 152.25pt;" type="#_x0000_t75"> <v:imagedata o:title="Herpes_Simplex_tongue-XX" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image004.jpg"> </v:imagedata></v:shape></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l33 level1 lfo34; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Infeksi herpes simpleks diseminata.</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> Bentuk herpes ini terjadi pada anak-anak usia 6 bulan sampai 3 tahun, dimulai dengan herpes gingivostomatitis berat. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jenis ini dapat mengenai paru-paru dan menimbulkan viremia masif, yang berakibat gastroenteritis disfungsi ginjal dan kelenjar adrenal, serta ensefalitis. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kematian banyak terjadi pada stadium viremia yang berat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l33 level1 lfo34; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes genitalis (progenitalis)</span></b><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">. Infeksi primer terjadi setelah melalui masa tunas 3-5 hari. Penularan dapat melalui hubungan seksual secara genito-genital, orogenital, maupun anogenital. Erupsinya juga berupa vesikel tunggal atau menggerombol, bilateral, pada dasar kulit yang eritematus, kemudian berkonfluensi, memecah, membentuk erosi atau ulkus yang dangkal disertai rasa nyeri. 31% penderita mengalami gejala konstitusi berupa demam, malaise, mialgia, dan sakit kepala; dan 50% mengalami limfadenopati inguinal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 99.25pt; mso-add-space: auto; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 115%;"><v:shape id="Bild_x0020_2" o:spid="_x0000_i1032" style="height: 163.5pt; mso-wrap-style: square; visibility: visible; width: 186.75pt;" type="#_x0000_t75"> <v:imagedata o:title="HERPES GENITAL" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image005.jpg"> </v:imagedata></v:shape></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 115%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 115%;"><v:shape id="Bild_x0020_3" o:spid="_x0000_i1031" style="height: 189.75pt; mso-wrap-style: square; visibility: visible; width: 131.25pt;" type="#_x0000_t75"> <v:imagedata o:title="HERPES GENITAL cewe" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image006.jpg"> </v:imagedata></v:shape></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 115%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 76.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level2 lfo3; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Insiden <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Karena HSV tidak dapat disembuhkan maka persentasi orang yang terinfeksi meningkat seiring dengan usia. Sekitar 1 dari 4 perempuan dan 1 dari 5 laki-laki terinfeksi oleh virus herpes genitalis. Kerentanan terhadap infeksi herpes bervariasi. HSV lebih sering dijumpai pada perempuan daripada laki-laki, mungkin karena luas permukaan mukosa saluran genetalia perempuan yang lebih besar dan terjadinya kerusakan mikro di mukosa selam hubungan kelamin. Dibandingkan dengan populasi umum, orang yang terinfeksi oleh HIV lebih rentan terhadap infeksi HSV dan lebih menular ke orang lain setelah terjangkit virus ini. Orang yang seropositif HSV-1 sedikit banyak tampaknya terproteksi dari infeksi HSV-2. Karena infeksi HSV tidak mengancan nyawa dan sering ringan atau asimtomatik, maka banyak orang yang tidak menyadari besarnya penyakit ini</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level2 lfo3; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Komplikasi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><span class="apple-style-span"><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">- Infeksi bakteri sekunder</span></span><span lang="DE" style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><br />
<span class="apple-style-span">- Eritema multiforme portherpetika</span><br style="mso-special-character: line-break;" /> <br style="mso-special-character: line-break;" /> </span><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level2 lfo3; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">h.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tes Diagnostik<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo72; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pada sebagian besar kasus, herpes genetalis dapat didiagnosis secara klinis saat infeksi akut atau rekuren. Sebelum ditemukannya uji amplifikasi DNA, biakan virus terhadap vesikel atau pustule merupakan baku emas untuk diagnosis. Biakan yang diambil dari lesi yang sudah berkrusta dan infeksi rekuren kurang sensitive, dan sering menyebabkan hasil uji negatif. Tersedia uji deteksi antigen dengan EIA atau uji fluoresensi langsung yang cepat dan murah. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes genetalis dilaporkan menyebabkan kelainan pada asupan papanicolaou ( pap smear ), walaupun tidak bersifat diagnostic. Karena tingginya frekuensi infeksi yang asimtomatik dan non tipikal maka dianjurkan pemeriksaan penyaring terhadap kelompok beresiko tinggi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l58 level1 lfo72; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span class="apple-style-span"><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pada percobaan Tzanck dengan perwarnaan Giemsa dari bahan vesikel dapat ditemukan sel datia berinti banyak dan badan inklusi intranuklear.</span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level2 lfo3; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">i.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penatalaksanaan medis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Karena infeksi HSV tidak dapat disembuhkan, maka terapi ditujukan untuk <b style="mso-bidi-font-weight: normal;">mengendalikan gejala dan menurunkan pengeluaran virus</b>. Obat antivirus analog nukleosida merupakan terapi yang dianjurkan. Obat-obatan ini bekerja dengan menyebabkan deaktivasi atau mengantagonisasi DNA polymerase HSV yang pada gilirannya menghentikan sintesis DNA dan replikasi virus. Tiga obat antivirus yang dianjurkan oleh petunjuk CDC 1998 adalak asiklovir, famsiklovir, dan valasiklovir. Obat antivirus harus dimulai sejak awal tanda kekambuhan untuk mengurangi dan mempersingkat gejala. Apabila obat tertunda sampai lesi kulit muncul, maka gejala hanya memendek 1 hari. Pasien yang mengalami kekambuhan 6 kali atau lebih setahun se</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">baik</span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">nya ditawari terapi supresif setiap hari yang dapat mengurangi frekuensi kekambuhan sebesar 75%.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Terapi topical dengan krim atau salep antivirus tidak terbukti efektif. Terapi supresif atau profilaksis dianjurkan untuk mengurangi resiko infeksi perinatal dan keharusan melakukan seksio sesarea pada wanita yang positif HSV. Vaksin untuk mencegah infeksi HSV-2 sekarang sedang diteliti.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level2 lfo3; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">j.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Konsep Proses Keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengkajian<o:p></o:p></span></i></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo5; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Biodata.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dapat terjadi pada semua orang di semua umur; sering terjadi pada remaja dan dewasa muda. Jenis kelamin; dapat terjadi pada pria dan wanita. Pekerjaan; beresiko tinggi pada penjaja seks komersial.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo5; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Keluhan utama<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Gejala yang sering menyebabkan penderita datang ketempat palayanan kesehatan adalah nyeri pada lesi yang timbul.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo5; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Riwayat penyakit sekarang<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kembangkan pola PQRST pada setiap keluhan klien. pada beberapa kasus, timbul lesi/vesikel perkelompok pada penderita yang mengalami demam atau penyakit yang disertai peningkatan suhu tubuh atau pada penderita yang mengalami trauma fisik maupun psikis. Penderita merasakan nyeri yang hebat, terutama pada area kulit yang mengalami peradangan berat dan vesikulasi yang hebat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo5; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Riwayat penyakit dahulu<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Sering diderita kembali oleh klien yang pernah mengalami penyakit herpes simplek atau memiliki riwayat penyakit seperti ini.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo5; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">e)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Riwayat penyakit kelarga<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Ada anggota keluarga atau teman dekat yang terinfeksi virus ini.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo5; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">f)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kebutuhan psikososial<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Klien dengan penyakit kulit, terutama yang lesinya berada pada bagian muka atau yang dapat dilihat oleh orang, biasanya mengalami gangguan konsep diri.hal itu meliputi perubahan citra tubuh, ideal diri tubuh, ideal diri, harga diri, penampilan peran, atau identitas diri. Reaksi yang mungkin timbul adalah:</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo6; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Menolak untuk menyentuh atau melihat salah satu bagian tubuh.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo6; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Menarik diri dari kontak social.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo6; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kemampuan untuk mengurus diri berkurang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo5; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">g)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kebiasaan sehari-hari. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dengan adanya nyeri, kebiasaan sehari-hari klien juga dapat mengalami gangguan, terutama untuk istirahat/tidur dan aktivitas. Terjadi gangguan BAB dan BAK pada herpes simpleks genitalis. Penyakit ini sering diderita oleh klien yang mempunyai kebiasaan menggunakan alat-alat pribadi secara bersama-sama atau klien yang mempunyai kebiasaan melakukan hubungan seksual dengan berganti-ganti pasangan.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.5in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo5; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">h)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pemeriksaan fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Keadaan umum klien bergantung pada luas, lokasi timbulnya lesi, dan daya tahan tubuh klien. pada kondisi awal/saat proses peradangan , dapat terjadi peningkatan suhu tubuh atau demam dan perubahan tanda-tanda vital yang lain. Pada pengkajian kulit, ditemukan adanya vesikel-vesikel berkelompok yang nyeri ,edema di sekitar lesi, dan dapat pula timbul ulkus pada infeksi sekunder. Perhatikan mukosa mulut, hidung, dan penglihatan klien. pada pemeriksaan genitalia pria, daerah yang perlu diperhatikan adalah bagian glans penis, batang penis, uretra, dan daerah anus. Sedangkan pada wanita, daerah yang perlu diperhatikan adalah labia mayor dan minor, klitoris, introitus vagina, dan serviks. Jika timbul lesi, catat jenis, bentuk, ukuran / luas, warna, dan keadaan lesi. Palpasi kelenjar limfe regional, periksa adanya pembesaran; pada beberapa kasus dapat terjadi pembesaran kelenjar limfe regional.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Untuk mengetahui adanya nyeri, kita dapat mengkaji respon individu terhadap nyeri akut secara fisiologis atau melalui respon perilaku. Secara fisiologis,terjadi diaphoresis, peningkatan denyut jantung, peningkatan pernapasan, dan peningkatan tekanan darah; pada perilaku, dapat juga dijumpai menangis, merintih, atau marah. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Lakukan pengukuran nyeri dengan menggunakan skala nyeri 0-10 untuk orang dewasa. Untuk anak-anak, pilih skala yang sesuai dengan usia perkembangannya kita bisa menggunakan skala wajah untuk mengkaji nyeri sesuai usia; libatkan anak dalam pemilihan. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diagnosa keperawatan<o:p></o:p></span></i></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l44 level1 lfo7; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Nyeri akut b.d inflamasi jaringan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l44 level1 lfo7; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Gangguan citra tubuh b.d perubahan penampilan, sekunder akibat penyakit herpes simpleks<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l44 level1 lfo7; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Risiko penularan infeksi b.d pemajanan melalui kontak (kontak langsung, tidak langsung , kontak droplet)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Intervensi keperawatan<o:p></o:p></span></i></b></div><div class="MsoNormalCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo8; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Nyeri akut b.d inflamasi jaringan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hasil yang diharapkan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo9; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Klien mengungkapkan nyeri hilang / berkurang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo9; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Menunjukkan mekanisme koping spesifik untuk nyeri dan metode untuk mengontrol nyeri secara benar.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo9; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Klien menyampaikan bahwa orang lain memvalidasi adanya nyeri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">rencana keperawatan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo10; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaji kembali factor yang menurunkan toleransi nyeri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo10; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kurangi atau hilangkan factor yang meningkatkan pengalaman nyeri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo10; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Sampaikan pada klien penerimaan perawat tentang responsnya terhadap nyeri ; akui adanya nyeri , dengarkan dan perhatikan klien saat mengungkapkan nyerinya bertujuan untuk lebih memahaminya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo10; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaji adanya kesalahan konsep pada keluarga tentang nyeri atau tindakannya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo10; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Beri informasi atau penjelasan pada klien dan keluarga tentang penyebab rasa nyeri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo10; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diskusikan dengan klien tentang penggunaan terapi distraksi, relaksasi, imajinasi , dan ajarkan tehnik / metode yang dipilih.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo10; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jaga kebersihan dan kenyamanan lingkungan sekitar klien <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo10; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kolaborasikan dengan tim medis untuk pemberian analgesik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo10; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pantau TTV<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo10; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaji kembali respons klien terhadap tindakan penurunan rasa nyeri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 139.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo8; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Gangguan citra tubuh b.d perubahan penampilan, sekunder akibat penyakit herpes simpleks<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hasil yang diharapkan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l29 level1 lfo11; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Klien mengatakan dan menunjukkan penerimaan atas penampilannya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l29 level1 lfo11; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Menunjukkan keinginan dan kemampuan untuk melakukan perawatan diri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l29 level1 lfo11; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Melakukan pola-pola penanggulangan yang baru</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">.</span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 139.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Rencana keperawatan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Ciptakan hubungan saling percaya antara klien-perawat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dorong klien untuk menyatakan perasaannya , terutama tentang cara ia merasakan , berpikir, atau memandang dirinya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jernihkan kesalahan konsepsi individu tentang dirinya, penatalaksanaan, atau perawatan dirinya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hindari mengkritik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jaga privasi dan lingkungan individu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Berikan informasi yang dapat dipercaya dan penjelas informasi yang telah diberikan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tingkatkan interaksi social.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level2 lfo12; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: 'Courier New'; font-size: 10pt; line-height: 150%;">o<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dorong klien untuk melakukan aktivitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level2 lfo12; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: 'Courier New'; font-size: 10pt; line-height: 150%;">o<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hindari sikap terlalu melindungi , tetapi terbatas pada permintaan individu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dorong klien dan keluarga untuk menerima keadaan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Beri kesempatan klien untuk berbagi pengalaman dengan orang lain.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Lakukan diskusi tentang pentingnya mengkomunikasikan penilaian klien dan pentingnya system daya dukungan bagi mereka.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo12; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dorong klien untuk berbagi rasa, masalah, kekuatiran, dan persepsinya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo8; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Risiko penularan infeksi b.d pemajanan melalui kontak (kontak langsung, tidak langsung , kontak droplet)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hasil yang diharapkan</span></i><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l73 level1 lfo13; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Klien menyebutkan perlunya isolasi sampai ia tidak lagi menularkan infeksi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l73 level1 lfo13; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Klien dapat menjelaskan cara penularan penyakit.<o:p></o:p></span></div><div class="MsoNormalCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 103.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormalCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Rencana keperawatan</span></i><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">:</span></i><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span></i><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level1 lfo14; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jelaskan tentang penyakit herpes simpleks, penyebab, cara penularan, dan akibat yang ditimbulkan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level1 lfo14; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Anjurkan klien untuk menghentikan kagiatan hubungan seksual selama sakit dan jika perlu menggunakan kondom.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level1 lfo14; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Beri penjelasan tentang pentingnya melakukan kegiatan seksual dengan satu orang ( satu sama lain setia ) dan pasangan yang tidak terinfeksi ( hubungan seks yang sehat ).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level1 lfo14; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Lakukan tindakan pencegahan sesuai:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level2 lfo14; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: 'Courier New'; font-size: 10pt; line-height: 150%;">o<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Cuci tangan sebelum dan setelah ke semua klien atau kontak dengan specimen.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level2 lfo14; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: 'Courier New'; font-size: 10pt; line-height: 150%;">o<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Gunakan sarung tangan setiap kali melakukan kontak langsung dengan klien <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level2 lfo14; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: 'Courier New'; font-size: 10pt; line-height: 150%;">o<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Anjurkan klien dan keluarga untuk memisahkan alat-alat mandi klien , dan tidak menggunakannya bersama.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level2 lfo14; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: 'Courier New'; font-size: 10pt; line-height: 150%;">o<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kurangi transfer pathogen dengan cara mengisolasi klien selama sakit ( Karena penyakit ini disebabkan oleh virus yang dapat menular melalui udara ).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 175.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo15; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">HERPES ZOSTER (SHINGLES)<o:p></o:p></span></i></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 3.15in; margin-right: 0in; margin-top: 0in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><v:shape id="Bild_x0020_8" o:spid="_x0000_i1030" style="height: 106.5pt; mso-wrap-style: square; visibility: visible; width: 136.5pt;" type="#_x0000_t75"> <v:imagedata o:title="herpes_zoster_shingles" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image007.jpg"> </v:imagedata></v:shape></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 3.15in; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo16; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengertian <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo35; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes Zoster adalah penyakit yang diserang oleh infeksi <b style="mso-bidi-font-weight: normal;">Virus Varicella</b>-<b style="mso-bidi-font-weight: normal;">zoster </b> yang menyerang kulit dan mukosa, infeksi ini merupakan reaktivitas virus yang terjadi setelah infeksi primer.(Adhi Djuanda, Ilmu Penyakit Kulit dan Kelamin, 2000 : 107)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo35; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes zoster adalah radang kulit akut dan setempat, terutama terjadi pada orang tua, ditandai adanya nyeri radikuler unilateral serta adanya erupsi vesikuler yang terbatas pada dermatom yang diinervasi oleh serabut saraf spinal maupun ganglion serabut saraf sensoris dari nervus cranialis. (Marwali Harahap, Ilmu Penyakit Kulit, 2000: 92)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo35; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes zoster (dampa, cacar ular) adalah penyakit yang disebabkan infeksi virus varisela zoster yang menyerang kulit dan mukosa. Infeksi ini merupakan reaktivasi virus yang terjadi setelah infeksi primer. (Kapita Selekta Kedokteran ed.III,2000 :128)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo35; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kesimpulan: herpes zoster adalah penyakit kulit dan mukosa yang disebabkan oleh infeksi virus varisela zoster ,ditandai adanya nyeri radikuler unilateral serta adanya erupsi vesikuler yang terbatas pada dermatom yang diinervasi oleh serabut saraf spinal maupun ganglion serabut saraf sensoris dari nervus cranialis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 81.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo16; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Etiologi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Reaktivasi virus varisela zoster<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 81.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo16; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Patofisiologi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penyebab </span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">h</span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">erpes zoster adalah virus <i style="mso-bidi-font-style: normal;">varisela zoster</i>. Virus ini masuk ke dalam tubuh melalui lesi pada kulit , mukosa saluran napas atas, dan orofaring. Vius ini berkembang biak serta menyebar ke berbagai organ , terutama ke kulit dan lapisan mukosa, selanjutnya masuk ke ujung saraf sensoris, dan menuju ganglion saraf tepi dan kornu posterior. Saat virus masuk pertama kali ke tubuh disebut infeksi primer, yang kemudian menimbulkan vesikel.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Setelah infeksi primer tersebut selesai, virus tidak hilang tuntas dari tubuh melainkan menetap pada bagian ganglion serta bersembunyi di sana beberapa tahun. Pertahanan dan kekebalan tubuh yang menurun dapat menjadi factor utama penyebab virus ini aktif kembali.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Saraf yang sering terkena adalah daerah torakalis , kemudian daerah-daerah cranial, lumbal,servikal, dan sacral. Masa inkubasinya 2-3 hari setelah kontak dengan varisela. Bila tidak diketahui adanya kontak, kasus tersebut merupakan kasus laten. </span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Factor-faktor yang dapat mempengaruhi timbulnya herpes zoster adalah:</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 127.6pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l68 level1 lfo30; tab-stops: 99.0pt; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penurunan imunitas tubuh<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 127.6pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l68 level1 lfo30; tab-stops: 99.0pt; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pemakaian kortikosteroid. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 127.6pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l68 level1 lfo30; tab-stops: 99.0pt; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Radio terapi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 127.6pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l68 level1 lfo30; tab-stops: 99.0pt; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Obat-obat immunosupresif<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 127.6pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l68 level1 lfo30; tab-stops: 99.0pt; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Stress emosi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 127.6pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo16; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Manifestasi Klinis<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; text-indent: 28.35pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Keluhan utama penyakit ini adalah rasa sakit, nyeri, dan pegal (neuritis) serta adanya vesikel yang berkelompok sepanjang satu dermatom. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Perjalanan dan gejala penyakit ini mulai dari ringan, sampai dengan berat. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Adapun stadium dari penyakit herpes zoster:</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Stadium prodormal (gejala awal)<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dapat berifat sistemik dan local. Gejala local berupa rasa gatal/nyeri pada dermatom ynang terserang disertai dengan rasa panas /terbakar. Gejala sistemik berupa demam, malaise, dan nyeri kepala. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Stadium erupsi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Mula-mula timbul papula atau plakat berbentuk urtika. Setelah 1-2 hari, akan timbul gerombolan vesikel / bintil-bintil berair yang tersusun berkelompok diatas kulit yang eritematosa , sedangkan kondisi kulit di antara gerombolan lain tidak sama. Lokalisasi lesi sesuai dengan dermatom yang dipersarafi oleh satu atau lebih saraf yeng terkena. Semua saraf dapat terkena , yang tersering adalah saraf torakal, lumbal/ cranial. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Stadium ini biasanya berlangsung selama 2 minggu dengan gejala utama berupa rasa nyeri. Rasa nyeri yang dirasa bersifat konstan atau intermiten , diikuti dengan rasa terbakar pada bagian visceral</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Stadium krustasi:<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Vesikula menjadi purulen , mengalami krustasi , dan lepas dalam waktu 1-2 minggu. Sering terjadi neuralgia pasca herpetika, terutama pada orang tua, yang dapat berlangsung beberapa bulan sampai beberapa tahun. Selain itu, ada pula gejala parestesia yang bersifat sementara.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo16; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Insiden <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Insiden penyakit herpes zoster ini tersebar merata di seluruh dunia dan tidak ada perbedaan angka kesakitan antara laki-laki dan perempuan. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Angka kesakitan meningkat seiring peningkatan usia. Diperkirakan kurang lebih terdapat 1,3 – 5 penderita per 1000 orang / tahun. Lebih dari 2/3 penderita berusia >50 tahun dan kurang dari 10% di bawah 20 tahun.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo16; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Komplikasi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level1 lfo36; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Infeksi sekunder <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level1 lfo36; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Neuralgia pasca herpetika adalah rasa nyeri yang timbul pada daerah berkas penyembuhan lebih dari sebulan setelah penyakit sembuh. Nyeri ini dapat berlangsung sampai beberapa bulan bahkan beberapa tahun dengan gradasi nyeri yang bervariasi dalam kehdupan sehari-hari. Kecenderungan ini dijumpai pada orang yang terkena herpes zoster di atas usia 40 tahun.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-list: l42 level1 lfo36; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">keratitis akut, skleritis, uveitis, glaucoma sekunder, ptosis, korioretinitis, neuritis optika dan paresis otot penggerak bola mata.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level1 lfo36; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">berupa komplikasi dari herpes zoster oftalmikus.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level1 lfo36; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes zoster generalisata, bentuk klinis yang berat dengan gejala umum yang berat dan lesi timbul tersebar merata ke seluruh tubuh.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level1 lfo36; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Alopesia arkata<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level1 lfo36; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Sindrom Ramsay Hunt. Gangguan pada saraf fasialis dan sarah optikus menimbulka gejala lumpuh pada otot wajah (paralisis Bell), telinga berdenging, sakit kepala seperti berputar, gangguan pendengaran dan mual.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; mso-list: l42 level1 lfo36; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">8.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Gangren superfisialis, menunjukan <b>Herpes zoster</b> yang berat, mengakibatkan hambatan penyembuhan dan pembentukan jaringan parut.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo16; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tes Diagnostik<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 81.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo38; text-align: justify; text-indent: -21.0pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Sitologi (64% t<i style="mso-bidi-font-style: normal;">zanck smear</i> positif); adanya sel raksasa yang multilokuler dan sel-sel <i style="mso-bidi-font-style: normal;">okantolitik.<o:p></o:p></i></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo37; tab-stops: list .5in; text-align: justify; text-indent: -21.0pt;"><span lang="DE" style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kultur dari cairan vesikel dan tes antibody : digunakan untuk membedakan diagnosis herpes virus<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo37; tab-stops: list .5in; text-align: justify; text-indent: -21.0pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Immunofluororescent : mengidentifikasi varicella di sel kulit<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo37; tab-stops: list .5in; text-align: justify; text-indent: -21.0pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pemeriksaan histopatologik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo37; tab-stops: list .5in; text-align: justify; text-indent: -21.0pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pemerikasaan mikroskop electron<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo37; tab-stops: list .5in; text-align: justify; text-indent: -21.0pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kultur virus<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo37; tab-stops: list .5in; text-align: justify; text-indent: -21.0pt;"><span lang="DE" style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Identifikasi anti gen / asam nukleat VVZ<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo37; tab-stops: list .5in; text-align: justify; text-indent: -21.0pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Deteksi antibody terhadap infeksi virus<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 81.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo16; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">h.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penatalaksanaan medis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Terapi sistemik</span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></i></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Terapi pada kasus herpes zoster bergantung pada tingkat keparahannya. Terapi sistemik umumnya bersifat simtomatik , untuk nyerinya diberikan analgesic. Jika disertai infeksi sekunder , diberikan antibiotic <i style="mso-bidi-font-style: normal;">asiklovir . </i>Herpes zoster sangat cocok dengan obat asiklovir yang diminum. Dengan cepat , obat akan menghentikan munculnya lepuhan kecil , memperkecil ukurannya, mengurangi rasa gatal , dan membunuh virus yang ada pada cairan lepuhan. Sebaliknya diberikan dalam 24-27 jam setelah terbentuknya lepuhan. Makin cepat diberikan, makin cepat khasiatnya. Obat itu harus diberikan dalam pengawasan dokter. <b style="mso-bidi-font-weight: normal;">Obat oles</b> bisa menolong kalau rasa nyeri yang timbul ringan atau jika keluar cairan.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Terapi topikal<o:p></o:p></span></i></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 99.25pt; mso-list: l69 level1 lfo39; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 85.5pt left 1.25in; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pada stadium vesicular diberi bedak salicyl 2% atau bedak kocok kalamin untuk mencegah vesikel pecah<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 99.25pt; mso-list: l69 level1 lfo39; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 85.5pt left 1.25in; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bila vesikel pecah dan basah, diberikan kompres terbuka dengan larutan antiseptik atau kompres dingin dengan larutan burrow 3 x sehari selama 20 menit<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 99.25pt; mso-list: l69 level1 lfo39; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 85.5pt left 1.25in; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Apabila lesi berkrusta dan agak basah dapat diberikan salep antibiotik (basitrasin / polysporin ) untuk mencegah infeksi sekunder selama 3 x sehari.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l35 level1 lfo16; text-indent: -21.3pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">i.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Konsep Proses Keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 81.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l74 level1 lfo17; text-align: justify; text-indent: -21.0pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengkajian<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l49 level1 lfo18; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Biodata. </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Cantumkan semua identitas klien : umur ( penyakit ini sering terjadi pada anak usia atau kelompok dewasa ), jenis kelamin ( tidak ada perbedaan angka kejadian antara laki-laki dan perempuan). <b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l49 level1 lfo18; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Keluhan utama. </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Alasan yang sering membawa klien penderita herpes datang berobat ke rumah sakit atau tempat pelayanan kesehatan lain adalah nyeri pada daerah terdapatnya vesikel berkelompok.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l49 level1 lfo18; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Riwayat penyakit sekarang.</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> Biasanya, klien mengeluh sudah beberapa hari demam dan timbul rasa gatal/nyeri pada dermatom yang terserang, klien juga mengeluh nyeri kepala dan terasa lelah. Pada daerah yang terserang , mula-mula timbul papula atau plakat berbentuk urtika, setelah 1-2 hari timbul gerombolan vesikula.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l49 level1 lfo18; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Riwayat penyakit keluarga. </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Biasanya, keluarga atau teman dekat ada yang menderita herpes zoster, atau klien pernah kontak dengan penderita varisela atau herpes zoster.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l49 level1 lfo18; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">e)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Riwayat psikososial. </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Perlu dikaji bagaimana konsep diri klien terutama tentang gambaran / citra diri dan harga diri. Sering kali kita jumpai gangguan konsep diri pada klien. hal ini karena herpes zoster merupakan penyakit yang merusak kulit dan mukosa , terutama pada kasus herpes zoster berat. Di samping itu, perlu dikaji tingkat kecemasan klien dan informasi/pengetahuan yang dimiliki tentang penyakit ini.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l49 level1 lfo18; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">f)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kebutuhan sehari-hari. </span></b><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dengan adanya rasa nyeri, klien akan mengalami gangguan tidur/istirahat dan juga aktivitas. Perlu dikaji juga tentang kebersihan diri klien dan cara perawatan diri, apakah alat-alat mandi/pakaian bercampur dengan orang lain. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Seharusnya , alat mandi / handuk dan pakaian tidak bercampur dengan orang lain.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l49 level1 lfo18; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">g)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pemeriksaan fisik. </span></b><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pada klien dengan herpes zoster jarang ditemukan gangguan kesadaran. Kecuali jika terjadi komplikasi infeksi lain. Tingkatan nyeri yang dirasakan oleh klien bersifat individual sehingga perlu dilakukan pemeriksaan tingkat nyeri dengan menggunakan skala nyeri. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Apabila nyeri terasa hebat, tanda-tanda vital cenderung akan meningkat. Pada inspeksi kulit ditemukan adanya veiskel berkelompok sesuai dengan alur dermatom (ini tanda yang khas pada herpes zoster karena virus ini berdiam di <i style="mso-bidi-font-style: normal;">ganglion posterior</i> susunan saraf tepi dan <i style="mso-bidi-font-style: normal;">ganglion kranialis</i>). Vesikel ini berisi cairan jernih yang kemudian menjadi keruh (berwarna abu-abu), dapat menjadi pustula dan krusta. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kadang ditemukan vesikel berisi nanah dan darah yang disebut herpes zoster hemoragik. Apabila yang terserang adalah ganglion kranialis, dapat ditemukan adanya kelainan motorik. Hiperestesi pada daerah yang terkena member gejala yang khas , misalnya kelainan pada wajah karena gangguan pada nervus trigeminus, nervus fasialis, dan oligus.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l74 level1 lfo17; text-align: justify; text-indent: -21.0pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diagnosa keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l43 level1 lfo19; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kerusakan integritas kulit b.d lesi dan respons peradangan<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l43 level1 lfo19; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Perubahan kenyamanan b.d erupsi dermal dan pruritus.<o:p></o:p></span></div><div class="MsoNormalCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l43 level1 lfo19; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Cemas s.d adanya lesi pada wajah<o:p></o:p></span></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l43 level1 lfo19; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Potensial terjadi penyebaran penyakit s.d infeksi virus<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: 58.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l74 level1 lfo17; text-align: justify; text-indent: -21.0pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Intervensi keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo20; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kerusakan integritas kulit b.d lesi dan respons peradangan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 120.5pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hasil yang diharapkan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l66 level1 lfo21; tab-stops: 531.6pt; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Lesi mulai pulih, integritas jaringan kembali, dan area bebas dari infeksi lanjut.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l66 level1 lfo21; tab-stops: 531.6pt; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kulit kulit bersih dan area sekitar bebas dari edema.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 531.6pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 120.5pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Rencana tindakan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo22; tab-stops: 1.5in 135.0pt; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaji kembali tentang lesi, bentuk, ukuran , jenis, dan distribusi lesi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo22; tab-stops: 1.5in 135.0pt; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Anjurkan klien untuk banyak istirahat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo22; tab-stops: 1.5in 135.0pt; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pertahankan integritas jaringan kulit dengan jalan mempertahankan kebersihan dan kekeringan kulit.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo22; tab-stops: 1.5in 135.0pt; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Laksanakan perawatan kulit setiap hari. Untuk mencegah pecahnya vesikel sehingga tidak terjadi infeksi sekunder , diberikan bedak salisil 2%. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bila erosif dapat diberikan kompres terbuka.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo22; tab-stops: 1.5in 135.0pt; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pertahankan kebersihan dan kenyamanan tempat tidur. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo22; tab-stops: 1.5in 135.0pt; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jika terjadi ulserasi, kolaborasikan dengan tim medis untuk pemberian salep antibiotic.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 1.5in 135.0pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo20; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Perubahan kenyamanan b.d erupsi dermal, nyeri, dan pruritus.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hasil yang diharapkan :<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo23; tab-stops: 1.5in 148.5pt; text-align: justify; text-indent: -20.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kllien mengatakan nyeri dan ketidaknyamanan berkurang dalam batas yang dapat ditoleransi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo23; tab-stops: 1.5in 148.5pt; text-align: justify; text-indent: -20.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Menampakkan ketenangan, ekspresi muka rileks.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo23; tab-stops: 1.5in 148.5pt; text-align: justify; text-indent: -20.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kebutuhan istirahat tidur / istirahat<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 1.5in 148.5pt; text-align: justify; text-indent: -20.25pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 120.5pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Rencana tindakan :<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo24; text-align: justify; text-indent: -20.25pt;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaji lebih lanjut intensitas nyeri dengan menggunakan skala/peringkat nyeri.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo24; text-align: justify; text-indent: -20.25pt;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jelaskan penyebab nyeri dan pruritus.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo24; text-align: justify; text-indent: -20.25pt;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bantu dan ajarkan penanganan terhadap nyeri, penggunaan tekhnik imajinasi, tekhnik relaksasi dan lainnya.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo24; text-align: justify; text-indent: -20.25pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tingkatan aktivitas distraksi.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo24; text-align: justify; text-indent: -20.25pt;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jaga kebersihan dan kenyamanan lingkungan sekitar klien.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo24; text-align: justify; text-indent: -20.25pt;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kolaborasikan dengan dokter untuk pemberian terapi:<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 163.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo25; tab-stops: 1.5in 117.0pt; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Analgesik untuk pereda/penawar rasa sakit<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 163.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo25; tab-stops: 1.5in 117.0pt; text-align: justify; text-indent: -21.3pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Larutan kalamin untuk mengurangi rasa gatal.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 163.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo25; tab-stops: 1.5in 117.0pt; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Steroid untuk mengurangi serangan neuralgia.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 163.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 1.5in 117.0pt; text-align: justify; text-indent: -21.3pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo20; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Cemas s.d adanya lesi pada wajah<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 120.5pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hasil yang diharapkan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo26; tab-stops: 1.5in; text-indent: -20.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pasien merasa yakin penyakitnya akan sembuh sempurna<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo26; tab-stops: 1.5in; text-indent: -20.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Lesi tidak ada infeksi sekunder<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: 1.5in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: 1.5in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: 1.5in;"><br />
</div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Rencana keperawatan:<o:p></o:p></span></i></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l36 level1 lfo27; tab-stops: list 1.25in left 1.5in; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaji tingkat kecemasan klien<o:p></o:p></span></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l36 level1 lfo27; tab-stops: list 1.25in left 1.5in; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jalaskan tentang penyakitnya dan prosedur perawatan<o:p></o:p></span></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l36 level1 lfo27; tab-stops: list 1.25in left 1.5in; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tingkatkan hubungan teraupeutik<o:p></o:p></span></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l36 level1 lfo27; tab-stops: list 1.25in left 1.5in; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Libatkan keluarga untuk member dukungan<o:p></o:p></span></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 135.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 1.5in 130.5pt 139.5pt;"><br />
</div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo20; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Potensial terjadi penyebaran penyakit s.d infeksi virus<o:p></o:p></span></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoNormalCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 120.5pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hasil yang diharapkan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l17 level1 lfo28; tab-stops: 1.5in; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Setelah perawatan tidak terjadi penyebaran penyakit<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 135.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 1.5in;"><br />
</div><div class="MsoNormalCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 120.5pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Rencana keperawatan:<o:p></o:p></span></i></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo29; tab-stops: list 1.25in left 1.5in; text-indent: -20.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Isolasikan klien<o:p></o:p></span></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo29; tab-stops: list 1.25in left 1.5in; text-indent: -20.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Gunakan teknik aseptic dalam perawatannya<o:p></o:p></span></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo29; tab-stops: list 1.25in left 1.5in; text-indent: -20.25pt;"><span lang="DE" style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Batasi pengunjung dan minimalkan kontak langsung<o:p></o:p></span></div><div class="MsoNormalCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 141.75pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo29; tab-stops: list 1.25in left 1.5in; text-indent: -20.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jelaskan pada klien/keluarga proses penularannya<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 112.5pt; margin-right: 0in; margin-top: 0in; tab-stops: 1.5in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 112.5pt; margin-right: 0in; margin-top: 0in; tab-stops: 1.5in;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l39 level1 lfo3; text-indent: -21.8pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">C.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">ASUHAN KEPERAWATAN PADA KLIEN DENGAN TINEA (DERMATOFITOSIS)<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level2 lfo29; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengertian<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo40; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dermatofitosis adalah adalah penyakit pada jaringan yang mengandung zat tanduk, misalnya stratum korneum pada epidermis, rambut, dan kuku, yang disebabkan golongan jamur dermatofita.(Adhi Djuanda, Ilmu Penyakit Kulit dan Kelamin, 2000:90)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l18 level1 lfo40; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dermatofitosis adalah penyakit jamur pada jaringan yang mengandung zat tanduk, seperti kuku, rambut, dan stratum korneum pada epidermis, yang disebabkan oleh golongan jamur dermatofita.(Marwali Harahap, ilmu penyakit kulit, 2000:75)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l18 level1 lfo40; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dermatositosis adalah Infeksi fungus superficial pada kulit yang disebabkan oleh spesies dermatofilia Micosporum, Epidermophyton, atau Trycophyton. ( Hartanto, Herawati, Kamus Saku Mosby. 2009 : 544)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l18 level1 lfo40; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kesimpulan : Dermatofitosis adalah penyakit jamur pada jaringan yang mengandung zat tanduk, disebabkan oleh spesies dermatofilia Micosporum, Epidermophyton, atau Trycophyton.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 76.5pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level2 lfo29; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Etiologi <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jamur golongan : </span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l71 level1 lfo29; text-indent: -21.3pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span></b><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Microsporum<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l71 level1 lfo29; text-indent: -21.3pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Trichophyton<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l71 level1 lfo29; text-indent: -21.3pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Epidermophyton<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 150%; margin-left: 56.7pt; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3. klasifikasi berdasarkan lokasi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l51 level1 lfo41; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">v<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Kapitis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l38 level1 lfo42; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Definisi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l5 level1 lfo43; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Kapitis adalah kelainan kulit pada daerah kepala berambut yang disebabkan oleh jamur golongan dermatofita.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l5 level1 lfo43; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Kapitis adalah .kelainan pada kulit dan rambut kepala, alis, dan bulu mata.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 1.25in; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><v:shape id="Picture_x0020_7" o:spid="_x0000_i1029" style="height: 211.5pt; mso-wrap-style: square; visibility: visible; width: 297pt;" type="#_x0000_t75"> <v:imagedata o:title="tiena kaoitis" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image008.jpg"> </v:imagedata></v:shape></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l38 level1 lfo42; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Etiologi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penyakit ini disebabkan oleh spesies dermatofita dari genera : <i style="mso-bidi-font-style: normal;">Trichophyton</i> dan <i style="mso-bidi-font-style: normal;">Microsporum</i>, misalnya <i style="mso-bidi-font-style: normal;">T.violaceum, T.gourvilii, T.mentagrophytes, T.tonsurans, M.audonii, M.canis, M.ferrugineum.</i> </span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l38 level1 lfo42; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Manifestasi Klinis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l46 level1 lfo44; text-align: justify; text-indent: -21.25pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">“Grey pacth ringworm”<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Merupakan tinea kapitis yang biasanya disebabkan oleh genus <i style="mso-bidi-font-style: normal;">Microsporum</i> dan ditemukan pada anak-anak. Penyakit ini biasanya dimulai dengan timbulnya papula merah kecil sekitar folikel rambut. Papula ini kemudian melebar dan membentuk bercak pucat karena adanya sisik. Penderita mengeluh gatal, warna rambut menjadi abu-abu, tidak berkilat lagi. Rambut menjadi mudah patah, dan juga mudah terlepas dari akarnya. Pada daerah yang terserang oleh jamur terbentuk alopesia setempat dan terlihat sebagai “grey pacth”.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l46 level1 lfo44; text-align: justify; text-indent: -21.25pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">“Kerion”<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Merupakan tinea kapitis yang disertai dengan reaksi peradangan yang hebat. Lesi berupa pembengkakan menyerupai sarang lebah, dengan serbukan sel radang disekitarnya. Kelainan ini menimbulkan jaringan parut yang menetap. Biasanya disebabkan jamur <i style="mso-bidi-font-style: normal;">zoofilik</i> dan <i style="mso-bidi-font-style: normal;">geofilik.<o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><v:shape id="Picture_x0020_2" o:spid="_x0000_i1028" style="height: 142.5pt; mso-wrap-style: square; visibility: visible; width: 159pt;" type="#_x0000_t75"> <v:imagedata o:title="kerion" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image009.gif"> </v:imagedata></v:shape></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l46 level1 lfo44; text-align: justify; text-indent: -21.25pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">“Black dot ringworm”<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Adalah tinea kapiti dengan gambaran klinis berupa terbentuknya titik-titik hitam pada kulit kepala akibat patahnya rambut yang terinfeksi tepat di muara folikel. Ujung rambut yang patah dan penuh spora terlihat sebagai titik hitam. Biasanya disebabkan <i style="mso-bidi-font-style: normal;">Trichophyton.<o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Yang beresiko tinggi adalah sosioekonomi rendah. Penyakit ini menular, meskipun cara penularannya masih diperdebatkan. Anak-anak sering tertular dari temannya dan cara penularan dapat juga terjadi pada satu keluaga. Penyebab dapat diisolasi dari sisir, sikat, kursi, topi, dan alat-alat pencukur rambut. Mula-mula jamur tersebut mengadakan kolonisasi pada permukaan kulit lalu terjadi reaksi peradangan bergantung pada hospes, genera/spesies jamur penyebab dan lokasi lesi. Organisme tersebut bertahan bertahun-tahun pada tubuh pasien, sehingga orang tersebut menjadi karier. Ketegangan atau trauma dapat menimbulkan eksaserbasi.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l38 level1 lfo42; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diagnosis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diagnosis ditegakkan berdasarkan gambaran klinik dan lokalisasinya, serta pemeriksaan kerokan kulit dengan mikroskop langsung dengan larutan KOH 10-20% untuk melihat hifa atau spora jamur.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l38 level1 lfo42; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Prognosis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Infeksi jamur yang ringan dapat sembuh spontan. Reaksi peradangan yang hebat lebih mudah sembuh terutama yang disebabkan spesies zoofilik. Infeksi ektotriks kadang-kadang dapat sembuh tanpa pengobatan. Infeksi endotriks dapat berjalan kronis dan berlangsung sampai dewasa.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l38 level1 lfo42; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penatalaksanaan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l65 level1 lfo45; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Berikan obat topical berupa sampo atau,selenium sulfida, sampo providone iodine atau sampo yang mengandung derivate azol <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Rasional : untuk mencegah penyebaran spora.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l65 level1 lfo45; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengobatan sistemik dengan griseofulvin microsize dengan dosis yang direkomendasikan. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Lamanya pemberian 6-8 minggu <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l65 level1 lfo45; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dalam keadaan tertetu perlu dipertimbangkan pemberian kortikosteroid oral Rasional : untuk menghindari reaksi ‘id’ dan mengurangi peradangan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l38 level1 lfo42; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengobatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengobatan pada anak biasanya diberikan per oral dengan griseofulvin 10-25 mg/kg BB/hari selama 6 minggu. Dosis pada orang dewasa adalah 500 mg per hari selama 6 minggu. Griseofulvin <i style="mso-bidi-font-style: normal;">“fine particle”</i> diminum bersama minuman yang mengandung lemak, mislanya dengan susu. Penggunaan antijamur topika. Dapat mengurangi penularan pada orang yang ada disekitarnya. Selain antijamur, pada bentuk kerion, kortikosteroid dapat diberikan dalam jangka pendek, misalnya prednison 20 mg sehari selama 5 hari dengan pertimbangan bahwa obat tersebut dapat mempercepat resolusi dan menghindarkan terjadinya reaksi id.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l51 level1 lfo41; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">v<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea korporis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">merupakan dermatofitosis pada kulit tubuh tidak berambut (glabrous skin) di daerah muka, badan, lengan , dan glutea.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l71 level4 lfo29; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">I.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Favosa<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l2 level1 lfo46; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Definisi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Favosa adalah infeksi jamur kronis, terutama oleh T.schoenleini, T.violaceum, dan M.gypseum. Penyakit ini merupakan bentuk lain dari tinea kapitis, yang ditandai oleh skutula berwarna kekuningan dan bau seperti tikus pada kulit kepala. Biasanya, lesinya menjadi sikatrik alopesia permanen. Kadang, kulit halus dan kuku dapat terkena.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l2 level1 lfo46; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Manifestasi Klinis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kemerahan pada kulit dan terkenanya folikel rambut tanpa kerontokan, hingga skutula dan kerontokan rambut, serta lesi menjadi lebih merah dan lebih luas. Setelah itu, terjadi kerontokan rambut luas, kulit mengalami atrofi, dan sembuh dengan jaringan parut permanen.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l2 level1 lfo46; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diagnosis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Berdasarkan gejala klinis dan pemeriksaan mikroskopis langsung, dengan menemukan miselium, “air bubbles” yang bentuk nya tidak teratur. Pada pemeriksaan dengan lampu Wood tampak fluoresensi hijau pudar <i style="mso-bidi-font-style: normal;">(“dull green”)</i>.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l2 level1 lfo46; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Terapi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Prinsip pengobatan tinea favosa sama dengan pengobatan tinea kapitis. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Untuk menghilangkan skutula dan debris, hygiene harus dijaga dengan baik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l71 level4 lfo29; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">II.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Imbrikata<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l10 level1 lfo49; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Definisi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Imbrikata adalah penyakit yang disebabkan oleh infeksi jamur dermatofita yang memberikan gambaran khas berupa kulit bersisik dengan sisik yang melingkar-lingkar dan terasa gatal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l10 level1 lfo49; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Etiologi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penyakit ini disebabkan jamur dermatofita <i style="mso-bidi-font-style: normal;">T.concentrium.</i><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l10 level1 lfo49; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Gambaran Klinis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penyakit ini dapat menyerang seluruh permukaan kulit halus, sehingga sering digolongkan dalam tinea korporis. Lesi bermula sebagai makula eritematosa yang gatal, kemudian timbul skuama yang agak tebal dan terletak konsentris dengan susunan seperti genting. Lesi makin lama makin melebar tanpa meninggalkan penyembuhan dibagian tengah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l10 level1 lfo49; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diagnosis banding<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diagnosis banding adalah <i style="mso-bidi-font-style: normal;">eritroderma </i>dan <i style="mso-bidi-font-style: normal;">pemfigus foliaseus.<o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l10 level1 lfo49; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diagnosis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diagnosis ditegakkan berdasarkan gambaran klinis yang sangat khas berupa lesi kosentris.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l10 level1 lfo49; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengobatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengobatan sistemik : griseofulvin dengan dosis 500 mg sehari selama 4 minggu. Sering terjadi kambuh setelah pengobatan, sehingga memerlukan pengobatan ulang yang lebih lama.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Obat sistemik yang lain adalah ketokonazol 200 mg sehari, itrakonazol 100 mg sehari, dan terbinafin 250 mg sehari selama 4 minggu. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengobatan topical tidak begitu efektif karena daerah yang terserang luas. Dapat diberikan preparat yang mengandung keratolitik kuat dan antimikotik, misalnya <i style="mso-bidi-font-style: normal;">salep Whitfield</i>, <i style="mso-bidi-font-style: normal;">Castellani paint</i>, atau campuran salisilat 5 % dan sulfur presipitatum 5%, serta obat-obat antimikotik berspektrum luas.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l51 level1 lfo41; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">v<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Kruris<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l7 level1 lfo50; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Definisi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l53 level1 lfo47; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea kruris adalah penyakit infeksi jamur dermatofita di daerah liptan paha, genitalia, dan sekitar anus, yang dapat meluas ke bokong dan perut bagian bawah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l53 level1 lfo47; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea kruris adalah dermatofitosis pada lipatan paha, daerah perineum, dan sekitar anus.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> <v:shape id="Picture_x0020_4" o:spid="_x0000_i1027" style="height: 168.75pt; mso-wrap-style: square; visibility: visible; width: 279pt;" type="#_x0000_t75"> <v:imagedata o:title="tinea kruris 1" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image010.jpg"> </v:imagedata></v:shape><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 1.25in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l7 level1 lfo50; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Etiologi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penyebab yang tersering yaitu <i style="mso-bidi-font-style: normal;">T.rubrum, T.mentagrophytes,</i> atau <i style="mso-bidi-font-style: normal;">E.floccosum.<o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l7 level1 lfo50; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Manifestasi klinis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kelainan ini dapap bersifat akut atau menahun, bahkan seumur hidup. Lesi kulit dapat terbatas pada daerah genito-krural, atau meluas ke sekitar anus, daerah gluteus dan perut bagian bawah, atau bagian tubuh lain.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Lesi umumnya bilateral namun tidak selalu simetris. Biasanya disertai rasa gatal dan kadang-kadang rasa panas. Kelainan kulit yang tampak pada sela paha merupakan lesi berbatas tegas. Peradangan pada tepi lebih nyata daripada daerah tengah. Pda bentuk kronis, lesi kulit hanya berupa bercak hiperpigmentasi denagn sedikit skuama. Erosi dan keluarnya cairan biasanya akibat garukan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l7 level1 lfo50; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penatalaksanaan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Prinsip pengobatan pada tinea kruris kurang lebih sama dengan prinsip pengobatan tinea korporis.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l13 level1 lfo51; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Obat topikal’<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Merupakan pilihan utama. Seperti pada pengobatan tinea korporis, obat-obat klasik, derivat imidazol, dan derivat alilamin dapat digunakan dengan cara pengobatan dan pengobatan yang kurang lebih sama.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l13 level1 lfo51; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Obat sistemik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengobatan sistemik hanya diberikan atas indikasi tertentu misalnya lesi yang luas atau <i style="mso-bidi-font-style: normal;">recalcitrant</i> karena pemakaian obat topikal saja sudah cukup efektif. Obat yang dipakai antara lain griseofulvin, ketokonazol, itrakonazol, flukonazol, serta terbinafin.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l51 level1 lfo41; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">v<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Manus Et Pedis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l37 level1 lfo52; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Definisi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l22 level1 lfo53; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea manus et pedis adalah penyakit yang disebabkan oleh infeksi jamur dermatofita di daerah kulit telapak tangan dan kaki, punggung tangan dan kaki, jari-jari tangan dan kaki, serta daerah interdigital.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l22 level1 lfo53; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea manus et pedis adalah infeksi deformitas pada kaki, terutama di sela jari dan telapak kaki terutama yang memakai kaus dan sepatu yang tetutup. Keadaan lembab dan panas merangsang pertumbuhan jamur. Tinea manum adalah dermatofitosit. Semua bentuk di kaki dapat terjadi pada tangan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> <v:shape id="Picture_x0020_5" o:spid="_x0000_i1026" style="height: 199.5pt; mso-wrap-style: square; visibility: visible; width: 241.5pt;" type="#_x0000_t75"> <v:imagedata o:title="tinea manum" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image011.jpg"> </v:imagedata></v:shape><o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l37 level1 lfo52; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Etiologi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penyebab tersering adalah <i style="mso-bidi-font-style: normal;">T.rubrum, T.mentagrophytes, E.floccosum.<o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l37 level1 lfo52; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Manifestasi Klinis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l64 level1 lfo54; text-align: justify; text-indent: -21.25pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bentuk intertriginosa<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Manifestasi klinisnya berupa maserasi, deskuamasi, dan erosi pada sela jari. Tampak warna keputihan basah dapat terjadi fisura yang terasa nyeri bila tersentuh. Infeksi sekunder dapat menyertai fisura tersebut dan lesi dapat ,eluas sampai kuku dan kulit jari. Pada kaki, lesi sering mulai dari sela jari III, IV, dan V. bentuk klinis ini dapat berlangsung bertahun-tahun tanpa keluhan sama sekali. Pada suatu ketika kelainan ini dapat disertai infeksi sekunder oleh bakteri, sehingga terjadi limfangitis, limfadenitis, selulitis, dan erysipelas yang disertai gejala-gejala umum.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l64 level1 lfo54; text-align: justify; text-indent: -21.25pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bentuk vesikuler akut<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penyakit ini ditandai terbentuknya vesikula-vesikula dan bula yang terletak agak dalam di bawah kulit dan sangat gatal. Lokasi yang sering adalah telapak kaki bagian tengah dan kemudian melebar serta vesikulanya memecah. Infeksi sekunder dapat memperburuk keadaan ini.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l64 level1 lfo54; text-align: justify; text-indent: -21.25pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bentuk moccasin foot<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pada bentuk ini seluruh kaki dari telapak, tepi sampai punggung kaki, terlihat kulit menebal dan beskuama. Eritem biasanya ringan terutama terlihat pada tepi lesi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l37 level1 lfo52; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penatalaksanaan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l23 level1 lfo55; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 10pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaus kaki yang dipakai dipilih kaus yang memungkinkan ventilasi dan diganti setiap hari<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l23 level1 lfo55; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaki harus bersih <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l23 level1 lfo55; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hindari memakai sepatu tertutup, sempit, sepatu olahraga dan sepatu plastic sepanjang hari<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l23 level1 lfo55; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 10pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaki dan sela-sela jari dijaga agar selalu kering<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l23 level1 lfo55; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 10pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Sesudah mandi dapat diberikan bedak atau tanpa antijamur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l63 level1 lfo56; text-align: justify; text-indent: -21.25pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Obat topikal<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bila lesi basah, maka sebaiknya direndam dalam larutan kalium permanganat 1/5.000 atau larutan asam asetat 0,25% selama 15-30 menit, 2-4 kali sehari. Atap vesikel dan bula dipecahkan untuk mengurangi keluhan. Bila peradangan hebat dikombinasikan dengan obat antibiotic sistemik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kalau peradangan sudah berkurang, diberikan obat topikal antijamur berspektrum luas antara lain, haloprogin, klotrimazol, mikonazol, bifonazol, atau ketokonazol.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pada tinea pedis tipe papuloskuamosa dengan hyperkeratosis, obat anti jamur topikal sukar menembus kulit.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l63 level1 lfo56; text-align: justify; text-indent: -21.25pt;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></i><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Obat sistemik<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Biasanya tidak digunakan. Namun, bila digunakan harus dikombinasi dengan obat-obat antijamur topikal. Obat-obat sistemik tersebut antara lain griseofulvin, ketokonazol, itrakonazol, dan terbinafin.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l37 level1 lfo52; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengobatan <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengobatan pada umumnya cukup topikal saja dengan obat-obat antijamur untuk bentuk interdigital dan vesikuler. Lama nya pengobatan 4-6 minggu. Bentuk <i style="mso-bidi-font-style: normal;">moccasin foot</i> yang kronik memerlukan pengobatan yang lebih lama, apalagi bila disertai dengan tinea unguium, pengobatan diberikan paling sedikit 6 minggu dan kadang-kadang memerlukan antijamur peroral, misalnya griseofulvin, intrakonazol, atau terbenafin. Bentuk klinis akut yang disertai selulitis memerlukan pengobatan antibiotic, misalnya penisilin prokain, penisilin V, fluklosasilin, eritromisin atau spiramisin dengan dosis yang adekuat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l51 level1 lfo41; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">v<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Unguium<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l14 level1 lfo57; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Definisi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l27 level1 lfo58; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Unguium adalah kelainan kuku yang disebabkan oleh infeksi jamur dermatofita.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l27 level1 lfo58; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 150%;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea Unguium adalah kelainan lempeng kuku yang disebabkan oleh invasi/ infeksi jamur dermatofit. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><v:shape id="Picture_x0020_6" o:spid="_x0000_i1025" style="height: 173.25pt; mso-wrap-style: square; visibility: visible; width: 250.5pt;" type="#_x0000_t75"> <v:imagedata o:title="tinea unguium" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image012.jpg"> </v:imagedata></v:shape></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l14 level1 lfo57; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Etiologi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penyebab penyakit yang tersering adalah <i style="mso-bidi-font-style: normal;">T.mentagrophytes, T.rubrum.</i><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l14 level1 lfo57; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Faktor predisposisi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Beb</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">e</span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">rapa hal yang merupakan factor predisposisi terjadinya tinea unguium adalah trauma, hiperhidrosis palmar dan plantar, keadaan imunosupresi, gangguan sirkulasi, distrofi lempeng kuku oleh berbagai sebab, dan salah posisi perifer kuku ke lipat kuku dan hiponikium. Biasanya pasien tine unguium mempunyai dermatofitosis di tempat lain yang sudah sembuh atau yang belum. Kuku kakia sering diserang daripada kuku tangan.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l14 level1 lfo57; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Manifestasi klinis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo61; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">bentuk subungal distalis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Dimulai dari tepi distal atau distolateral kuku. Proses ini menjalar ke proksimal dan di bawah kuku terbentuk sisa kuku yang rapuh. Kalau proses berjalan terus, maka permukaan kuku bagian distal akan hancur dan yang terlihathanya kuku yang rapuh yang menyerupai kapur.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo61; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Benruk lateralis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penyakit ini mulai dengan perubahan bagian luar alur lateral kuku yang menjadi kuning. Lesi meluas ke bagian distal atau proksimal kuku. Kemudain terjadi paronikia ( peradangan jaringan sekitar kuku)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo61; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">leukonikia trikofita/mikotika<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">merupakan leukonikia atau keputihan di permukaan kuku yang dapat dikerok untuk dibuktikan adanya elemen jamur. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo61; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">bentuk subungal proksimalis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">bentuk ini mulai dari pangkal kuku bagian proksimal terutama menyerang kuku dan membentuk gambaran klinis yang jhas, yaitu terlihat kuku di bagian distal masih utuh, sedangkan bagian proksimal rusak. Biasanya penderita tinea inguinum mempunyai dermatofitosis di tempat lain yang sudah sembuh atau yang belum. Kuku kaki lebih sering daripada kuku tangan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo61; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bentuk distrofi kuku total<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bentuk ini merupakan keadaan lanjut dari bentuk klinis di atas. Pada bentuk ini kerusakan terjadi pada seluruh lempeng kuku.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l14 level1 lfo57; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Penatalaksanaan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengobatan dapat secara topikal maupun sistemik, tetapi umumnya pengobatan topikal tidak efektif. Pengobatan topikal dapat diberikan bila hanya 1-2 kuku yang terkena dan tidak sampai menyerang matriks kuku.</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Beberapa cara pengobatan topikal dan dapat digunakan:</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l41 level1 lfo59; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Cara klasik menggunakan obat antidermatofit topikal dan sedapat mungkin menghilangkan bagian yang rusak misalnya dengan pengikiran atau kuretase kuku. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Obat antidermatofit yang dapat dipakai antara lain golongan azol, haloprogin, siklopirosilamin, dan alilamin. </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Solusio glutaraldehid 10% dan kirim tianbendazol 10% dengan bebat oklusifjuga dapat digunakan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l41 level1 lfo59; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Avulsi( pengangkatan) kuku yang diikuti pemberian obat antidermatofit topikal. Avulsi kuku dapat dilakukan dengan bedah skapel atau bedah kimia, misalnya dengan menggunakan urea. Sediaan kombinasi urea 40% dan bifonazol yang terdapat di beberapa Negara juga dapat dipakai untuk cara ini.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l41 level1 lfo59; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Obat topikal antara lain cat kuku berisi siklopiroksolamin 5% dan cat kuku berisi amorofilin.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 120.5pt; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Untuk pengobatan sistemik dapat dipakai :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l26 level1 lfo60; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Griseofulvin 0,5-1 gram/hari. Untuk infeksi kuku tangan dibutuhkan pengobatan rata-rata 4-6 bulan, sedangkan untuk kuku kaki 8-18 bulan. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tetapi keberhasilan pengobatan ini rendah dan rekurensi tinggi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l26 level1 lfo60; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Itrakonazol. Semula dianjurkan penggunaan dosis 200 mg per hari selama 3 bulan pada infeksi kuku kaki. Akhir-akhir ini penggunaan terapi pulse 400 mg per hari selama seminggu tiap bulan member hasil baik dalam 3 bulan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l26 level1 lfo60; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Terbinafin.dosis 250 mg per hari selama 1,5 bulan pada infeksi kuku tangan dan selama 3 bulan pada kuku.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l26 level1 lfo60; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pemeriksaan penunjang</span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.25pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Bahan pemeriksaan berupa kerokan kulit berambut halus ( glabrous skin), kulit berrambut, dan kuku. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pada sediaan kulit dan kuku yang terlihat adalah hifa, sebagai dua garis sejajar, terbagi oleh sekat, dan bercabang , maupun spora berderet (artospora) pada kelainan kulit yang lama dan/ atau sudah diobati. </span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pada sediaan rambut yang dilihat adalah spora kecil (mikrospora) atau besar (makrospora). Spora dapat tersusun di luar rambut (ektotriks) atau di dalam rambut ( endotriks). Kadang-kadang dapat terlihat juga hifa pada sediaan rambut .<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l26 level1 lfo60; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Asuhan keperawat</span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">an</span></b><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l24 level1 lfo66; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">v<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pengkajian keperawatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 114.0pt; mso-add-space: auto; mso-list: l70 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Biodata<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 114.0pt; mso-add-space: auto; mso-list: l70 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Keluhan utama<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 114.0pt; mso-add-space: auto; mso-list: l70 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Riwayat penyakit sekarang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 114.0pt; mso-add-space: auto; mso-list: l70 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Riwayat penyakit dahulu<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 114.0pt; mso-add-space: auto; mso-list: l70 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Riwayat penyakit keluarga<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 114.0pt; mso-add-space: auto; mso-list: l70 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Riwayat psikososial<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 114.0pt; mso-add-space: auto; mso-list: l70 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kebiasaan sehari-hari<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 114.0pt; mso-add-space: auto; mso-list: l70 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">8.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pemeriksaan fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 114.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l24 level1 lfo66; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">v<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Diagnosa keperawatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l24 level2 lfo66; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">gangguan </span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">konsep diri (</span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">body image</span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">)</span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> b.d perubahan penampilan fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l24 level2 lfo66; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">kerusakan integritas kulit b.d lesi akibat efek dari garuk<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l24 level2 lfo66; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">gangguan pola tidur / istirahat b.d gatal/pruritus<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l24 level1 lfo66; text-align: justify; text-indent: -21.3pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">v<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Intervensi Keperawatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l24 level2 lfo66; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">gangguan konsep diri (body image) b.d perubahan penampilan fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"> </span></i><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">hasil yang diharapkan</span></i><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify; text-indent: -21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l12 level1 lfo67; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">klien menilai keadaan dirinya terhadap hal-hal yang realistik tanpa menyimpang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l12 level1 lfo67; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">dapat menyatakan dan menunjukkan peningkatan konsep diri<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l12 level1 lfo67; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">dapat menunjukkan adaptasi yang baik dan menguasai kemampuan diri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 99.25pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">rencana keperawatan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l28 level1 lfo68; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">bina hubungan saling percaya antara perawat-klien<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l28 level1 lfo68; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">dorong klien untuk menyatakan perasannya, terutama cara ia merasakan sesuatu, berpikir, atau memandang dirinya sendiri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l28 level1 lfo68; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">dorong klien untuk mengajukan pertanyaan mengenai masalah kesehatan, pengobatan, dan kemajuan pengobatan dankemungkinan hasilnya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l28 level1 lfo68; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">beri informasi yang dapat dipercaya dan menguatkan informasi yang telah diberikan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l28 level1 lfo68; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">jernihkan kesalahan persepsi individu tentang dirinya, mengenai perawatan dirinya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l28 level1 lfo68; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">hindari kata-kata yang mengecam dan memojokkan klien.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l28 level1 lfo68; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">lindungi privasi dan jamin lingkungan yang kondusif.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l28 level1 lfo68; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">kaji kembali tanda dan gejala gangguan harga diri, gangguan citra tubuh, dan perubahan penampilan peran.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l28 level1 lfo68; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Beri penjelasan dan penyuluhan tentang konsep diri yang positif.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l24 level2 lfo66; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">kerusakan integritas kulit b.d lesi akibat efek dari garukan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">hasil yang diharapkan<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.25pt; mso-add-space: auto; mso-list: l55 level1 lfo74; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Area terbebas dari infeksi lanjut.</span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.25pt; mso-add-space: auto; mso-list: l55 level1 lfo74; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kulit bersih, kering, dan lembab</span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">rencana keperawatan:</span></i><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.25pt; mso-add-space: auto; mso-list: l61 level1 lfo75; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaji keadaan kulit<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.25pt; mso-add-space: auto; mso-list: l61 level1 lfo75; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kaji perubahan warna kulit<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.25pt; mso-add-space: auto; mso-list: l61 level1 lfo75; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Pertahankan agar area luka tetap bersih dan kering<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.25pt; mso-add-space: auto; mso-list: l61 level1 lfo75; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Kolaborasi dengan dokter dalam pemberian terapi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.25pt; mso-add-space: auto; mso-list: l61 level1 lfo75; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Anjurkan klien untuk memakai pakaian ( baju, celana, dalam, kaus kaki) yang mudah menyerap keringat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; mso-list: l24 level2 lfo66; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">gangguan pola tidur / istirahat b.d gatal/pruritus<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 99.25pt; mso-add-space: auto; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">hasil yang diharapkan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l62 level1 lfo69; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">klien dapat menjelaskan faktor-faktor penghambat atau pencegah tidur<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l62 level1 lfo69; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">klien dapat mengidentifikasi tehnik untuk mempermudah tidur.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 99.25pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">rencana keperawatan<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l15 level1 lfo70; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">identifikasi faktor-faktor penyebab tidak bisa tidur dan penunjang keberhasilan tidur.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l15 level1 lfo70; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">beri penjelasan pada klien dan keluarga penyebab gangguan pola tidur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l15 level1 lfo70; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">atur prosedur tindakan medis atau keperawatan untuk member sesedikit mungkin gangguan selama periode tidur (mis. ketika individu bangun untuk makan obat, pada saat pengukuran tanda-tanda vital)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l15 level1 lfo70; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">hindari prosedur yang tidak penting selama waktu penting.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l15 level1 lfo70; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">anjurkan klien mandi air hangat sebelum tidur dan mengoleskan obat salep (sesuai terapi) pada daerah lesi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l15 level1 lfo70; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">kolaborasikan dengan tim medis dalam pemberian antihistamin/antigatal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">BAB III<o:p></o:p></span></b></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">PENUTUP<o:p></o:p></span></b></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l31 level1 lfo64; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">A.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Simpulan <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 42.55pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Herpes merupakan kelainan kulit yang disebabkan oleh virus. Terdiri dari herpes simpleks yang disebabkan oleh virus herpes simpleks tipe I dan II , dan herpes zoster yang disebabkan oleh virus varisela zoster. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 42.55pt; text-align: justify; text-indent: 21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Tinea merupakan kulit yang disebabkan oleh jamur golongan <i style="mso-bidi-font-style: normal;">Microsporum, Trichophyton, Epidermophyton.</i> Berdasarkan lokasinya tinea dibagi menjadi tine kapitis, korporis, kruris, manus et pedis, dan unguium.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l31 level1 lfo64; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">B.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Saran <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 42.55pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.25pt;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Baik herpes maupun tinea, sama-sama merupakan kelainan kulit yang banyak membawa dampak tidak baik pada fisik dan psikologis pasien , oleh karena itu, sebagai perawat harus bisa memberikan askep yang tepat sehingga dampak yang timbul bisa diatasi.<o:p></o:p></span></div><div align="center" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 42.55pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center; text-indent: 21.25pt;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p> </o:p></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p> </o:p></span></b></div><div align="center" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">DAFTAR PUSTAKA</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo65; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Djuanda, Adhi. 2000. </span><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Ilmu Penyakit Kulit dan Kelamin. Cet. 2, ed. 3</span></i><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">. Jakarta : FKUI.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo65; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Harahap, Marwali. 2000<i style="mso-bidi-font-style: normal;">. Ilmu penyakit Kulit, Cet. 1.</i> Jakarta : Hipokrates.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo65; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Hartanto, Hurawati.2009. <i style="mso-bidi-font-style: normal;">Kamus Saku Mosby.</i> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jakarta. EGC<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo65; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Mansjoer, Arif. 2000<i style="mso-bidi-font-style: normal;">. Kapita Selekta Kedokteran, Ed. III. Jil. 2. </i></span><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jakarta </span></i><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">: Media Aesculapius.</span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo65; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Price, Sylvia A. 2006. <i style="mso-bidi-font-style: normal;">Patofisiologi : Konsep Klinis Proses Proses Penyakit II. Ed. 6, Cet. 1 : Jil. II</i> </span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Jakarta: EGC.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo65; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Rahariyani, Loetfia Dwi. 2008. <i style="mso-bidi-font-style: normal;">Asuhan Keperawatan Klien Gangguan Sistem Integumen</i>. Jakarta: EGC<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo65; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 10pt; line-height: 150%;">û<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 150%;">Smeltzer, Suzanne C. 2002. <i style="mso-bidi-font-style: normal;">Bukur Ajar Keperawatan Medikal Bedah III, ed. 8, Cet 2, jil. III</i>. Jakarta : EGC.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div>Ian zkate pakpahanhttp://www.blogger.com/profile/10259135788220046244noreply@blogger.com2tag:blogger.com,1999:blog-2556652656898751244.post-48631566795628235852010-10-17T12:18:00.000+07:002010-10-17T12:18:46.168+07:00ASKEP OSTEOPOROSIS<div align="center" class="MsoNormal" style="text-align: center;"><span style="font-size: 36.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-no-proof: yes;">OSTEOPOROSIS<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">MAKALAH<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;">disusun untuk memenuhi tugas mata ajaran Keperawatan Medikal Bedah III<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;"><br />
</span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEja9m2dcWNzqT69Os-AZWnn7yklaS15o-s21jh1iCGWR3DEOPYjeVxEFQl7fLqTf9uSxrK_UkwiwEREZpyMMHeWGPZLNkv8jbu2ziCUlVOT5qvtOBqL6_zn8bf7NyhGbtIPHp1kfBJ-Z3c/s1600/DAH+AH+CAPE.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEja9m2dcWNzqT69Os-AZWnn7yklaS15o-s21jh1iCGWR3DEOPYjeVxEFQl7fLqTf9uSxrK_UkwiwEREZpyMMHeWGPZLNkv8jbu2ziCUlVOT5qvtOBqL6_zn8bf7NyhGbtIPHp1kfBJ-Z3c/s320/DAH+AH+CAPE.jpg" width="320" /></a></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas> <v:path gradientshapeok="t" o:connecttype="rect" o:extrusionok="f"> <o:lock aspectratio="t" v:ext="edit"> </o:lock></v:path></v:stroke></v:shapetype><v:shape id="Picture_x0020_1" o:spid="_x0000_s1026" style="height: 207.9pt; left: 0; margin-left: 105.85pt; margin-top: 10.15pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.65pt; z-index: 1;" type="#_x0000_t75"> <v:imagedata o:title="Logo STIKes ku Don't open,please call me again" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image001.jpg"> <w:wrap type="square"> </w:wrap></v:imagedata></v:shape><v:shape id="Picture_x0020_1" o:spid="_x0000_s1026" style="height: 207.9pt; left: 0; margin-left: 105.85pt; margin-top: 10.15pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.65pt; z-index: 1;" type="#_x0000_t75"><br />
</v:shape><v:shape id="Picture_x0020_1" o:spid="_x0000_s1026" style="height: 207.9pt; left: 0; margin-left: 105.85pt; margin-top: 10.15pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.65pt; z-index: 1;" type="#_x0000_t75"><br />
</v:shape><v:shape id="Picture_x0020_1" o:spid="_x0000_s1026" style="height: 207.9pt; left: 0; margin-left: 105.85pt; margin-top: 10.15pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.65pt; z-index: 1;" type="#_x0000_t75"><br />
</v:shape><v:shape id="Picture_x0020_1" o:spid="_x0000_s1026" style="height: 207.9pt; left: 0; margin-left: 105.85pt; margin-top: 10.15pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.65pt; z-index: 1;" type="#_x0000_t75"><br />
</v:shape><v:shape id="Picture_x0020_1" o:spid="_x0000_s1026" style="height: 207.9pt; left: 0; margin-left: 105.85pt; margin-top: 10.15pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.65pt; z-index: 1;" type="#_x0000_t75"><br />
</v:shape><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="line-height: normal; text-align: center;"><br />
</div><div class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt; mso-no-proof: yes;"><br clear="all" style="mso-special-character: line-break;" /> <o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;">oleh :<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;">PROGRAM STUDI D III KEPERAWATAN<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;">Sekolah tinggi ilmu kesehatan santo borromeus<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;">bandung<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">BAB II<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">TINJAUAN TEORITIS<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">ANATOMI DAN FISIOLOGI TULANG<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">System musculoskeletal terdiri dari tulang, sendi, otot dan struktur pendukung lainnya (tendon, ligament, fasia dan bursae). Pertumbuhan dan perkembangan struktur ini terjadi selama masa kanak-kanak dan remaja.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 22.5pt; mso-add-space: auto; mso-list: l44 level1 lfo23; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">TULANG<o:p></o:p></span></u></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Struktur tulang dan jaringan ikat menyusun kurang lebih 25% berat badan dan otot menyusun kurang lebih 50%. Kesahatan dan fungsi system musculoskeletal sangat bergantung pada system tubuh lain. Struktur tulang member perlindungan terhadap organ vital, termasuk otak, jantung dan paru-paru. Kerangka tulang merupakan kerangka yang kuat untuk menyangga struktur tubuh. Otot yang melekat ke tulang memungkinkan tubuh bergerak.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Pembagian skeletal, yaitu:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l11 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Axial skeleton terdiri dari kerangka tulang kepala dan leher, tengkorak, kolumna vertebrae, tulang iga, tulang hyoid sternum.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l11 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Apendikular skeleton terdiri dari:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 92.25pt; mso-add-space: auto; mso-list: l42 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kerangka tulang lengan dan kaki<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 92.25pt; mso-add-space: auto; mso-list: l42 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Ekstrmitas atas (scapula, klavikula, humerus, ulna, radial) dan tangan (karpal, metacarpal, falang)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 92.25pt; mso-add-space: auto; mso-list: l42 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Ekstremitas bawah (tulang pelvic, femur, patella, tibia, fibula) dan kaki (tarsal, metatarsal, falang).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 92.25pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l20 level1 lfo22; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Jenis Tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Ada empat jenis tulang, yaitu :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l18 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tulang Panjang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tulang panjang (mis, femur, humerus) bentuknya silindris dan berukuran panjang seperti batang (diafisis) tersusun atas tulang kompakta, dengan kedua ujungnya berbentuk bulat (epifisis) tersusun atas tulang kanselus. Tulang diafisis memiliki lapisan luar berupa tulang kompakta yyang melindungi sebuah rongga tengah yang disebut kanal medulla yang mengandung sumsum kuning. Sumsum kuning terdiri dari lemak dan pembuluh darah, tetapi suplai darah atau eritrositnya tidak banyak. Tulang epifisis terdiri dari tulang spongiosa yang mengandung sumsuum merah yang isinya sama seperti sumsum kuning dan dibungkus oleh selapis tipis tulang kompakta. Bagian luar tulang panjang dilapisi jaringan fibrosa kuat yang disebut periosteum. Lapisan ini kaya dengan pembuluh darah yang menembus tulang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><span style="mso-tab-count: 1;"> </span>Periostenum member nutrisi tulang dibawahnya melalui pembuluh darah. Jika periostenum robek, tulang dibawahnya akan mati. Periostenum berperan untuk pertambahan kekebalan tulang melalui kerja osteoblas. Periostenum berfungsi protektif dan merupakan tempat pelekatan tendon. Periostenum tidak ditemukan pada permukaan sendi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l18 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tulang Pendek<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tulang pendek (mis,falang, karpal) bentuknya hampir sama dengan tulang panjang, tetapi bagian distal lebih kecil dari pada bagian proksimal, serta berukuran pendek dan kecil.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l18 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tulang Pipih<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tulang pipih (mis, sternum, kepala, scapula, panggul) bentuknya gepeng, berisi sel-sel pembentuk darah, dan melindungi organ vital dan lunak dibawahnya. Tulang pipih terdiri dari 2 lapis tulang kompakta dan di bagian tengahnya terdapat lapisan spongiosa. Tulang ini juga dilapisi oleh periostenum yang dilewati oleh dua kelompok pembuluh darah menembus tulang untuk menyuplai tulang kompakta dan tulang spongiosa.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l18 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tulang Tidak Beraturan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tulang tidak beraturan (mis, vertebra, telinga tengah) mempunyai bentuk yang unik sesuai fungsinya. Tulang tidak beraturan terdiri dari tulang spongiosa yang dibungkus oleh selapis tipis tulang kompakta. Tulang ini diselubungi periostenum kecuali pada permukaan sendinya seperti tulang pipih. Periostenum ini member dua kelompok pembuluh darah untuk menyuplai tulang kompakta dan spongiosa.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l18 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tulang Sesamoid<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tulang sesamoid (mis, patella) merupakan tulang kecil yang terletak disekitar tulang yang berdekatan dengan persendian, berkembang bersama tendon dan jaringan fasia.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l20 level1 lfo22; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">STRUKTUR TULANG<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tersusun oleh jaringan tulang kompakta (kortikal) dan kanselus (trabekular atau spongiosa ). Tulang kompakta terlihat padat. Akan tetapi jika diperiksa dengan makroskop terdiri dari <i style="mso-bidi-font-style: normal;">system havers</i>. System havers terdiri dari kanal havers. Sebuah kanal havers mengandung pembuluh darah, saraf, dan pembuluh limfe,lamela (lempengan tulang yang mengelilingi kanal sentral), kaluna (ruang diantara lamella yang mengandung sel-sel tulang atau osteosit dan saluran limfe), dan kanalikuli ( saluran kecil yang menghubungkan lacuna dan kanal sentral). Saluran ini mengandung pembuluh limfe yang membawa nutrient dan oksigen ke osteosit.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l20 level1 lfo22; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">SEL – SEL PENYUSUN TULANG TERDIRI DARI:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.5pt; mso-add-space: auto; mso-list: l15 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoblas</span></b><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"> berfungsi menghasilkan jarinagan osteosid dan menyekresi sejumlah besar fosfatase alkali yang berperan penting dalam pengendapan kalsium dan fosfat kedalam matriks tulang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.5pt; mso-add-space: auto; mso-list: l15 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteosit</span></b><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"> adalah sel-sel tulang dewasa yang bertindak sebagai lintasan untuk pertukaran kimiawi melalui tulang yang padat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.5pt; mso-add-space: auto; mso-list: l15 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoklas</span></b><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"> adalah sel-sel berinti banyak yang memungkinkan mineral dan matriks tulang dapat diabsorbsi. Sel-sel ini menghasilkan enzim proteolitik yang memecah matriks dan beberapa asam yang melarutkan mineral tulang, sehingga kalsium dan fosfat terlepas kedalam darah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.5pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.5pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.5pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l20 level1 lfo22; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">PERTUMBUHAN DAN METABOLISME<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.5pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: 22.5pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Pertumbuhan dan metabolism tulang dipengaruhi oleh sejumlah mineral dan hormon yang meliputi:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l29 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -13.5pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kalsium dan fosfor. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Jumlah kalsium dalam tulang 99% dan fosfor 90%. Konsentrasi kalsium dam fosfor mempunyai ikatan yang sangat erat. Jika kadar Ca meningkat, jumlah fosfor berubah. Keseimbangan kalsium dan fosfor dipertahankan oleh kalsitonin dan hormone paratiroid (PTH).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l29 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -13.5pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kalsitonin<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Diproduksi oleh kelenjar tiroid dan menurunkan konsentrasi Ca serum. Jika jumlah kalsitonin meningkat diatas normal, kalsitonin menghambat absorpsi kalsium dan fosfor dalam tulang serta meningkatkan ekskresi kalsium dan fosfor melalui urine sehingga dibutuhkan Ca dan fosfor.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l29 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -13.5pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Vitamin D terkandung dalam lemak hewan, minyak ikan,dan mentega. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tubuh manusia juga dapat memproduksi vitamin D. sinar ultra violet sinar matahari dapat mengubah ergosterol pada kulit menjadi vit.D. vitamin D diperlukan agar kalsium dan fosfor dapat diabsorpsi dari usus dan digunakan tubuh. Defisiensi vitamin D mengakibatkan deficit mineralisasi , deformitas, patah tulang, penyakit rikets pada anak-anak, dan osteomalasia pada orang dewasa.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l29 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -13.5pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Hormone paratiroid (PTH). <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Pada saat kadar Ca menurun, sekresi PTH meningkat dan menstimulasi tulang untuk meningkatkan aktivitas osteoblastik dan menyumbangkan kalsium ke darah. Jika kadar Ca meningkatkan sekresi PTH diminimalkan, hormone tersebut mengurangi ekskresi Ca diginjal dan memfasilitasi absorpsinya dari usus halus. Hal ini untuk mempertahankan suplai Ca ditulang. Respon ini merupakan contoh umpan balik system Loop yang terjadi dalam system endokrin.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l29 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -13.5pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Hormone pertumbuhan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"> </span>Bertanggung jawab meningkatkan panjang tulang dan menentukan jumlah matriks tulang dibentuk sebelum masa pubertas. Sekresi yang meningkat selama masa kanak-kanak menghasilkan gigantisme dan menurunnya sekresi menghasilkan drawfisme. Pada orang dewasa, peningkatan tersebut menyebabkan akromegali yang ditandai oleh kelainan bentuk tulang dan jaringan lemak.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l29 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -13.5pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Glukokortikoid.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"> </span>Mengatur metabalolisme protein. Pada saat dibutuhka, hormone dapat meningkatkan atau menurunkan katabolisme untuk mengurangi atau mengintensifkan matriks organik ditulang dan membantu dalam pengaturan kalsium di intestinum dan absorpsi fosfor.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l29 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -13.5pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Hormone seksual<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l50 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Estrogen mengstimulasi aktivitas osteoblastik dan cenderung menghambat peran hormone paratiroid. Jumlah estrogen menurun saat menopause sehingga penurunan kadar kalsium pada tulang dalam waktu lama menyebabkan osteoporosis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l50 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Androgen seperti testosterone meningkatkan anabolisme dan massa tulang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l44 level1 lfo23; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">SENDI<o:p></o:p></span></u></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Pergerakan tidak mungkin terjadi jika kelenturan dalam rangka tulang tidak ada.Kelenturan dimungkinkan oleh adanya persendian.Sendi adalah suatu ruangan, tempat satu atau dua tulang berada saling berdekatan.Fungsi utama sendi adalah memberikan pergerakan dan fleksibilitas dalam tubuh.Bentuk persendian ditetapkan berdasarkan jumlah dan tipe pergerakannya, sedangkan klasiikasi sendi berdasarkan pada jumlah pergerakan yang dilakukan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Menurut klasifikasinya, sendi terdiri dari:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l23 level1 lfo34; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Sendi sinartrosis (sendi yang tidak bergerak sama sekali). Contohnya satura tulang tengkorak.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l23 level1 lfo34; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Sendi amfriartosis (sendi bergerak terbatas) contohnya pelvic, simfisis, dan tibia.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l23 level1 lfo34; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Sendi diartrosis/ sinoval (sendi bergerak bebas). Contohnya siku, lutut, dan pergelangan tangan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Berdasarkan strukturnya,sendi dibedakan atas:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l2 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Fibrosa<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l26 level1 lfo36; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">è<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Sendi ini tidak memiliki lapisan tulang rawan, dan tulang yang satu dengan yang lainnya dihubungkan oleh jaringan penyambung pibrosa. Contohnya, sutura tulang tengkorak perlekatan tulang tibia dan fibula bagian distal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l2 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kartilago.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l13 level1 lfo37; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">è<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Sendi yang ujung-ujung tulungnya terbungkus oleh tulang rawan hialin, disokong oleh ligament dan hanya dapat sedikit bergerak. Sendi ini terbagi menjadi 2,yaitu:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l41 level1 lfo38; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Sinkondrosis </span><span style="font-family: Wingdings; mso-ascii-font-family: Arial; mso-bidi-font-family: Arial; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Arial; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">à</span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">sendi-sendi yang seluruh persendiannya diliputi oleh tulang rawan hialin. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Contohnya, sendi-sendi kostokondral.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l41 level1 lfo38; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Simfisis </span><span style="font-family: Wingdings; mso-ascii-font-family: Arial; mso-bidi-font-family: Arial; mso-char-type: symbol; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Arial; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">à</span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">sendi yang tulang-tulangnya memiliki suatu hubungan fibrokartilago dan selapis tipis tulang rawan hialin yang menyelimuti permukaan sendi. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Contohnya, simfisis pubis dan sendi tulang punggung.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l2 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Sendi synovial <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 94.5pt; mso-add-space: auto; mso-list: l0 level1 lfo39; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">è<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Sendi tubuh yang dapat digerakan serta memiliki rongga sendi dan permukaan sendi yang dilapisi tulang rawan hialin. Sendi ini adalah jenis sendi yang paling<span style="mso-spacerun: yes;"> </span>umum dalam tubuh dan berasal dari kata sinovium yang merupakan membrane yang menyekresi cairan synovial untuk lumbrikasi dan absorpsi syok.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kondrosit merupakan satu-satunya sel hidup di dalam tulang rawan sendi. Kondrosit ini dipengaruhi oleh factor anabolic dan factor katabolic dalam mempertahankan keseimbangan sintesis dan degradasi. Factor katabolic utama diperankan oleh sitoksin interkeukin 1 beta, dan tumor necrosis factor alfa. Sedangkan factor anabolic diperankan oleh transforming growth factor( TGF beta) dan insulin-like growth factor 1 (IGF 1)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Dalam menjaga keseimbangan atau homeostasis apabila terjadi osteoarthritis kondrosit akan meningkatkan aktivitas sitokinin yang menyebabkan dikeluarkannya mediator inflamasi dan matriks metalloproteinase(MMP). <o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l44 level1 lfo23; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">OTOT<o:p></o:p></span></u></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Otot skeletal secara volunteer dikendalikan oleh system syaraf pusat dan perifer.Penghubung antara saraf motorik perifer dan sel-sel otot dikenal sebagai motor end-plate. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Otot dibagi dalam tiga kelompok,yaitu:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l43 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Otot rangka(lurik) <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Diliputi oleh kapsul jaringan ikat. Lapisan jaringan ikat yang membungkus otot disebut fasia otot atau episium. Otot ini terdiri dari berkas-berkas sel otot kecil yang dibungkus lapisan jaringan ikat yang disebut perimisium. Sel otot ini dilapisi jaringan ikat yang disebut endomisium.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l43 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Otot visceral (polos) <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Terdapat pada saluran pencernaan, saluran perkemihan, dan pembuluh darah. Otot ini dipersarafi oleh system saraf otonom dan kontraksinya tidak dibawah control keinginan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l43 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Otot jantung <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Ditemukan hanya pada jantung dan kontraksinya diluar control atau diluar keinginan. Otot berkontraksi jika ada rangsangan dari adenosine trifosfat (ATP) dan kalsium.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Fungsi Otot Skelet<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Fungsi otot skelet adalah mengontrol pergerakan, mempertahankan postur tubuh dan menghasilkan panas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l27 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Eksitabilitas adalah kesanggupan sel untuk menerima dan merespons stimulus. Stimulus biasanya dihantarkan oleh nuerotransmiter yang dikeluarkan oleh neuron dan respons yang distransmisikan dan dihasilkan oleh potensial aksi pada membrane plasma dari sel otot.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l27 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kontraktibilitas adalah kesanggupan sel untuk merespons stimulus dengan memendek secara paksa.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l27 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Ekstensibilitas adalah kesanggupan sel untuk merespons stimulus dengan memperpanjang <span style="mso-spacerun: yes;"> </span>dan memperpendek serat otot saat relaksasi ketika berkontraksi dan memanjang jika rileks.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l27 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Elastisitas adalah kesanggupan sel untuk menghasilkan waktu istirahat yang lama setelah memendek dan memanjang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kontraksi Otot<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Otot berkontraksi jika ada rangsangan. Energy kontraksi berasal dari pemecahan adenosine trifosfat (ATP) dan kalsium. Beberapa tipe kontraksi otot yaitu:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l16 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tonik yaitu kontraksi sebagian otot secara terus menerus yang penting dalam mempertahankan postur tubuh.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l16 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Isotonic adalah kontraksi otot yang otot menjadi tegang, tetapi kontraksi tersebut tidak mengubah otot, hanya mengubah panjang otot (otot lebih pendek).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l16 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Isometric. Pada isometric ketegangan otot meningkat, namun otot menjadi lebih pendek.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l16 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Twich adalah reaksi sentakan (reflex) pada suatu stimulus.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l16 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tetanik adalah kontraksi yang lebih menopang daripada twuch yang dihasilkan akibat rangkaian stimulus yang cepat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l16 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Treppe adalah twich yang lebih kuat dalam merespons stimulus yang terus-menerus berulung secara konstan dan kuat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l16 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Fibrillation adalah kontraksi asincronus pada setiap otot individu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l16 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Konvulsi adalah kontraksi titanic yang tidak terkoordinir secara normal pada kelompok otot tertentu.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">STRUKTUR LAIN DALAM SISTEM MUSKULOSKELETAL<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; mso-add-space: auto; mso-list: l28 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Ligamen<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Ligament adalah sekumpulan jaringan fibrosa yang tebal yang merupakan akhir dari suatu otot dan berfungsi mengikat suatu tulang.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; mso-add-space: auto; mso-list: l28 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tendon<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tendon adalah suatu perpanjangan dari pembungkus fibrosa yang membungkus setip otot dan berkaitan dengan periosteum jaringan penyambung yang mengelilingi tendon, khususnya pada pergelangan tangan dan tumit. Pembungkus ini dibatasi oleh membrane synovial yang member lumbrikasi untuk memudahkan pergerakan tendon.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; mso-add-space: auto; mso-list: l28 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Fasia<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Fasia adalah suatu permukaan jaringan penyambung langgar yang didapatkan langsung dibawah kulit sebagai fasia superficial (sebagai pembungkus tebal) jarigan penyambung fibrosa yang membungkus otot, saraf dan pembuluh darah<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; mso-add-space: auto; mso-list: l28 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Bursae<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Bursae adalah suatu kantong kecil dari jaringan penyambung, yang digunakan diatas bagian yang bergerak (mis, antara kulit dan tulung, antara tendon dan tulung/ otot). Bursae bertindak sebagai penampang antara bagian yang bergerak (mis, bursae olekranon yang terletak diantara presesus dan kulit).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span> <div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l33 level1 lfo18; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%;">ASUHAN KEPERAWATAN PADA KLIEN DENGAN OSTEOPOROSIS<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto;"><br />
</div><div class="MsoNormal" style="line-height: 150%;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%; mso-no-proof: yes;"><v:shape id="Picture_x0020_1" o:borderbottomcolor="#4a452a" o:borderleftcolor="#4a452a" o:borderrightcolor="#4a452a" o:bordertopcolor="#4a452a" o:spid="_x0000_i1026" style="height: 277.5pt; mso-wrap-style: square; visibility: visible; width: 318.75pt;" type="#_x0000_t75"> <v:imagedata o:title="596_osteoporosis1" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image002.jpg"> <w:bordertop type="single" width="24"> <w:borderleft type="single" width="24"> <w:borderbottom type="single" width="24"> <w:borderright type="single" width="24"> </w:borderright></w:borderbottom></w:borderleft></w:bordertop></v:imagedata></v:shape></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l31 level1 lfo1; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Pengertian <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l37 level1 lfo2; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Osteoporosis adalah penyakit metabolik tulang yang memiliki penurunan matrix dan proses mineralisasi yang normal tetapi massa atau densitas tulang berkurang (Gallagher, 1999)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l37 level1 lfo2; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis adalah penyakit metabolisme tulang yang cirinya adalah pengurangan massa tulang dan kemunduran mikroarsitektur tulang sehingga meningkatkan risiko fraktur oleh karena fragilitas tulang meningkat.</span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><a href="http://hidayat2.wordpress.com/2009/05/12/askep-osteoporosis/"><span style="color: windowtext; font-family: "Arial","sans-serif";">http://hidayat2.wordpress.com/2009/05/12/askep-osteoporosis/</span></a><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">Osteoporosis</span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"> adalah penyakit tulang yang mempunyai sifat-sifat khas berupa massa </span><a href="http://id.wikipedia.org/wiki/Tulang" title="Tulang"><span style="color: windowtext; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">tulang</span></a><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"> yang rendah, disertai mikro arsitektur tulang dan penurunan kualitas </span><a href="http://id.wikipedia.org/w/index.php?title=Jaringan_tulang&action=edit&redlink=1" title="Jaringan tulang (halaman belum tersedia)"><span style="color: windowtext; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">jaringan tulang</span></a><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"> yang dapat akhirnya menimbulkan kerapuhan tulang. (</span><a href="http://id.wikipedia.org/wiki/Osteoporosis"><span style="color: windowtext; font-family: "Arial","sans-serif";">http://id.wikipedia.org/wiki/Osteoporosis</span></a> )<span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman";">Jadi osteoporosis adalah gangguan metabolism tulang yang menyebabkan masa tulang mengalami pengurangan sehingga tulang menjadi mudah rapuh.</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l31 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Etiologi</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Penyebab osteoporosis secara pasti belum diketahui.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Factor resiko terjadinya osteoporosis:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l39 level1 lfo30; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Jenis kelamin wanita<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l39 level1 lfo30; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Diet rendah kalsium<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l39 level1 lfo30; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Orang Caucasion atau Asian- Amerika<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l39 level1 lfo30; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Pecandu alcohol<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l39 level1 lfo30; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Perokok<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l39 level1 lfo30; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kurang aktivitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l39 level1 lfo30; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Penggunaan obat dalam jangka waktu lama: Kortikosteroid<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-add-space: auto; mso-list: l31 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Gambaran klinis<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis dapat berjalan lambat selama beberapa dekade, hal ini disebabkan karena osteoporosis tidak menyebabkan gejala fraktur tulang. Beberapa fraktur osteoporosis dapat terdeteksi hingga beberapa tahun kemudian. Tanda klinis utama dari osteoporosis adalah fraktur pada vertebra, pergelangan tangan, pinggul, humerus, dan tibia. Gejala yang paling lazim dari fraktur korpus vertebra adalah nyeri pada punggung dan deformitas pada tulang belakang. Nyeri biasanya terjadi akibat kolaps vertebra terutama pada daerah dorsal atau lumbal. Secara khas awalnya akut dan sering menyebar kesekitar pinggang hingga kedalam perut. Nyeri dapat meningkat walaupun dengan sedikit gerakan misalnya berbalik ditempat tidur. Istirahat ditempat tidaur dapat meringankan nyeri untuk sementara, tetapi akan berulang dengan jangka waktu yang bervariasi. Serangan nyeri akut juga dapat disertai oleh distensi perut dan ileus<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-add-space: auto; mso-list: l31 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Klasifikasi osteoporosis<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis dibagi 3 , yaitu:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis primer</span></b><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis primer sering menyerang </span><a href="http://id.wikipedia.org/wiki/Wanita" title="Wanita"><span style="color: windowtext; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman"; text-decoration: none; text-underline: none;">wanita</span></a><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"> paska </span><a href="http://id.wikipedia.org/wiki/Menopause" title="Menopause"><span style="color: windowtext; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman"; text-decoration: none; text-underline: none;">menopause</span></a><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"> dan juga pada </span><a href="http://id.wikipedia.org/wiki/Pria" title="Pria"><span style="color: windowtext; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman"; text-decoration: none; text-underline: none;">pria</span></a><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"> usia lanjut dengan penyebab yang belum diketahui<b>.<o:p></o:p></b></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .25in;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis sekunder</span></b><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Sedangkan osteoporosis sekunder disebabkan oleh penyakit yang berhubungan dengan :<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Cushing's disease<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Hyperthyroidism<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Hyperparathyroidism<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Hypogonadism<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kelainan </span><a href="http://id.wikipedia.org/w/index.php?title=Hepar&action=edit&redlink=1" title="Hepar (halaman belum tersedia)"><span style="color: windowtext; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman"; text-decoration: none; text-underline: none;">hepar</span></a><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kegagalan </span><a href="http://id.wikipedia.org/wiki/Ginjal" title="Ginjal"><span style="color: windowtext; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman"; text-decoration: none; text-underline: none;">ginjal</span></a><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"> kronis<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kurang gerak<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kebiasaan minum </span><a href="http://id.wikipedia.org/wiki/Alkohol" title="Alkohol"><span style="color: windowtext; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman"; text-decoration: none; text-underline: none;">alkohol</span></a><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Pemakai obat-obatan/corticosteroid<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kelebihan </span><a href="http://id.wikipedia.org/wiki/Kafein" title="Kafein"><span style="color: windowtext; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman"; text-decoration: none; text-underline: none;">kafein</span></a><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><a href="http://id.wikipedia.org/wiki/Rokok" title="Rokok"><span style="color: windowtext; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman"; text-decoration: none; text-underline: none;">Merokok</span></a><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 94.5pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-list: l7 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis Idiopatik<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis yang tidak diketahui penyebabnya dan sering ditemukan pada:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 94.5pt; mso-add-space: auto; mso-list: l7 level2 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Usia anak-anak<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 94.5pt; mso-add-space: auto; mso-list: l7 level2 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Usia remaja<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 94.5pt; mso-add-space: auto; mso-list: l7 level2 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Wanita pra menopause<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 94.5pt; mso-add-space: auto; mso-list: l7 level2 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Pria usia pertengahan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l31 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tes Diagnostik</span></b><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l38 level1 lfo31; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif";">Radiologi<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-indent: .5in;"><span style="font-family: "Arial","sans-serif";">Gejala radiologi yang khas adalah densitas atau massa tulang yang menurun yang dapat dilihat pada vertebra spinalis. Dinding dekat korpus vertebra biasanya merupakan lokasi yang paling berat. Penipisan korteks dan hilangnya trabekula transversal merupakan kelainan yang sering ditemukan. Lemahnya korpus vertebrae menyebabkan penonjolan yang menggelembung dari nucleus pulposus kedalam ruang intervertebral dan menyebabkan deformitas bikonkaf.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l38 level1 lfo31; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif";">CT-Scan<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-indent: .5in;"><span style="font-family: "Arial","sans-serif";">Dapat mengukur densitas tulang secara kuantitatif yang mempunyai nilai penting dalam diagnostic dan terapi follow up. Mineral vertebra diatas 110 mg/cm<sup>3 </sup>biasanya tidak menimbulkan fraktur vertebra atau penonjolan, sedangkan mineral vertebra dibawah 65 mg/cm<sup>3 </sup><span style="mso-spacerun: yes;"> </span>ada pada hampir semua klien yang mengalami fraktur.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l38 level1 lfo31; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif";">Pemeriksaan laboratorium<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l9 level1 lfo32; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Kadar Ca, P, dan fosfatase alkali tidak menunjukan kelainan yang nyata.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l9 level1 lfo32; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Kadar HPT (pada pascamenopause kadar HPT meningkat) dan Ct (terapi estrogen merangsang pembentukan Ct)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l9 level1 lfo32; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Kadar 1,25-(OH)-D3 dan absorpsi Ca menurun.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l9 level1 lfo32; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Ekskresi fosfat hidroksiprolin terganggu sehingga meningkat kadarnya.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: .25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">F.<span style="mso-spacerun: yes;"> </span>Asuhan Keperawatan <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l25 level1 lfo19; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Pengkajian <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.5pt; mso-add-space: auto; mso-list: l7 level2 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -13.5pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Riwayat keperawatan. Dalam pengkajian riwayat keperawatan, perawat perlu mengidentifikasi adanya:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Rasa nyeri atau sakit tulang punggung (bagian bawah), leher, dan pinggang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Berat badan menurun<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Biasanya diatas 45 tahun<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Jenis kelamin sering pada wanita<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Pla latihan dan aktivitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">f.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Keadaan nutrisi (mis, kurang vitamin D serta kalsium)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">g.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Merokok, mengkonsumsi alcohol dan kafein<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">h.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Adanya penyakit endokrin: diabetes mellitus, hipertiroid, hiperparatiroid, sindrom cushing, hipogonadisme<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 67.5pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 49.5pt; mso-add-space: auto; mso-list: l7 level2 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Pemeriksaan Fisik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 13.5pt; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B6(Bone)<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 49.5pt; mso-add-space: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif";">Pada inspeksi dan palpasi daerah kolumna vertebralis, klien osteoporosis sering menunjukan kifosis atau gibbus (dowager’s hump) dan penurunan tinggi badan dan berat badan. Ada perubahan gaya berjalan, deformitas tulang, leg-length inequality, dan nyeri spinal. Lokasi fraktur yang sering terjadi adalah antara vertebra torakalis 8 dan lumbalis 3.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.5pt; mso-add-space: auto; mso-list: l7 level2 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Riwayat psikososial. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.5pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: 22.5pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Penyakit ini sering terjadi pada wanita. Biasanya sering timbul kecemasan, takut melakukan aktivitas dan perubahan konsep diri. Perawat perlu mengkaji masalah-masalah psikologis yang timbul akibat proses ketuaan dan efek penyakit yang menyertainya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.5pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l25 level1 lfo19; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Diagnosa Keperawatan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 45.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Berdasarkan data pengkajian, diagnosis keperawatan untuk pasien osteoporosis sebagai berikut:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 76.5pt; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Hambatan mobilitas fisik yang berhubungan dengan disfungsi sekunder akibat perubahan skeletal (kifosis),nyeri sekunder.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 76.5pt; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Gangguan body image b.d perubahan bentuk tubuh<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 76.5pt; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Nyeri berhubungan dengan dampak sekunder dari fraktur vertebra<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 76.5pt; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Resiko cedera (fraktur) berhubungan dengan tulang osteoporosis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 76.5pt; mso-add-space: auto; mso-list: l19 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kurang pengetahuan tentang perawatan dirumah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l25 level1 lfo19; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Intervensi dan Implementasi keperawatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 0.2in; width: 624px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 2.0in;" valign="top" width="192"> <div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">DIAGNOSA KEPERAWATAN<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 153.6pt;" valign="top" width="205"> <div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">TUJUAN <o:p></o:p></span></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">KEPERAWATAN<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 170.7pt;" valign="top" width="228"> <div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">INTERVENSI <o:p></o:p></span></div><div align="center" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">KEPERAWATAN<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 2.0in;" valign="top" width="192"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 17.1pt; mso-add-space: auto; mso-list: l6 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Hambatan mobilitas fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 153.6pt;" valign="top" width="205"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Dapat meningkatkan mobilitas dan aktivitas fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 170.7pt;" valign="top" width="228"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Gunakan matras dengan tempat tidur papan untuk membantu memperbaiki posisi tulang belakang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Bantu pasien menggunakan alat bantu walker atau tongkat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Bantu dan ajarkan latihan ROM setiap 4jam untuk meningkatkan fungsi persendian dan mencegah kontraktur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Anjurkan menggunakan brace punggung atau korset,pasien perlu dilatih menggunakannya dan jelaskan tujuannya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kolaborasi dengan ahli gizi dalam program diet tinggi kalsium serta vitamin D<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kolaborasi dengan petugas laboratorium dalam memantau kadar kalsium<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 2.0in;" valign="top" width="192"> <div class="MsoListParagraph" style="line-height: 150%; margin-left: 17.1pt; mso-add-space: auto; mso-list: l6 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Gangguan konsep diri<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 153.6pt;" valign="top" width="205"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: "Arial","sans-serif";">Dapat menggunakan koping yang positif<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 170.7pt;" valign="top" width="228"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Bantu pasien mengekspresikan perasaan dan dengarkan dengan penuh perhatian. Perhatian sungguh-sungguh dapat meyakinkan pasien bahwa perawat bersedia membantu mengatasi masalahnya dan akan tercipta hubungan yang harmonis sehingga timbul koordinasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Klariikasi jika terjadi kesalahpahaman tentang proses penyakit dan pengobatan yang telah diberikan. Klarifikasi ini dapat meningkatkan koordinasi pasien selama perawatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Bantu pasien mengidentifikasi pengalaman masa lalu yang menimblkan kesuksesan atau kebanggaan saat itu. Ini dapat membantu upaya mengenal diri dan menerima diri kembali<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Identifikasi bersama pasien tentang alternative pemecahan masalah yang positif. Hal ini akan dapat mengembalikan rasa percaya diri<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Bantu untuk meningkatkan komunikasi dengan keluarga dan teman<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 2.0in;" valign="top" width="192"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo20; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Nyeri b.d fraktur dan spasme otot<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 153.6pt;" valign="top" width="205"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: "Arial","sans-serif";">Nyeri reda<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 170.7pt;" valign="top" width="228"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Anjurkan istirahat ditempat tidur dengan posisi terlentang atau miring<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Atur posisi lutut fleksi, meningkatkan rasa nyaman dengan merelaksasi otot<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kompres hangat intermiten dan pijit punggung dapat memperbaiki relaksasi otot<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Anjurkan posisi tubuh yang baik dan ajarkan mekanika tubuh<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Gunakan korset atau brace punggung, saat pasien turun dari tempat tidur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Kolaborasi dalam pemberian analgesic untuk mengurangi nyeri<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 2.0in;" valign="top" width="192"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo20; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Resiko cedera (fraktur) yang b.d tulang osteoporosis<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 153.6pt;" valign="top" width="205"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: "Arial","sans-serif";">Cedera tidak terjadi<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 170.7pt;" valign="top" width="228"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Anjurkan melakukan aktivitas fisik untuk memperkuat otot, mencegah atrofi, dan memperkuat demineralisasi tulang progresif<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Latihan isometric dapat digunakan untuk memperkuat otot batang tubuh<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Anjurkan pasien untuk berjalan, mekanika tubuh yang baik dan postur tubuh yang baik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Hindari aktivitas membungkuk mendadak, melengok, dan mengangkat baben lama<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Lakukan aktivitas diluar ruangan dan dibawah sinar matahari untuk memperbaiki kemampuan tubuh menghasilkan vitamin D<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 5; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 2.0in;" valign="top" width="192"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 17.1pt; mso-add-space: auto; mso-list: l6 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Kurang pengetahuan</span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 153.6pt;" valign="top" width="205"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><span style="font-family: "Arial","sans-serif";">Memahami osteoporosis dan program pengobatan</span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 170.7pt;" valign="top" width="228"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Jelaskan pentingnya diet yang tepat,latihan, dan aktivitas fisik yang sesuai serta istirahat yang cukup<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Jelaskan penggunaan obat serta efek samping obat yang diberikan secara detail<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Jelaskan pentingnya lingkungan yang aman. Misalnya lantai tidak licin, tangga menggunakan pegangan untuk menghindar jatuh<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Anjurkan mengurangi kafein, alcohol, dan merokok<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 15.1pt; mso-add-space: auto; mso-list: l37 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Jelaskan pentingnya parewatan lanjutan<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoListParagraph" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l25 level1 lfo19; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Evaluasi Keperawatan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 9.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Setelah dilakukan intervensi keperawatan diharapkan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 63.0pt; mso-add-space: auto; mso-list: l14 level1 lfo21; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Aktivitas dan mobilitas fisik terpenuhi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Melakukan ROM secara teratur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Menggunakan alat bantu saat aktivitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l7 level3 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Menggunakan brace atau korset saat aktivitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 63.0pt; mso-add-space: auto; mso-list: l14 level1 lfo21; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Koping pasien positif<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l40 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Mengekspresikan perasaan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l40 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Memilih alternative pemecahan masalah<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l40 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Meningkatkan komunikasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 63.0pt; mso-add-space: auto; mso-list: l14 level1 lfo21; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Nyeri berkurang/hilang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l32 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Mengalami peredaan nyeri saat istirahat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l32 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Mengalami ketidaknyamanan minimal selama aktivitas sehari-hari<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l32 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Menunjukan berkurangnya nyeri tekan pada tempat fraktur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 63.0pt; mso-add-space: auto; mso-list: l14 level1 lfo21; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Tidak terjadi cedera<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l24 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Mempertahankan postur tubuh yang baik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l24 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Menggunakan mekanika tubuh yang baik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l24 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Latihan isometric<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l24 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Berpartisipasi aktivitas diluar rumah<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l24 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Menghindari aktivitas yang menimbulkan cedera<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 63.0pt; mso-add-space: auto; mso-list: l14 level1 lfo21; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Mendapatkan pengetahuan mengenai osteoporosis dan program pengobatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l10 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Menyebutkan hubungan asupan kalsium dan latihan fisik terhadap massa tulang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l10 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Mengkonsumsi kalsium dengan jumlah yang mencukupi <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l10 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Meningkatkan latihan fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l10 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">Mengetahui waktu perawatan lanjutan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span> <div class="MsoNormal"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; mso-list: l33 level1 lfo18; text-align: justify; text-indent: -27.0pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%;">ASUHAN KEPERAWATAN PADA KLIEN OSTEOARTRITIS<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%; mso-no-proof: yes;"><v:shape id="Picture_x0020_3" o:spid="_x0000_i1025" style="height: 207.75pt; mso-wrap-style: square; visibility: visible; width: 255.75pt;" type="#_x0000_t75"> <v:imagedata o:title="osteoartritis_lutut" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image003.jpg"> </v:imagedata></v:shape></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l7 level5 lfo12; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Pengertian<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 58.5pt; mso-add-space: auto; mso-list: l36 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Osteoartritis</span></b><span style="font-family: "Arial","sans-serif";"> (OA) adalah<span style="mso-spacerun: yes;"> </span>suatu penyakit kerusakkan tulang rawan sendi yang berkembang lambat yang tidak diketahui<span style="mso-spacerun: yes;"> </span>penyebabnya. ( Noer, hal 76).<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 58.5pt; mso-add-space: auto; mso-list: l36 level1 lfo25; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Osteoartritis</span></b></span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";"> adalah penyakit sendi degeneratif yang merupakan kerusakan tulang rawan sendi yang berkembang lambat dan berhubungan dengan usia lanjut. ( kapita selekta kedokteran. 2000. Hal 1807)<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 58.5pt; mso-add-space: auto; mso-list: l36 level1 lfo25; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Osteoartritis (OA) atau penyakit degeneratif sendi adalah suatu penyakit kerusakan tulang rawan sendi yang berkembang lambat yang tak diketahui penyebabnya, meskipun terdapat beberapa faktor resiko yang berperan ( Handono Kalim, hal.76)<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 58.5pt; mso-add-space: auto; mso-list: l36 level1 lfo25; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Osteoartritis adalah ganguan pada sendi yang bergerak, bersifat kronik, berjalan progresif lambat, tidak meradang, dan ditadai oleh adanya deterosiasi<span style="mso-spacerun: yes;"> </span>dan abrasi dari rawan sendi dan adanya pembentukan tulang baru pada permukaan persendian. (sylvia A price.2000. hal. 1218)<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 58.5pt; mso-add-space: auto; mso-list: l36 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">¨<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Jadi Osteoartritis merupakan penyakit degeneratif (semakin lama semakin bertambah berat) yang terjadi pada rawan sendi yang berkembang lambat dan tidak tahu penyebabnya.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 58.5pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l7 level5 lfo12; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Etiologi<o:p></o:p></span></b></div><div class="MsoBodyText" style="line-height: 150%; margin-left: 45.0pt; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;">Penyebab sebenarnya dari osteoarthritis belum diketahui namun proses penuaan ada hubungannya dengan perubahan-perubahan dalam fungsi kondrosit, menimbulkan perubahan pada komposisi rawan sendi</span><span style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l7 level5 lfo12; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Faktor – Faktor Resiko<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 21.3pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-list: l30 level1 lfo26; tab-stops: 177.2pt; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Umur <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Dari semua faktor resiko untuk timbulnya osteoartritis, faktor ketuaan adalah yang terkuat. Prevalensi dan beratnya orteoartritis semakin meningkat dengan bertambahnya umur.osteoartiritis hampir tak pernah dijumpai pad anak, jarang dijumpai pada usia dibawah 40 tahun dan lebih sering dijumpai pada usia diatas 60 tahun.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-list: l30 level1 lfo26; tab-stops: 177.2pt; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Jenis kelamin<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Wanita lebih sering terkena osteoartritis lutut dan sendi , dan lelaki lebih sering terkena osteoartritis paha, pergelangan tangan dan leher. Secara keeluruhan dibawah 45 tahun frekuensi osteoartritis kurang lebih sama pada laki dan wanita tetapi diatas 50 tahun frekuensi oeteoartritis lebih banyak pada wanita dari pada pria hal ini menunjukkan adanya peran hormonal pada patogenesis<span style="mso-spacerun: yes;"> </span>osteoartritis.</span></span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-list: l30 level1 lfo26; tab-stops: 177.2pt; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Genetik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Faktor herediter juga berperan pada timbulnya osteoartritis missal, pada ibu dari seorang wanita dengan osteoartritis pada sendi-sendi inter falang distal terdapat dua kali lebih sering osteoartritis pada sendi-sendi tersebut, dan anak-anaknya perempuan cenderung mempunyai tiga kali lebih sering dari pada ibu dan anak perempuan dari wanita tanpa artritis.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-list: l30 level1 lfo26; tab-stops: 177.2pt; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Suku Bangsa<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Prevalensi dan pola terkenanya sendi pada osteoartritis nampaknya terdapat perbedaan diantara masing-masing suku bangsa, misalnya osteoartritis paha lebih jarang diantara orang-orang kulit hitam dan usia dari pada kaukasia. Osteoartritis lebih sering dijumpai pada orang – orang Amerika asli dari pada orang kulit putih.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Hal ini mungkin berkaitan dengan perbedaan cara hidup maupun perbedaan pada frekuensi kelainan kongenital dan pertumbuhan.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-list: l30 level1 lfo26; tab-stops: 177.2pt; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Kegemukan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Berat badan yang berlebihan nyata berkaitan dengan meningkatnya resiko untuk timbulnya osteoartritis baik pada wanita maupun pada pria. Kegemukan ternyata tak hanya berkaitan dengan osteoartritis pada sendi yang menanggung beban, tapi juga dengan osteoartritis sendi lain (tangan atau sternoklavikula)<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; tab-stops: 177.2pt;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l7 level5 lfo12; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Patofisiologi<o:p></o:p></span></b></div><div style="line-height: 150%; margin-left: 45.0pt; text-indent: 27.0pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;">Kartilago hialin dalah jaringan elastis yang 95 persen terdiri dari air dan matrik ekstra selular, 5 persen sel kondrosit. Fungsinya sebagai penyangga atau shock breaker, juga sebagai pelumas, sehingga tidak menimbulkan nyeri pada saat pergerakan sendi.<o:p></o:p></span></div><div style="line-height: 150%; margin-left: 45.0pt; text-indent: 27.0pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;">Apabila kerusakan jaringan rawan sendi lebih cepat dari kemampuannya untuk memperbaiki diri, maka terjadi penipisan dan kehilangan pelumas sehingga kedua tulang akan bersentuhan. Inilah yang menyebabkan rasa nyeri pada sendi lutut.<o:p></o:p></span></div><div style="line-height: 150%; margin-left: 45.0pt; text-indent: 27.0pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;">Setelah terjadi kerusakan tulang rawan, sendi dan tulang ikut berubah. Pada permukaan sendi yang sudah aus terjadilah pengapuran. Yaitu tumbuhnya tulang baru yang merupakan mekanisme pertahanan tubuh untuk menjadikan sendi kembali stabil, tapi hal ini justru membuat sendi kaku.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; text-indent: 27.0pt;"><span style="font-family: "Arial","sans-serif";">Sendi yang sering menjadi sasaran penyakit ini adalah sendi yang sering digunakan sebagai penopang tubuh seperti lutut, tulang belakang, panggul, dan juga pada sendi tangan/kaki. Jika tidak diobati sakit akan bertambah dan tidak bisa berjalan. Selain itu, tulang bisa mengalami perubahan bentuk atau deformity bersifat permanen. Bengkok pada kaki bisa ke dalam maupun keluar. Dampak kelainan ini muncul perlahan 10 tahun kemudian untuk itu perlu waspada.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto;"><br />
</div><div style="line-height: 150%; margin-left: 45.0pt; mso-list: l7 level5 lfo12; text-indent: -.25in;"><strong><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></strong><strong><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;">Jenis –Jenis OA<o:p></o:p></span></strong></div><div style="line-height: 150%; margin-left: .5in; text-indent: 9.0pt;"><strong><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;">1. Primer</span></strong><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;"><o:p></o:p></span></b></div><div style="line-height: 150%; margin-left: 45.0pt; text-indent: .5in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;">Penyebab tak diketahui, akibat proses penuaan alami. Dialami setelah usia 45 tahun, tidak diketahui penyebab secara pasti, menyerang perlahan tapi pasti, dan dapat mengenai banyak sendi. Biasanya mengenai sendi lutut dan panggul, bisa juga sendi lain seperti punggung dan jari-jari.<o:p></o:p></span></div><div style="line-height: 150%; margin-left: .5in; text-indent: 9.0pt;"><strong><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;">2. Sekunder</span></strong><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;"><o:p></o:p></span></b></div><div style="line-height: 150%; margin-left: 45.0pt; text-indent: .5in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;">Dialami sebelum usia 45 tahun, penyebab trauma (instability) yang menyebabkan luka pada sendi (misalnya </span><span lang="IN"><a href="http://mukipartono.com/pengobatan-patah-tulang-mahal" title="patah tulang"><span style="color: windowtext; font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%; text-decoration: none; text-underline: none;">patah tulang</span></a></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 11.0pt; line-height: 150%;"> atau permukaan sendi tidak sejajar), akibat sendi yang longgar dan pembedahan pada sendi. Penyebab lain adalah faktor genetik dan penyakit metabolik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%;"><br />
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</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l7 level5 lfo12; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Patoflow<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;"><br />
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</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 21.3pt; mso-add-space: auto; mso-list: l7 level5 lfo12; text-indent: -14.2pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">G.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Manifestasi klinis<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-indent: .5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gejala-gejala utama ialah adanya nyeri pada sendi yang terkena, terutama waktu bergerak. Umumnya timbul secara perlahan-lahan, mula-mula rasa kaku, kemudian timbul rasa nyeri yang berkurang saat istirahat. Terdapat hambatan pada pergerakan sendi, kaku pagi , krepitasi, pembesaran sendi, dan perubahan gaya berjalan</span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 21.3pt; mso-add-space: auto; mso-list: l7 level5 lfo12; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">H.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Penatalaksanaan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 21.3pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l12 level1 lfo27; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Obat – Obatan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: .5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Sampai sekarang belum ada obat yang spesifik yang khas untuk osteoartritis, oleh karena patogenesisnya yang belum jelas, obat yang diberikan bertujuan untuk mengurangi rasa sakit, meningkatkan mobilitas dan mengurangi ketidak mampuan. Obat-obat anti inflamasinon steroid bekerja sebagai analgetik dan sekaligus mengurangi sinovitis, meskipun tak dapat memperbaiki atau menghentikan proses patologis osteoartritis.</span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l12 level1 lfo27; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Perlindungan sendi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: .5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Osteoartritis mungkin timbul atau diperkuat karena mekanisme tubuh yang kurang baik. Perlu dihindari aktivitas yang berlebihan pada sendi yang sakit. Pemakaian tongkat, alat-alat listrik yang dapat memperingan kerja sendi juga perlu diperhatikan. Beban pada lutut berlebihan karena kaki yang tertekuk (pronatio).</span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l12 level1 lfo27; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Diet <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: .5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Diet untuk menurunkan berat badan pasien osteoartritis yang gemuk harus menjadi program utama pengobatan osteoartritis. Penurunan berat badan seringkali dapat mengurangi timbulnya keluhan dan peradangan.</span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l12 level1 lfo27; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Dukungan psikososial <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: .5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Dukungan psikososial diperlukan pasien osteoartritis oleh karena sifatnya yang menahun dan ketidakmampuannya yang ditimbulkannya. Disatu pihak pasien ingin menyembunyikan ketidakmampuannya, dipihak lain dia ingin orang lain turut memikirkan penyakitnya. Pasien osteoartritis sering kali keberatan untuk memakai alat-alat pembantu karena faktor-faktor psikologis.</span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l12 level1 lfo27; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Persoalan seksual <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-indent: .5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gangguan seksual dapat dijumpai pada pasien osteoartritis terutama pada tulang belakang, paha dan lutut. Sering kali diskusi karena ini harus dimulai dari dokter karena biasanya pasien enggan mengutarakannya.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l12 level1 lfo27; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Fisioterapi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: .5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Fisioterapi berperan penting pada penatalaksanaan osteoartritis, yang meliputi pemakaian panas dan dingin dan program latihan ynag tepat. Pemakaian panas yang sedang diberikan sebelum latihan untk mengurangi rasa nyeri dan kekakuan. Pada sendi yang masih aktif sebaiknya diberi dingin dan obat-obat gosok jangan dipakai sebelum pamanasan. Berbagai sumber panas dapat dipakai seperti Hidrokolator, bantalan elektrik, ultrasonic, inframerah, mandi paraffin dan mandi dari pancuran panas.<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-indent: .5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Program latihan bertujuan untuk memperbaiki gerak sendi dan memperkuat otot yang biasanya atropik pada sekitar sendi osteoartritis. Latihan isometric lebih baik dari pada isotonic karena mengurangi tegangan pada sendi. Atropi rawan sendi dan tulang yang timbul pada tungkai yang lumpuh timbul karena berkurangnya beban ke sendi oleh karena kontraksi otot. Oleh karena otot-otot periartikular memegang peran penting terhadap perlindungan rawan senadi dari beban, maka penguatan otot-otot tersebut adalah penting.</span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l12 level1 lfo27; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Operasi <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: .5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Operasi perlu dipertimbangkan pada pasien osteoartritis dengan kerusakan sendi yang nyata dengan nyari yang menetap dan kelemahan fungsi. Tindakan yang dilakukan adalah osteotomy untuk mengoreksi ketidaklurusan atau ketidaksesuaian, debridement sendi untuk menghilangkan fragmen tulang rawan sendi, pebersihan osteofit.<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: 2.25pt; margin-left: 0in; margin-right: 0in; margin-top: 2.25pt;"><b style="mso-bidi-font-weight: normal;"><span style="color: black; font-family: "Arial","sans-serif"; mso-fareast-font-family: "Times New Roman";">I. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Pemeriksaan <span style="mso-spacerun: yes;"> </span>diagnostik <o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: 2.25pt; margin-left: 0in; margin-right: 0in; margin-top: 2.25pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l38 level1 lfo31; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Pemeriksaan laboratorium<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify;"><span style="font-family: "Arial","sans-serif";">Meliputi LED,Kolesterol serum<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l38 level1 lfo31; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Pemeriksaan Sinar X<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: .25in;"><span style="font-family: "Arial","sans-serif";">Dapat dilakukan setiap saat untuk memantau aktivitas dan progesivitas penyakit. Photo rogen yang diambil setiap saat dapat memperlihatkan hilangnya kartilago dan menyempitnya rongga sendi. Pemeriksaan Sinar X dapat pula menunjukan abnormalitas kartilago, erosi sendi, pertumbuhan tulang yang abnormal dan osteopeni (mineralisasi tulang menurun). Pemeriksaan radiologi dilakukan dengan photo polos. Gambaran yang khas pada photo p[olos adalah:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l47 level1 lfo33; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Densitas tulang normal atau meninggi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l47 level1 lfo33; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Penyempitan ruang sendi yang asimetris karena hilangnya tulang rawan sendi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l47 level1 lfo33; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Kista tulang pada permukaan sendi terutama subkondral<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l47 level1 lfo33; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Osteofit pada tepi sendi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l47 level1 lfo33; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Gambaran ini terutama jelas ditemukan pada sendi besar.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l38 level1 lfo31; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">CT Scan dan MRI pada tulang dan sendi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif";">Pemindaian tulang menggambarkan derajat ambilan atau absorpsi isotok radio aktif oleh jaringan tulang. Daerah yang memperlihatkan peningkatan ambilan (mis sendi) dianggap abnormal. Pemindaian sendi memungkinkan penentuan kerusakan sendi diseluruh tubuh. Pemindaian merupakan pemeriksaan yang paling sensitive untuk mendeteksi penyakit secara dini.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l38 level1 lfo31; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Pemindaian radionuklida<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; text-align: justify; text-indent: .5in;"><span style="font-family: "Arial","sans-serif";">Dilakukan dengan menggunakan 99’ Tc-HDP dan terlihat peningkatan aktivitas tulang pada bagian subkondral dari sendi yang mengalami osteoatritis. Dapat pula ditemukan penambahan vaskularisasi dan pembentukan tulang baru.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">J.<span style="mso-spacerun: yes;"> </span>ASUHAN<span style="mso-spacerun: yes;"> </span>KEPERAWATAN</span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 28.35pt; mso-add-space: auto; mso-list: l45 level1 lfo28; text-indent: -14.15pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">DATA DASAR PENGKAJIAN<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 28.35pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto; mso-list: l48 level1 lfo29; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Aktivitas/ istirahat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gejala: Nyeri sendi karena gerakan, nyeri tekan, memburuk dengan stress pada sendi : kekakuan pada pagi, keletihan.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Tanda : malaise, Keterbatasan rentang gerak ; atrofi otot, kulit : kontraktur atau kelainan pada sendi dan otot.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto; mso-list: l48 level1 lfo29; text-indent: -14.2pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Kardiovaskuler <o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gejala : Jantung cepat, tekanan darah menurun<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto; mso-list: l48 level1 lfo29; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Integritas ego<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gejala: Faktor-faktor stress akut atau kronis : Misalnya finansial, pekerjaan, ketidakmampuan, factor-faktor hubungan<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Keputusan dan ketidakberdayaan.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Ancaman pada konsep diri, citra tubuh, identitas pribadi misalnya ketergantungan pada orang<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto; mso-list: l48 level1 lfo29; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Makanan atau cairan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gejala: Ketidakmampuan untuk menghasilkan/ mengkonsumsi makanan/ cairan adekuat : mual, anoreksia, kesulitan untuk mengunyah.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto; mso-list: l48 level1 lfo29; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Higiene<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gejala: berbagai kesulitan untuk melaksanakan aktivitas pribadi, ketergantungan pada orang lain.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto; mso-list: l48 level1 lfo29; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Neurosensori <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gejala: kebas/kesemutan pada tangan dan kaki, hilangnya sensasi pada jari tangan.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Tanda : pembengkakan sendi<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto; mso-list: l48 level1 lfo29; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Nyeri / kenyamanan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gejala: fase akut dari nyeri.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Terasa nyeri akut dan kekakuan<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto; mso-list: l48 level1 lfo29; text-indent: -14.2pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Keamanan <o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gejala: Kesulitan dalam menangani tugas/pemeliharaan rumah tangga<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto; mso-list: l48 level1 lfo29; text-indent: -14.2pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Interaksi sosial<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Gejala: kerusakan interaksi dan keluarga / orang lsin : perubahan peran: isolasi<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 42.55pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 7.1pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l45 level1 lfo28; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;">DIAGNOSA KEPERAWATAN<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-indent: -.25in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">1.<b style="mso-bidi-font-weight: normal;"><span style="mso-tab-count: 1;"> </span></b>Nyeri b/d penurunan fungsi tulang<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-indent: -.25in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">2. <span style="mso-tab-count: 1;"> </span></span></span><span style="font-family: "Arial","sans-serif";">Hambatan mobilitas fisik bd perubahan otot<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -.25in;"><span style="font-family: "Arial","sans-serif";">3. <span style="mso-tab-count: 1;"> </span><span class="apple-style-span">Risiko cedera b/d penurunan fungsi tulang.<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: .5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">4.<span style="mso-spacerun: yes;"> </span>Perubahan pola tidur b/d nyeri<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -.25in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">5.<span style="mso-spacerun: yes;"> </span>Defisit perawatan diri b/d nyeri<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-indent: -.25in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">6. <span style="mso-tab-count: 1;"> </span>Gangguan citra tubuh/ perubahan penampilan peran b/d perubahan kemampuan untuk melakukan tugas-tugas umum.<span style="mso-bidi-font-weight: bold;"><o:p></o:p></span></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .75in; text-indent: -.25in;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l45 level1 lfo28; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">INTERVENSI KEPERAWATAN</span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 7.1pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 7.1pt; mso-add-space: auto; text-indent: 28.9pt;"><span class="apple-style-span"><b><span style="font-family: "Arial","sans-serif";">Diagnosa 1</span></b></span><span class="apple-style-span"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">: Nyeri b/d penurunan fungsi tulang<o:p></o:p></span></b></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 7.1pt; mso-add-space: auto; text-indent: 28.9pt;"><span style="font-family: "Arial","sans-serif";">Tujuan : nyeri berkurang sampai dengan hilang.<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 5.4pt; width: 586px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b><span style="font-family: "Arial","sans-serif";">INTERVENSI</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 213.8pt;" valign="top" width="285"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center; text-indent: 21.3pt;"><b><span style="font-family: "Arial","sans-serif";">RASIONAL</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l8 level1 lfo40; text-indent: -12.85pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">kaji keluhan nyeri, catat lokasi dan intensitas (skala 0 – 10). Catat faktor-faktor yang mempercepat dan tanda-tanda rasa sakit non verbal</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l8 level1 lfo40; text-indent: -12.85pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">berikan matras atau kasur keras, bantal kecil. Tinggikan linen tempat tidur sesuai kebutuhan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l8 level1 lfo40; text-indent: -12.85pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">biarkan pasien mengambil posisi yang nyaman pada waktu tidur atau duduk di kursi. Tingkatkan istirahat di tempat tidur sesuai indikasi</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l8 level1 lfo40; text-indent: -12.85pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">dorong untuk sering mengubah posisi. Bantu pasien untuk bergerak di tempat tidur, sokong sendi yang sakit di atas dan di bawah, hindari gerakan yang menyentak</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l8 level1 lfo40; text-indent: -12.85pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">anjurkan pasien untuk mandi air hangat atau mandi pancuran pada waktu bangun. Sediakan waslap hangat untuk mengompres sendi-sendi yang sakit beberapa kali sehari. Pantau suhu air kompres, air mandi</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l8 level1 lfo40; text-indent: -12.85pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">berikan masase yang lembut<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -12.85pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 12.85pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l8 level1 lfo40; text-indent: -12.85pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Beri obat sebelum aktivitas atau latihan yang direncanakan sesuai petunjuk seperti asetil salisilat. <o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 213.8pt;" valign="top" width="285"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l3 level1 lfo41; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Membantu dalam menentukan kebutuhan managemen nyeri dan keefektifan program.</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l3 level1 lfo41; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Matras yang lembut/empuk, bantal yang besar akan mencegah pemeliharaan kesejajaran tubuh yang tepat, menempatkan setres pada sendi yang sakit. Peninggian linen tempat tidur menurunkan tekanan pada sendi yang terinflamasi / nyeri</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l3 level1 lfo41; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Pada penyakit berat, tirah baring mungkin diperlukan untuk membatasi nyeri atau cedera sendi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l3 level1 lfo41; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Mencegah terjadinya kelelahan umum dan kekakuan sendi. Menstabilkan sendi, mengurangi gerakan/rasa sakit pada sendi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l3 level1 lfo41; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Panas meningkatkan relaksasi otot dan mobilitas, menurunkan rasa sakit dan melepaskan kekakuan di pagi hari. Sensitifitas pada panas dapat dihilangkan dan luka dermal dapat disembuhkan</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l3 level1 lfo41; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Meningkatkan relaksasi/mengurangi ketegangan otot</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l3 level1 lfo41; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Meningkatkan relaksasi, mengurangi ketegangan otot, memudahkan untuk ikut serta dalam terapi<b>.</b><o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-indent: .5in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";">Diagnosa 2 : hambatan mobilitas fisik bd perubahan otot<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; text-indent: .5in;"><span style="font-family: "Arial","sans-serif";">Tujuan : klien mampu berpartisipasi pada aktivitas yang diinginkan<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid black .5pt; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b><span style="font-family: "Arial","sans-serif";">INTERVENSI</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 227.95pt;" valign="top" width="304"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b><span style="font-family: "Arial","sans-serif";">RASIONAL</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l46 level1 lfo42; text-indent: -17.35pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Pertahankan istirahat tirah baring/duduk jika diperlukan.</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l46 level1 lfo42; text-indent: -17.35pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Bantu bergerak dengan bantuan seminimal mungkin.</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l46 level1 lfo42; text-indent: -17.35pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Dorong klien mempertahankan postur tegak, duduk tinggi, berdiri dan berjalan. </span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l46 level1 lfo42; text-indent: -17.35pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Berikan lingkungan yang aman dan menganjurkan untuk menggunakan alat bantu. </span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l46 level1 lfo42; text-indent: -17.35pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Berikan obat-obatan sesuai indikasi seperti steroid.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 227.95pt;" valign="top" width="304"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l35 level1 lfo43; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Untuk mencegah kelelahan dan mempertahankan kekuatan.</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l35 level1 lfo43; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Meningkatkan fungsi sendi, kekuatan otot dan stamina umum.</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l35 level1 lfo43; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Memaksimalkan fungsi sendi dan mempertahankan mobilitas.</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l35 level1 lfo43; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Menghindari cedera akibat kecelakaan seperti jatuh.</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l35 level1 lfo43; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Untuk menekan inflamasi sistemik akut.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: .5in;"><span class="apple-style-span"><b><span style="font-family: "Arial","sans-serif";">Diagnosa 3</span></b></span><span class="apple-style-span"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";"> : Risiko cedera b/d penurunan fungsi tulang.</span></b></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: .5in;"><span class="apple-style-span"><b><span style="font-family: "Arial","sans-serif";">Kriteria Hasil</span></b></span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";"> : Klien dapat me mpertahankan keselamatan fisik.</span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid black .5pt; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b><span style="font-family: "Arial","sans-serif";">INTERVENSI</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 227.95pt;" valign="top" width="304"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b><span style="font-family: "Arial","sans-serif";">RASIONAL</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l17 level1 lfo44; text-indent: -17.35pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Kendalikan lingkungan dengan : Menyingkirkan bahaya yang tampak jelas, mengurangi potensial cedera akibat jatuh ketika tidur misalnya menggunakan penyanggah tempat tidur, usahakan posisi tempat tidur rendah, gunakan pencahayaan malam siapkan lampu panggil <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l17 level1 lfo44; text-indent: -17.35pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Izinkan kemandirian dan kebebasan maksimum dengan memberikan kebebasan dalam lingkungan yang aman, hindari penggunaan restrain, ketika pasien melamun alihkan perhatiannya ketimbang mengagetkannya.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 227.95pt;" valign="top" width="304"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l34 level1 lfo45; text-indent: -16.7pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Lingkungan yang bebas bahaya akan mengurangi resiko cedera dan membebaskan keluarga dari kekhawatiran yang konstan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-list: l34 level1 lfo45; text-indent: -16.7pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Hal ini akan memberikan pasien merasa otonomi, restrain dapat meningkatkan agitasi, mengagetkan pasien akan meningkatkan ansietas.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: .5in;"><span class="apple-style-span"><b><span style="font-family: "Arial","sans-serif";">Diagnosa 4</span></b></span><span class="apple-style-span"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";"> : Perubahan pola tidur b/d nyeri</span></b></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: .5in;"><span class="apple-style-span"><b><span style="font-family: "Arial","sans-serif";">Kriteria Hasil</span></b></span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";"> : Klien dapat memenuhi kebutuhan istirahat atau tidur. </span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid black .5pt; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b><span style="font-family: "Arial","sans-serif";">INTERVENSI</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 227.95pt;" valign="top" width="304"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b><span style="font-family: "Arial","sans-serif";">RASIONAL</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l21 level1 lfo46; text-indent: -17.35pt;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Tentukan kebiasaan tidur biasanya dan biasanya dan perubahan yang terjadi.</span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l21 level1 lfo46; text-indent: -17.35pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Berikan tempat tidur yang nyaman<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l21 level1 lfo46; text-indent: -17.35pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Buat rutinitas tidur baru yang dimasukkan dalam pola lama dan lingkungan baru<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l21 level1 lfo46; text-indent: -17.35pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Instruksikan tindakan relaksasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l21 level1 lfo46; text-indent: -17.35pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Tingkatkan regimen kenyamanan waktu tidur, misalnya mandi hangat dan massage.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l21 level1 lfo46; text-indent: -17.35pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Gunakan pagar tempat tidur sesuai indikasi: rendahkan tempat tidur bila mungkin.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l21 level1 lfo46; text-indent: -17.35pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Hindari mengganggui bila mungkin, misalnya membangunkan untuk obat atau terapi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -17.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l21 level1 lfo46; text-indent: -17.35pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Berikan sedative, hipnotik sesuai indikasi<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 227.95pt;" valign="top" width="304"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-list: l49 level1 lfo47; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Mengkaji perlunya dan mengidentifikasi intervensi yang tepat. </span><span lang="IN" style="font-family: "Arial","sans-serif"; mso-ansi-language: IN;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; text-indent: -9.05pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-list: l49 level1 lfo47; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Meningkatkan kenyamaan tidur serta dukungan fisiologis/psikologis <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; text-indent: -9.05pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-list: l49 level1 lfo47; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Bila rutinitas baru mengandung aspek sebanyak kebiasaan lama, stress dan ansietas yang berhubungan dapat berkurang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; text-indent: -9.05pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-list: l49 level1 lfo47; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Membantu menginduksi tidur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; text-indent: -9.05pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-list: l49 level1 lfo47; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Meningkatkan efek relaksasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; text-indent: -9.05pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; text-indent: -9.05pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-list: l49 level1 lfo47; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Dapat merasakan takut jatuh karena perubahan ukuran dan tinggi tempat tidur, pagar tempat untuk membantu mengubah posisi <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; text-indent: -9.05pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-list: l49 level1 lfo47; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Tidur tanpa gangguan lebih menimbulkan rasa segar dan pasien mungkin mungkin tidak mampu kembali tidur bila terbangun.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; text-indent: -9.05pt;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-list: l49 level1 lfo47; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Mungkin diberikan untuk membantu pasien tidur atau istirahat.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: .5in;"><span class="apple-style-span"><b><span style="font-family: "Arial","sans-serif";">Diagnosa 5</span></b></span><span class="apple-style-span"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";"> : Defisit perawatan diri b/d nyeri</span></b></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: .5in;"><span class="apple-style-span"><b><span style="font-family: "Arial","sans-serif";">Kriteri Hasil</span></b></span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";"> : Klien dapat melaksanakan aktivitas per awatan sendiri secara mandiri</span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid black .5pt; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><span style="font-family: "Arial","sans-serif";">. <b>INTERVENSI</b><o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 227.95pt;" valign="top" width="304"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b><span style="font-family: "Arial","sans-serif";">RASIONAL</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l4 level1 lfo48; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Kaji tingkat fungsi fisik <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l4 level1 lfo48; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Pertahankan mobilitas, kontrol terhadap nyeri dan progran latihan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-list: l4 level1 lfo48; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Kaji hambatan terhadap partisipasi dalam perawatan diri, identifikasi untuk modifikasi lingkungan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l4 level1 lfo48; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Identifikasikasi untuk perawatan yang diperlukan, misalnya; lift, peninggian dudukan toilet, kursi roda<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 227.95pt;" valign="top" width="304"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l1 level1 lfo49; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Mengidentifikasi tingkat bantuan/dukungan yang diperlukan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l1 level1 lfo49; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Mendukung kemandirian fisik/emosional<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l1 level1 lfo49; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Menyiapkanuntuk meningkatkan kemandirian yang akan meningkatkan harga diri<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -13.5pt;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l1 level1 lfo49; text-indent: -13.5pt;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Memberikan kesempatan untuk dapat melakukan aktivitas secara mandiri<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="margin-left: 103.5pt; text-indent: -67.5pt;"><br />
</div><div class="MsoNormal" style="margin-left: 103.5pt; text-indent: -67.5pt;"><span class="apple-style-span"><b><span style="font-family: "Arial","sans-serif";">Diagnosa 6</span></b></span><span class="apple-style-span"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif";"> : Gangguan citra tubuh/ perubahan penampilan peran b/d perubahan <span style="mso-spacerun: yes;"> </span>kemampuan untuk melakukan tugas-tugas umum.</span></b></span><b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 112.5pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -76.5pt;"><span class="apple-style-span"><b><span style="font-family: "Arial","sans-serif";">Tujuan </span></b></span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";"><span style="mso-spacerun: yes;"> </span>: mengungkapkan peningkatan rasa percaya kemampuan untuk menghadapi penyakit, perubahan gaya hidup dan kemungkinan keterbatasan.</span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid black .5pt; mso-padding-alt: 0in 0in 0in 0in; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b><span style="font-family: "Arial","sans-serif";">INTERVENSI</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 0in 0in 0in; width: 227.95pt;" valign="top" width="304"> <div align="center" class="MsoNormal" style="line-height: 150%; mso-layout-grid-align: none; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b><span style="font-family: "Arial","sans-serif";">RASIONAl</span></b><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 225.65pt;" valign="top" width="301"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l22 level1 lfo50; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Dorong pengungkapan mengenaimasalah mengenai proses penyakit,harapan masa depan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -7.1pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l22 level1 lfo50; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Diskusikan arti dari kehilangan/perubahan pada pasien/orang terdekat. Memastikan bagaimana pandangan pribadi psien dalam memfungsikan gaya hidup sehari-hari termasuk aspek-aspek seksual.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -7.1pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l22 level1 lfo50; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Diskusikan persepsi pasien mengenai bagaiman orang terdekat menerima keterbatasan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -7.1pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -7.1pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l22 level1 lfo50; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Akui dan terima perasaan berduka, bermusuhan, ketergantungan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -7.1pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l22 level1 lfo50; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Perhatikan perilaku menarik diri, penguanan menyangkal atau terlalumemperhatikan tubuh/perubahan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -7.1pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l22 level1 lfo50; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Susun batasan pada prilaku maladaptive. Bantu pasien untuk mengidentifikasi perilaku positifyang dapat membantu koping.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -7.1pt;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l22 level1 lfo50; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Ikut sertakan pasien dalam merencanakan perawatan dan membuat jadwal aktivitas.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 17.35pt; mso-layout-grid-align: none;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l22 level1 lfo50; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Rujuk pada konseling psikiatri<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 17.35pt; mso-layout-grid-align: none;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: 17.35pt; mso-layout-grid-align: none;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 17.35pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l22 level1 lfo50; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Berikan obat-obat sesuai petunjuk<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 0in 0in 0in; width: 227.95pt;" valign="top" width="304"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l5 level1 lfo51; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Beri kesempatan untuk mengidentifikasi rasa takut/kesalmenghadapinya secara langsung.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -.25in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l5 level1 lfo51; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Mengidentifikasi bagaimana penyakit mempengaruhi persepsi diri dan interaksi dengan orang lain akan menentukan kebutuhan terhadap intervensi atau konseling lebih lanjut. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -.25in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l5 level1 lfo51; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Isyarat verbal/nonverbal orang terdekat dapat mempunyai pengaruh mayor pada bagaimana pasien memandang dirinya sendiri. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -.25in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l5 level1 lfo51; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Nyeri melelahkan, dan perasaan marah, bermusuhan umum terjadi. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -.25in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l5 level1 lfo51; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Dapat menunjukkan emosional atau metode maladaptive, membutuhkan intervensi lebih lanjut atau dukungan psikologis. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -.25in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l5 level1 lfo51; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Membantu pasien mempertahankan kontrol diri yang dapat meningkatkan perasaan harga diri. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -.25in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l5 level1 lfo51; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Meningkatkan perasaan kompetensi/harga diri, mendorong kemandirian, dan mendorong partisipasi dan terapi. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -.25in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l5 level1 lfo51; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Pasien/orang terdekat mungkin membutuhkadukungann selama berhadapan dengan proses jangkapanjang/ketidakmampuan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; text-indent: -.25in;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 16.7pt; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l5 level1 lfo51; text-indent: -.25in;"><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif";">Mungkin dibutuhkan pada saat munculnya depresi hebat sampai pasien mengembangkan kemampuankoping yang efektif.<o:p></o:p></span></div></td> </tr>
</tbody></table><div align="center" class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%;">DAFTAR PUSTAKA<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: -35.45pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Brunner and Sudart. 2006. <i style="mso-bidi-font-style: normal;">Buku Ajar Keperawatan Medikal Bedah Volume <span style="mso-spacerun: yes;"> </span>3</i>. Jakarta : EGC.<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-indent: -35.45pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Doenges E Marilynn, 2000, <i>Rencana Asuhan Keperawatan</i>. Jakarta : EGC<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; tab-stops: 40.5pt; text-indent: -35.45pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Kalim, Handono, 1996., <i>Ilmu Penyakit Dalam.</i> Jakarta: Balai Penerbit FKUI<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; tab-stops: 40.5pt; text-indent: -35.45pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Mansjoer, Arif, 2000., <i>Kapita Selekta Kedokteran</i>.jakarta: Media Aesculapius FKUI<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; tab-stops: 40.5pt; text-indent: -35.45pt;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Muttaqin, Arif.2008. Asuhan Keperawatan Klien Dengan Gangguan Sistem Muskuloskeletal. Jakarta: EGC<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; text-indent: -45.0pt;"><span style="font-family: "Arial","sans-serif";">Noer, Sjaifoellah. 1999. <i style="mso-bidi-font-style: normal;">Buku Ajar Ilmu Penyakit Dalam Cet. 3, Ed. 2</i>. Jakarta : Balai Penerbit <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; text-indent: -45.0pt;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; text-indent: -9.0pt;"><span style="font-family: "Arial","sans-serif";">Fakultas Kedokteran Universitas Indonesia<span class="apple-style-span"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; tab-stops: 40.5pt; text-indent: -.5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";">Prince, Sylvia Anderson, 2000., <i>Patofisiologi: Konsep Klinis Proses-Proses Penyakit</i>. Ed. 4, <o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; tab-stops: 40.5pt; text-indent: -.5in;"><span class="apple-style-span"><span style="font-family: "Arial","sans-serif";"><span style="mso-tab-count: 1;"> </span>Jakarta: EGC</span></span><span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;">Robbins ,Kumar, Cotran. 2007. Buku Ajar Patologi Robbins. Jakarta : EGC</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><a href="http://hidayat2.wordpress.com/2009/05/12/askep-osteoporosis/"><span style="color: windowtext; font-family: "Arial","sans-serif";">http://hidayat2.wordpress.com/2009/05/12/askep-osteoporosis/</span></a></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><a href="http://id.wikipedia.org/wiki/Osteoporosis"><span style="color: windowtext; font-family: "Arial","sans-serif";">http://id.wikipedia.org/wiki/Osteoporosis</span></a> )<span style="font-family: "Arial","sans-serif";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoNormal" style="line-height: 150%;"><span style="font-family: "Arial","sans-serif";">. <o:p></o:p></span></div>Ian zkate pakpahanhttp://www.blogger.com/profile/10259135788220046244noreply@blogger.com1tag:blogger.com,1999:blog-2556652656898751244.post-20497798835782284262010-10-17T12:17:00.002+07:002010-10-19T06:03:12.536+07:00ASKEP ARTHRITIS GOUT DAN RHEUMATOID ARTHRITIS<div class="Section1"><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #0070c0; font-family: "Rockwell Condensed","serif"; font-size: 20.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman"; mso-no-proof: yes;">ASUHAN KEPERAWATAN PADA KLIEN</span><span style="color: #0070c0; font-family: "Rockwell Condensed","serif"; font-size: 20.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-no-proof: yes;"><span style="mso-spacerun: yes;"> </span></span><span lang="IN" style="color: #0070c0; font-family: "Rockwell Condensed","serif"; font-size: 20.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman"; mso-no-proof: yes;">DENGAN </span><span style="color: #0070c0; font-family: "Rockwell Condensed","serif"; font-size: 20.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-no-proof: yes;">GANGGUAN MUSKULOSKELETAL :<span style="mso-spacerun: yes;"> </span></span><span lang="IN" style="color: #0070c0; font-family: "Rockwell Condensed","serif"; font-size: 20.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman"; mso-no-proof: yes;">ARTHRITIS GOUT DAN RHEUMATOID ARTHRITIS<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #0070c0; font-family: "Rockwell Condensed","serif"; font-size: 20.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman"; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-no-proof: yes;">MAKALAH</span></b></div><div align="center" class="MsoNormal" style="text-align: center;"><v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas> <v:path gradientshapeok="t" o:connecttype="rect" o:extrusionok="f"> <o:lock aspectratio="t" v:ext="edit"> </o:lock></v:path></v:stroke></v:shapetype><v:shape id="_x0000_s1152" style="height: 207.75pt; left: 0; margin-left: 92.7pt; margin-top: 33.45pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.5pt; z-index: 127;" type="#_x0000_t75"> <v:imagedata o:title="Logo STIKes ku Don't open,please call me again" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image003.jpg"> <w:wrap type="square"> </w:wrap></v:imagedata></v:shape><v:shape id="_x0000_s1152" style="height: 207.75pt; left: 0; margin-left: 92.7pt; margin-top: 33.45pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 247.5pt; z-index: 127;" type="#_x0000_t75"><br />
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</v:shape><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-no-proof: yes;">disusun untuk memenuhi tugas mata </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;">ajaran Keperawatan Medikal Bedah III</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-no-proof: yes;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
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</o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-no-proof: yes;"><o:p><br />
</o:p></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEielHaBj7wz_LDAyGAnjhKHhijvBBAojHG3Hfq2N1rw3TtK3M3GxBf6fXIBeQUzVL10f7GNk6GWATHyXmE75zeqOUTNp7CAmlEWUAtWU2X1kGEsrfWO9VDLIAhvzR157S-Lshilvpp-YcE/s1600/DAH+AH+CAPE.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEielHaBj7wz_LDAyGAnjhKHhijvBBAojHG3Hfq2N1rw3TtK3M3GxBf6fXIBeQUzVL10f7GNk6GWATHyXmE75zeqOUTNp7CAmlEWUAtWU2X1kGEsrfWO9VDLIAhvzR157S-Lshilvpp-YcE/s320/DAH+AH+CAPE.jpg" width="320" /></a></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-no-proof: yes;"><o:p><br />
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</div><div class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt; mso-no-proof: yes;"><br clear="all" style="mso-special-character: line-break;" /> <o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-no-proof: yes;">oleh :</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-no-proof: yes;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
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</div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;">PROGRAM STUDI D III KEPERAWATAN<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;">Sekolah tinggi ilmu kesehatan santo borromeus<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;">bandung<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;"><br />
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</span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="color: #00b0f0; font-family: Algerian; font-size: 14.0pt; line-height: 115%; mso-bidi-font-family: Arial; mso-no-proof: yes;"><br />
</span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%;">BAB I</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%;">PENDAHULUAN<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l36 level2 lfo48; text-align: justify; text-indent: -28.35pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.1<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Latar Belakang Penulisan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pengetahuan tentang asuhan keperawatan muskuloskeleta makin dibutuhkan mahasiswa ataupun perawat selaku pemberi pelayan kesehatan. Pergeseran tingkat pendidikan pada dunia keperawatan di Indonesia menuju ere profesionalisasi menjadikan asuhan keperawatan pada pola asuhan per sistem. Perkembangan asuhan keperawatan sistem muskoskeletal sendiri sejak lama tidak lepas dari bedah ortopedi, suatu disiplin ilmu dari bagian medis yang di Indonesia sekarang ini masih belum dikenal luas oleh masyarakat. Hal ini disebabkan oleh keadaan masih adanya pereanan yang cukup besar dari ahli urut tulang (khususnya di daerah), yaitu lebih dari 25% klien berobat ke ahli urut tulang/dukun patah tanpa memnadang derajat sosial dan pendidikan dan umumnya datang ke rumah sakit setelah timbul penyulit atau penyakit sudah dalam stadium lanjut. Untuk mengantisipasi masalah tersebut, salah satu fungsi dari peranan perawat adalah mensosialisasikan pada masyarakat umum guna mencegah/menghindari hal-hal yang sebenarnya tidak perlu terjadi. <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Oleh karena itu, kami menyusun makalah yang berjudul “Asuhan Keperawatan Pada Klien dengan Gangguan Muskuloskeletal: Gout dan Rheumatoid Arthritis“. Dengan harapan sebagai perawat kita mampu memahami konsep penyakit yang dialami klien dengan gangguan sistem Muskuloskeletal, khususnya Gout dan Rheumatoid Arthristis, sehingga kita pun mampu memberi asuhan keperawatan yang tepat dan kontrahensif, yang meliputi pengenalan konsep anatomi fisiologi, dan patofisiologi sistem muskuloskeletal, pengkajian untuk menegakkan masalah keperawatan, perencanaan dan tindakan keperawatan, sampai mengevaluasi hasil asuhan keperawatan pada masalah sistem muskuloskeletal.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l36 level2 lfo48; text-align: justify; text-indent: -27.0pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.2<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tujuan Penulisan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify; text-indent: 27.0pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Adapun tujuan yang ingin dicapai :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l29 level1 lfo47; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tujuan umum<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 22.5pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diharapkan agar Mahasiswa/i tingkat II Program Studi D III Keperawatan, mampu memahami tentang</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> konsep asuhan keperawatan pada klien dengan Arthritis Guot dan Rheumatoid Arthritis</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 22.5pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l29 level1 lfo47; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tujuan khusus<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 58.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo49; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Mahasiswa dapat </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">memahami anatomi dan fisiologi system musculoskeletal.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 58.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo49; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Mahasiswa dapat mengetahui </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">konsep penyakit arthritis gout.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 58.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo49; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Mahasiswa dapat </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">mengerti tentang konsep asuhan keperawatan pada klien dengan arthritis gout.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 58.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo49; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Mahasiswa dapat mengetahui </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">konsep penyakit rheumatoid arthritis.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 58.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo49; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">mahasiswa dapat </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">mengerti tentang konsep asuhan keperawatan pada klien dengan rheumatoid arthritis.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 58.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo49; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Mahasiswa dapat</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> mengaplikasikan konsep asuhan keperawatan pada klien dengan gangguan sistem mus</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">k</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">uloskeletal : Arthritis Guot dan Rheumatoid Arthritis</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 58.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l36 level2 lfo48; text-align: justify; text-indent: -28.35pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.3<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Metode Penulisan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Dalam menyusun makalah ini, penulis mengunakan metode<span style="mso-spacerun: yes;"> </span>deskriptif yaitu dengan mengumpulkan data-data yang diambil dari sumber buku perpustakaan, diskusi kelompok, serta konsultasi dengan dosen pembimbing.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 28.35pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l36 level2 lfo48; text-align: justify; text-indent: -27.0pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.4<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>Sistematika penulisan<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: .25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Dalam penyusunan makalah ini, penulis membagi dalam tiga bab, yaitu BAB I Pendahuluan yang berisi: latar belakang penulisan, tujuan penulisan, metode penulisan, sistematika penulisan. BAB II Tinjauan Teoritis yang berisi : anatomi fisiologi sistem muskuloskeletal, konsep penyakit arthritis gout, konsep asuhan keperawatan pada klien dengan arthritis guot, konsep penyakit rheumatoid arthritis, dan konsep asuhan keperawatan pada klien dengan rheumatoid arthritis. BAB III<span style="mso-spacerun: yes;"> </span>Penutup berisi: kesimpulan dan saran. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%;">BAB II</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 14.0pt; line-height: 150%;">TINJAUAN TEORETIS<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l41 level2 lfo1; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.1<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">ANATOMI FISIOLOGI SISTEM MUSKULOSKELETAL<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo2; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Anatomi Fisiologi Rangka<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><v:shape alt="[SKE1ATL.BMP]" id="Picture_x0020_92" o:spid="_x0000_s1151" stroked="t" style="height: 371.2pt; left: 0; margin-left: 267.45pt; margin-top: 68.4pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 201pt; z-index: -13;" type="#_x0000_t75"> <v:imagedata o:title="[SKE1ATL" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image004.jpg"> </v:imagedata></v:shape><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Muskuloskeletal berasal dari kata muscle (otot) dan skeletal (tulang). Rangka (skeletal) merupakan bagian tubuh yang terdiri dari tulang, sendi dan tulang rawan (kartilago), sebagai tempat menempelnya otot dan memungkinkan tubuh untuk mempertahankan sikap dan posisi.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -.15pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-no-proof: yes;"><v:shape id="Picture_x0020_3" o:spid="_x0000_i1025" style="height: 370.5pt; mso-wrap-style: square; visibility: visible; width: 216.75pt;" type="#_x0000_t75"> <v:imagedata o:title="2" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image005.gif"> </v:imagedata></v:shape></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><br />
</div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>Gambar</span></i><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-ansi-language: EN-US;"> </span></i><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-ansi-language: EN-US;">:</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"> </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-ansi-language: EN-US;">tulang </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">pada tubuh manusia</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: 10.0pt; margin-left: 49.5pt; margin-right: 0in; margin-top: 12.0pt; text-align: center;"><span style="mso-ansi-language: EN-US;"><span style="mso-spacerun: yes;"> </span>(http://kerzt.files.wordpress.com/2009/02/normal.gif)<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Rangka manusia dewasa tersusun dari tulang – tulang (sekitar 206 tulang ) yang membentuk suatu kerangka tubuh yang kokoh. Walaupun rangka terutama tersusun dari tulang, rangka di</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">sebagian tempat dilengkapi dengan kartilago. Rangka digolongkan menjadi rangka aksial, rangka apendikular, dan persendian. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo3; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Rangka aksial, melindungi organ-organ pada kepala, leher, dan torso.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l2 level1 lfo4; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kolumna vertebra<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l2 level1 lfo4; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tengkorak<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 92.15pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l27 level1 lfo5; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tulang cranial : menutupi dan melindungi otak dan organ-organ panca indera.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 92.15pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l27 level1 lfo5; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tulang wajah : memberikan bentuk pada muka dan berisi gigi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 92.15pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l27 level1 lfo5; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tulang auditori : terlihat dalam transmisi suara.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 92.15pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l27 level1 lfo5; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tulang hyoid : yang menjaga lidah dan laring.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo3; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Rangka apendikular, tulang yang membentuk lengan tungkai dan tulang pectoral serta tonjolan pelvis yang menjadi tempat melekatnya lengan dan tungkai pada rangkai aksial.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo3; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Persendian, adalah artikulasi dari dua tulang atau lebih.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -8.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Fungsi Sistem Rangka :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo6; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tulang sebagai penyangga (penopang); berdirinya tubuh, tempat melekatnya ligamen-ligamen, otot, jaringan lunak dan organ, juga memberi bentuk pada tubuh.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo6; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pergerakan ; dapat mengubah arah dan kekuatan otot rangka saat bergerak, adanya persendian.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo6; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Melindungi organ-organ halus dan lunak yang ada dalam tubuh.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo6; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pembentukan sel darah (hematopoesis / red marrow).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo6; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tempat penyimpanan mineral (kalium dan fosfat) dan lipid (yellow marrow).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -14.2pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -8.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Menurut bentuknya tulang dibagi menjadi 4, yaitu :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level1 lfo7; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">F<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tulang panjang, terdapat dalam tulang paha, tulang lengan atas<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level1 lfo7; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">F<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tulang pendek (carpals) bentuknya tidak tetap dan didalamnya terdiri dari tulang karang, bagian luas terdiri dari tulang padat.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level1 lfo7; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">F<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tulang ceper yang terdapat pada tulang tengkorak yang terdiri dari 2 tulang karang di</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">sebelah dalam dan tulang padat disebelah luar.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level1 lfo7; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">F<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Bentuk yang tidak beraturan (vertebra) sama seperti tulang pendek.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -22.35pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Struktur Tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Dilihat dari bentuknya tulang dapat dibagi menjadi tulang pendek, panjang, tulang berbentuk rata (flat) dan tulang dengan bentuk tidak beraturan. Terdapat juga tulang yang berkembang didalam tendon misalnya tulang patella (tulang sessamoid). Semua tulang memiliki sponge tetapi akan bervariasi dari kuantitasnya.Bagian tulang tumbuh secara longitudinal,bagian tengah disebut epiphyse yang berbatasan dengan metaphysic yang berbentuk silinder.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 14.15pt;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Vaskularisasi</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">.<b style="mso-bidi-font-weight: normal;"> </b>Tulang merupakan bagian yang kaya akan vaskuler dengan total aliran sekitar 200-400 cc/menit.Setiap tulang memiliki arteri menyuplai darah yang membawa nutrient masuk di dekat pertengahan tulang kemudian bercabang ke atas dan ke bawah menjadi pembuluh darah mikroskopis, pembuluh ini menyuplai korteks, morrow, dan sistem harvest.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 14.15pt;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Persarafan</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">. Serabut syaraf simpatik dan afferent (sensorik) mempersarafi tulang dilatasi kapiler dan di control oleh saraf simpatis sementara serabut syaraf efferent menstramisikan rangsangan nyeri. <o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -22.35pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pertumbuhan dan Metabolisme Tulang <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Setelah pubertas tulang mencapai kematangan dan pertumbuhan maksimal. Tulang merupakan jaringan yang dinamis walaupun demikian pertumbuhan yang seimbang pembentukan dan penghancuran hanya berlangsung hanya sampai usia 35 tahun. Tahun –tahun berikutnya rebsorbsi tulang mengalami percepatan sehigga tulang mengalami penurunan massanya dan menjadi rentan terhadap injury.Pertumbuhan dan metabolisme tulang di pengaruhi oleh mineral dan hormone sebagai berikut : <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo8; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kalsium dan Fosfor</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">. Tulang mengandung 99% kalsium dan 90% fosfor. Konsentrasi ini selalu di pelihara dalam hubungan terbalik. Apabila kadar kalsium meningkat maka kadar fosfor akan berkurang, ketika kadar kalsium dan kadar fosfor berubah, calsitonin dan PTH bekerja untuk memelihara keseimbangan.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo8; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Calsitonin </span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">di produksi oleh kelenjar tiroid memiliki aksi dalam menurunkan kadar kalsium jika sekresi meningkat di atas normal. Menghambat reabsorbsi tulang dan meningkatkan sekresi fosfor oleh ginjal bila di perlukan.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l50 level1 lfo8; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Vit. D. </span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">diproduksi oleh tubuh dan di trasportasikan ke dalam darah untuk meningkatkan reabsorbsi kalsium dan fosfor dari usus halus, juga memberi kesempatan untuk aktifasi PHT dalam melepas kalsium dari tulang.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -22.35pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Proses Pembentukan Tulang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Pada bentuk alamiahnya, vitamin D di proleh dari radiasi sinar ultraviolet matahari dan beberapa jenis makanan. Dalam kombinasi denagan kalsium dan fosfor, vitamin ini penting untuk pembentukan tulang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Vitamin D sebenarnya merupakan kumpulan vitamin-vitamin, termasuk vitamin D2 dan D3. Substansi yang terjadi secara alamiah ialah D3 (kolekalsiferol), yang dihasilkan olehakifitas foto kimia pada kulit ketika dikenai sinar ultraviolet matahari. D3 pada kulit atau makanan diwa ke (liver bound) untuk sebuah alfa – globulin sebagai transcalsiferin,sebagaian substansi diubah menjadi 25 dihidroksi kolekalsiferon atau kalsitriol. Calcidiol kemudian dialirkan ke ginjal untuk transformasi ke dalam metabolisme vitamin D aktif mayor, 1,25 dihydroxycho lekalciferol atau calcitriol. Banyaknya kalsitriol yang di produksi diatur oleh hormone parathyroid (PTH) dan kadar fosfat di dalam darah, bentuk inorganic dari fosfor penambahan produksi kalsitriol terjadi bila kalsitriol meningkat dalam PTH atau pengurangan kadar fosfat dalam cairan darah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Kalsitriol dibutuhkan untuk penyerapan kalsium oleh usus secara optimal dan bekerja dalam kombinasi dengan P</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">T</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">H untuk membantu pengaturan kalsium darah. Akibatnya, kalsitriol atau pengurangan vitamin D dihasilkan karena pengurangan penyerapan kalsium dari usus, dimana pada gilirannya mengakibatka stimulasi<span style="mso-spacerun: yes;"> </span>PHT dan pengurangan,baik itu kadar fosfat maupun kalsium dalam darah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l76 level1 lfo9; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Hormon parathyroid. </span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Saat kadar kalsium dalam serum menurun sekresi hormone parathyroid akan meningkat aktifasi osteoclct dalam menyalurkan kalsium ke dalam darah lebih lanjutnya hormone ini menurunkan hasil ekskresi kalsium melalui ginjal dan memfasilitasi absorbsi kalsium dari usus kecil dan sebaliknya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l76 level1 lfo9; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Growth hormone</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> bertanggung jawab dalam peningkatan panjang tulang dan penentuan matriks tulang yang dibentuk pada masa sebelum pubertas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l76 level1 lfo9; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Glukokortikoid </span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">mengatur metabolism protein. Ketika diperlukan hormone ini dapat meningkat atau menurunkan katabolisme untuk mengurangi atau meningkatkan matriks organic. Tulang ini juga membantu dalam regulasi absorbsi kalsium dan fosfor dari usus kecil.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l76 level1 lfo9; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Seks hormone</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> estrogen menstimulasi aktifitas osteobalstik dan menghambat hormone paratiroid. Ketika kadar estrogen menurun seperti pada masa menopause, wanita sangat rentan terjadinya massa tulang (osteoporosis). <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Persendian<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><v:shape id="Picture_x0020_4" o:spid="_x0000_s1150" style="height: 103.7pt; left: 0; margin-left: 180.85pt; margin-top: 65.7pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 116.6pt; z-index: -7;" type="#_x0000_t75"> <v:imagedata o:title="hal14a" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image006.jpg"> </v:imagedata></v:shape><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Persendian dapat diklasifikasikan menurut struktur (berdasarkan ada tidaknya rongga persendian diantara tulang-tulang yang beratikulasi dan jenis jaringan ikat yang berhubungan dengan paersendian tersebut)</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">dan menurut fungsi persendian (berdasarkan jumlah gerakan yang mungkin dilakukan pada persendian).</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 175.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 175.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 175.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 175.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 175.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 175.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div align="center" class="MsoNormal" style="margin-left: 49.65pt; text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US;">Gambar. Sendi<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>(</span><span lang="IN"><a href="http://www.e-dukasi.net/mapok/mp_files/mp_376/images/hal14a.jpg"><span lang="EN-US" style="mso-ansi-language: EN-US;">http://www.e-dukasi.net/mapok/mp_files/mp_376/images/hal14a.jpg</span></a></span><span style="mso-ansi-language: EN-US;">)<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l77 level1 lfo10; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Klasifikasi struktural persendian : <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l22 level1 lfo11; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Persendian fibrosa <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l22 level1 lfo11; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Persendian kartilago <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l22 level1 lfo11; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Persendian synovial.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l77 level1 lfo10; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Klasifikasi fungsional persendian :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo12; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sendi Sinartrosis atau Sendi Mati<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Secara structural, persendian ii dibungkus dengan jaringan ikat fibrosa atau kartilago.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo12; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Amfiartrosis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sendi dengan pergerakan terbatas yang memungkinkan terjadinya sedikit gerakan sebagai respon terhadap torsi dan kompresi .<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo12; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diartrosis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sendi ini dapat bergerak bebas,disebut juga sendi sinovial.Sendi ini memiliki rongga sendi yang berisi cairan sinovial,suatu kapsul sendi yang menyambung kedua tulang, dan ujung tilang pada sendi sinovial dilapisi kartilago artikular.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l77 level1 lfo10; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Klasifikasi persendian sinovial :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo12; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sendi sfe</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">n</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">oidal : memungkinkan rentang gerak yang lebih besar,menuju ke tiga arah. Contoh : sendi panggul dan sendi bahu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo12; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sendi engsel : memungkinkan gerakan ke satu arah saja. Contoh : persendian pada lutut dan siku.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo12; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sendi kisar : memungkinkan terjadinya rotasi di sekitar aksis sentral.Contoh : persendian antara bagian kepala proximal tulang radius dan ulna.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo12; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Persendian kondiloid : memungkinkan gerakan ke dua arah di sudut kanan setiap tulang. Contoh : sendi antara tulang radius dan tulang karpal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo12; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sendi pelana : Contoh : ibu jari.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo12; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sendi peluru : memungkinkan gerakan meluncur antara satu tulang dengan tulang lainnya. C</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">o</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">ntoh : persendian intervertebra.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo2; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Anatomi Fisiologi Otot.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Otot (muscle) adalah jaringan tubuh yang berfungsi mengubah energi kimia menjadi kerja mekanik sebagai respon tubuh terhadap perubahan lingkungannya. Jaringan otot, yang mencapai 40% -50% berat tubuh,pada umumnya tersusun dari sel-sel kontraktil yang serabut otot. Melalui kontraksi, sel-sel otot menghasilkan pergerakan dan melakukan pekerjaan.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l77 level1 lfo10; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Fungsi sistem Muskular<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l37 level1 lfo13; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pergerakan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l37 level1 lfo13; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Penopang tubuh dan mempertahankan postur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l37 level1 lfo13; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Produksi panas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l77 level1 lfo10; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Ciri-ciri otot<o:p></o:p></span></div></div><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br clear="all" style="mso-break-type: section-break; page-break-before: auto;" /> </span> <div class="Section2"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo14; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kontraktilitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo14; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Eksitabilitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo14; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Ekstensibilitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l9 level1 lfo14; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Elastisita</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">s</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">.<o:p></o:p></span></div></div><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br clear="all" style="mso-break-type: section-break; page-break-before: auto;" /> </span> <div class="Section3"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l77 level1 lfo10; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Klasifikasi Jaringan Otot<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Otot diklasifikasikan secara structural berdasarkan ada tidaknya striasi silang (lurik), dan secara fungsional berdasarkan kendali konstruksinya,volunteer (sadar) atau involunter (tidak sadar), dan juga berdasarkan lokasi,seperti otot jantung, yang hanya ditemukan di jantung.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l77 level1 lfo10; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Jenis-jenis Otot <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo15; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Otot rangka adalah otot lurik,volunter, dan melekat pada rangka.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo15; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Otot polos adalah otot tidak berlurik dan involunter. Jenis otot ini dapat ditemukan pada dinding organ berongga seperti kandung kemih dan uterus, serta pada dinding tuba, seperti pada sistem respiratorik, pencernaan,reproduksi, urinarius, dan sistem sirkulasi darah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo15; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Otot jantung adalah otot lurik,involunter, dan hanya ditemukan pada jantung.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -14.2pt;"><v:shape alt="http://www.daviddarling.info/images/muscles_human_body_front.jpg" id="Picture_x0020_9" o:spid="_x0000_s1149" stroked="t" style="height: 291.15pt; left: 0; margin-left: 244.85pt; margin-top: 16.25pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 217.4pt; z-index: -14;" type="#_x0000_t75"> <v:imagedata o:title="muscles_human_body_front" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image007.jpg"> </v:imagedata></v:shape><v:shape alt="http://www.daviddarling.info/images/muscles_human_body_back.jpg" id="Picture_x0020_6" o:spid="_x0000_s1148" stroked="t" style="height: 291.55pt; left: 0; margin-left: 37.5pt; margin-top: 16.25pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 207.6pt; z-index: -15;" type="#_x0000_t75"> <v:imagedata o:title="muscles_human_body_back" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image008.jpg"> </v:imagedata></v:shape><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: center;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><span style="mso-spacerun: yes;"> </span></span></i><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gambar</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">. Otot pada tubuh manusia<o:p></o:p></span></div></div><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br clear="all" style="mso-break-type: section-break; page-break-before: auto;" /> </span> <div class="Section4"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l41 level2 lfo1; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.2<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">ARTHRITIS GOUT<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo16; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">PENGERTIAN<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l68 level1 lfo19; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gout adalah penyakit metebolik yang ditandai dengan penumpukan asam urat yang nyeri pada tulang sendi, sangat sering ditemukan pada kaki bagian atas, pergelangan dan kaki bagian tengah. (Merkie, Carrie. 2005).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l68 level1 lfo19; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gout merupakan penyakit<span style="mso-spacerun: yes;"> </span>metabolic yang ditandai oleh penumpukan asam urat yang menyebabkan nyeri pada sendi. (Moreau, David. 2005;407).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l68 level1 lfo19; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gout merupakan kelompok keadaan heterogenous yang berhubungan dengan defek genetic<span style="mso-spacerun: yes;"> </span>pada metabolism purin atau hiperuricemia. (Brunner & Suddarth. 2001;1810).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l68 level1 lfo19; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Artritis pirai (gout) merupakan suatu sindrom klinik sebagai deposit kristal asam urat di daerah persendian yang menyebabkan terjadinya serangan inflamasi akut. </span><span lang="IN"><a href="file:///F:/bahan%20seminar%20KMB%20III%20kel%206/(http:/denfirman.blogspot.com/2009/09/neprolitiasis.html"><span style="color: windowtext; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">(http://denfirman.blogspot.com/2009/09/neprolitiasis.html</span></a></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l68 level1 lfo19; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Jadi, Gout atau<span style="mso-spacerun: yes;"> </span>sering disebut “asam urat” adalah suatu penyakit metabolik dimana tubuh tidak dapat mengontrol asam urat sehingga terjadi penumpukan asam urat yang menyebabkan rasa nyeri pada tulang dan sendi. (Kesimpulan Kelompok).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><v:shape id="Picture_x0020_7" o:spid="_x0000_s1147" style="height: 164.6pt; left: 0; margin-left: 251.1pt; margin-top: 2.5pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 162.65pt; z-index: -6;" type="#_x0000_t75"> <v:imagedata o:title="0281_Gout" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image009.jpg"> </v:imagedata></v:shape><v:shape alt="http://jogjafisio.files.wordpress.com/2009/06/gout.jpg" id="Picture_x0020_3" o:spid="_x0000_s1146" strokecolor="windowText" stroked="t" style="height: 165.2pt; left: 0; margin-left: 65.05pt; margin-top: 1.7pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 177.25pt; z-index: -5;" type="#_x0000_t75"> <v:imagedata o:title="gout" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image010.jpg"> </v:imagedata></v:shape><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
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</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
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</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 256.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span style="color: red; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Gbr. Tofi</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> <o:p></o:p></span></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Gambar : gout<o:p></o:p></span></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">(</span><span lang="IN"><a href="http://jogjafisio.files.wordpress.com/2009/06/gout.jpg"><span style="color: windowtext;">http://jogjafisio.files.wordpress.com/2009/06/gout.jpg</span></a></span><span style="mso-ansi-language: EN-US;">)<o:p></o:p></span></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo16; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">ETIOLOGI<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Penyebab utama terjadinya gout adalah karena adanya deposit / penimbunan kristal asam urat dalam sendi. Penimbunan asam urat sering terjadi pada penyakit dengan metabolisme asam urat abnormal dan Kelainan metaboli</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">k</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> dalam pembentukan purin dan ekskresi asam urat yang kurang dari ginjal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: 335.3pt; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Beberapa factor lain yang mendukung, seperti :<span style="mso-tab-count: 1;"> </span><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l53 level1 lfo17; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Faktor genetik seperti gangguan metabolisme purin yang menyebabkan asam urat berlebihan (hiperuricemia), retensi asam urat, atau keduanya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l53 level1 lfo17; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Penyebab sekunder yaitu akibat obesitas, diabetes mellitus, hipertensi, gangguan ginjal yang akan menyebabkan :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l33 level1 lfo18; text-align: justify; text-indent: -7.1pt;"><span lang="IN" style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pemecahan asam yang dapat menyebabkan hiperuricemia.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 70.9pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l33 level1 lfo18; text-align: justify; text-indent: -7.1pt;"><span lang="IN" style="font-size: 10.0pt; line-height: 150%; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Karena penggunaan obat-obatan yang menurunkan ekskresi asam urat seperti : aspirin, diuretic, levodopa, diazoksid, asam nikotinat, aseta zolamid dan etambutol.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l45 level1 lfo16; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">INSIDEN <o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 14.2pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">95% penderita Gout ditemukan pada pria. Gout sering menyerang wanita post menopouse usia 50 – 60 tahun. Juga dapat menyerang laki-laki usia pubertas dan atau usia di atas 30 tahun. Penyakit ini paling sering mengenai sendi metatrsofalangeal, ibu jari kaki, sendi lutut dan pergelangan kaki.<o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 14.2pt;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l45 level1 lfo16; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">PATOFISIOLOGI<o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 20.7pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN;">Adanya gangguan metabolisme purin dalam tubuh, intake bahan yang mengandung asam urat tinggi, dan sistem ekskresi asam urat yang tidak adequat akan menghasilkan akumulasi asam urat yang berlebihan di dalam plasma darah (Hiperurecemia), sehingga mengakibatkan kristal asam urat menumpuk dalam tubuh. </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Penimbunan ini menimbulkan iritasi lokal dan menimbulkan respon inflamasi. <o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 4.5pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Hiperurecemia merupakan hasil</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN;"> </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">:</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN;"><o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo20; text-align: justify; text-indent: -22.5pt;"><span style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN;">M</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">eningkatnya produksi asam urat akibat metabolisme purine abnormal</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN;">.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo20; text-align: justify; text-indent: -22.5pt;"><span style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN;">M</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">enurunnya ekskresi asam urat</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN;">.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-list: l5 level1 lfo20; text-align: justify; text-indent: -22.5pt;"><span style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN;">K</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">ombinasi keduanya</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN;">.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Saat asam urat menjadi bertumpuk dalam darah dan cairan tubuh lain, maka asam urat tersebut akan mengkristal dan akan membentuk garam-garam urat yang akan berakumulasi atau menumpuk di jaringan konectiv diseluruh tubuh, penumpukan ini disebut <i style="mso-bidi-font-style: normal;">tofi</i>. Adanya kristal akan memicu respon inflamasi akut dan netrofil melepaskan lisosomnya. Lisosom tidak hanya merusak jaringan, tapi juga menyebabkan inflamasi. <o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><br />
</div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pada penyakit gout akut tidak ada gejala-gejala yang timbul. Serum urat maningkat tapi tidak akan menimbulkan gejala. Lama kelamaan penyakit ini akan menyebabkan hipertensi karena adanya penumpukan asam urat pada ginjal.<o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Serangan akut pertama biasanya sangat sakit dan cepat memuncak. Serangan ini meliputi hanya satu tulang sendi. Serangan pertama ini sangat nyeri yang menyebabkan tulang sendi menjadi lunak dan terasa panas, merah. Tulang sendi metatarsophalangeal biasanya yang paling pertama terinflamasi, kemudian mata kaki, tumit, lutut, dan tulang sendi pinggang. Kadang-kadang gejalanya disertai dengan demam ringan. Biasanya berlangsung cepat tetapi cenderung berulang dan dengan interval yang tidak teratur. <o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>Periode intercritical adalah periode dimana tidak ada gejala selama serangan gout.<span style="mso-spacerun: yes;"> </span>Kebanyakan pasien mengalami serangan kedua pada bulan ke-6 sampai 2 tahun setelah serangan pertama. Serangan berikutnya disebut dengan polyarticular yang tanpa kecuali menyerang tulang sendi kaki maupun lengan yang biasanya disertai dengan demam. Tahap akhir serangan gout atau gout kronik ditandai dengan polyarthritis yang berlangsung sakit dengan tofi yang besar pada kartilago, membrane synovial, tendon dan jaringan halus. Tofi terbentuk di jari, tangan, lutut, kaki, ulnar, helices pada telinga, tendon achiles dan organ internal seperti ginjal. Kulit luar mengalami ulcerasi dan mengeluarkan pengapuran, eksudat yang terdiri dari Kristal asam urat. <o:p></o:p></span></div><div style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 22.5pt;"><br />
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</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><v:rect fillcolor="#4bacc6 [3208]" id="_x0000_s1138" strokecolor="#f2f2f2" strokeweight="3pt" style="height: 24.75pt; left: 0; margin-left: 156.9pt; margin-top: 1.65pt; position: absolute; text-align: left; width: 133.5pt; z-index: 116;"> <v:shadow color="#215968" offset2="-1pt" offset="1pt" opacity=".5" type="perspective"> <v:textbox> </v:textbox></v:shadow></v:rect></div><table cellpadding="0" cellspacing="0"><tbody>
<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 115%;">Pathoflow Diagram<o:p></o:p></span></div><div class="MsoNormal"><br />
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</tbody></table><u><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p><span style="text-decoration: none;"> </span></o:p></span></u><br />
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</div><br clear="ALL" style="mso-ignore: vglayout;" /> <div class="MsoNormal" style="margin-left: -35.45pt; text-indent: 35.45pt;"><v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t32" o:oned="t" o:spt="32" path="m,l21600,21600e"> <v:path arrowok="t" fillok="f" o:connecttype="none"> <o:lock shapetype="t" v:ext="edit"> </o:lock></v:path></v:shapetype><v:shape id="_x0000_s1142" o:connectortype="straight" style="height: 31.5pt; left: 0; margin-left: 231.7pt; margin-top: 13.2pt; position: absolute; text-align: left; width: 0; z-index: 120;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><v:shape id="_x0000_s1141" o:connectortype="straight" style="height: 13.9pt; left: 0; margin-left: 395.7pt; margin-top: 13.2pt; position: absolute; text-align: left; width: 0; z-index: 119;" type="#_x0000_t32"><v:shape id="_x0000_s1140" o:connectortype="straight" style="height: 13.9pt; left: 0; margin-left: 25.5pt; margin-top: 13.2pt; position: absolute; text-align: left; width: 0; z-index: 118;" type="#_x0000_t32"><span lang="IN">Genetik<span style="mso-spacerun: yes;"> </span>Sekresi asam urat berkurang<span style="mso-spacerun: yes;"> </span>Produksi asam urat >> </span></v:shape></v:shape></div><div class="MsoNormal" style="tab-stops: 51.75pt;"><br />
</div><br clear="ALL" style="mso-ignore: vglayout;" /> <div align="center" class="MsoNormal" style="margin-left: 28.35pt; text-align: center;"><v:shape id="_x0000_s1027" o:connectortype="straight" style="height: 26.1pt; left: 0; margin-left: 233.25pt; margin-top: 15.25pt; position: absolute; text-align: left; width: 0; z-index: 2;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><span lang="IN">Gangguan metabolism purin</span></div><div align="center" class="MsoNormal" style="line-height: normal; tab-stops: 51.75pt; text-align: center;"><v:shape id="_x0000_s1028" o:connectortype="straight" style="height: 30.25pt; left: 0; margin-left: 231.7pt; margin-top: 41.85pt; position: absolute; text-align: left; width: .05pt; z-index: 3;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><v:rect fillcolor="#9bbb59 [3206]" id="_x0000_s1137" strokecolor="#f2f2f2" strokeweight="3pt" style="height: 26.1pt; left: 0; margin-left: 204pt; margin-top: 15.95pt; position: absolute; text-align: left; width: 49.95pt; z-index: 112;"> <v:shadow color="#4e6128" offset2="-1pt" offset="1pt" opacity=".5" type="perspective"> <v:textbox> </v:textbox></v:shadow></v:rect></div><table cellpadding="0" cellspacing="0"><tbody>
<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><span style="mso-ansi-language: EN-US;">gout<o:p></o:p></span></div></div></td> </tr>
</tbody></table><span lang="IN"><o:p> </o:p></span><br />
<div align="center" class="MsoNormal" style="line-height: normal; margin-left: 28.35pt; tab-stops: 51.75pt; text-align: center;"><br />
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</div><br clear="ALL" style="mso-ignore: vglayout;" /> <div align="center" class="MsoNormal" style="line-height: normal; tab-stops: 51.75pt; text-align: center;"><span lang="IN"><span style="mso-spacerun: yes;"> </span>Hiperurisemia & serangan sinovitis</span></div><div align="center" class="MsoNormal" style="line-height: normal; tab-stops: 51.75pt; text-align: center;"><v:shape id="_x0000_s1029" o:connectortype="straight" style="flip: x; height: 35.25pt; left: 0; margin-left: 232.5pt; margin-top: 15.35pt; position: absolute; text-align: left; width: .75pt; z-index: 4;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><span lang="IN"><span style="mso-spacerun: yes;"> </span>Akut berulang-ulang</span></div><div align="center" class="MsoNormal" style="line-height: normal; tab-stops: 51.75pt; text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="line-height: normal; tab-stops: 51.75pt; text-align: center;"><span lang="IN"><span style="mso-spacerun: yes;"> </span>Penimbunan Kristal urat</span></div><div align="center" class="MsoNormal" style="line-height: normal; tab-stops: 51.75pt; text-align: center;"><v:shape id="_x0000_s1031" o:connectortype="straight" style="height: 14.25pt; left: 0; margin-left: 231.7pt; margin-top: 14.05pt; position: absolute; text-align: left; width: .05pt; z-index: 6;" type="#_x0000_t32"><span lang="IN"><span style="mso-spacerun: yes;"> </span>Monohidrat monosodium</span></v:shape></div><div align="center" class="MsoNormal" style="line-height: normal; tab-stops: 51.75pt; text-align: center;"><v:shape id="_x0000_s1030" o:connectortype="straight" style="flip: x y; height: 4.5pt; left: 0; margin-left: 58.5pt; margin-top: 4.85pt; position: absolute; text-align: left; width: 307.2pt; z-index: 5;" type="#_x0000_t32"><v:shape id="_x0000_s1032" o:connectortype="straight" style="flip: x; height: 15.75pt; left: 0; margin-left: 364.95pt; margin-top: 9.35pt; position: absolute; text-align: left; width: .75pt; z-index: 7;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><v:shape id="_x0000_s1033" o:connectortype="straight" style="flip: x; height: 20.25pt; left: 0; margin-left: 58.5pt; margin-top: 4.85pt; position: absolute; text-align: left; width: .75pt; z-index: 8;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><span lang="IN"><o:p> </o:p></span></v:shape></div><br clear="ALL" style="mso-ignore: vglayout;" /> <div class="MsoNormal" style="margin-left: -14.2pt; tab-stops: -103.5pt; text-indent: -14.15pt;"><v:shape id="_x0000_s1042" o:connectortype="straight" style="height: 35.25pt; left: 0; margin-left: 364.95pt; margin-top: 31.7pt; position: absolute; text-align: left; width: 0; z-index: 17;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><v:shape id="_x0000_s1036" o:connectortype="straight" style="flip: x; height: 35.25pt; left: 0; margin-left: 58.5pt; margin-top: 31.7pt; position: absolute; text-align: left; width: .75pt; z-index: 11;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><span lang="IN"><span style="mso-spacerun: yes;"> </span>Penimbunan asam urat di korteks &<span style="mso-spacerun: yes;"> </span>Penimbunan Kristal pada membran synovial<span style="mso-spacerun: yes;"> </span>reaksi inflamasi pada ginjal<span style="mso-spacerun: yes;"> </span>&<span style="mso-spacerun: yes;"> </span>tulang rawan artikular</span></div><div class="MsoNormal" style="margin-left: 13.5pt; tab-stops: -103.5pt; text-indent: -13.5pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; tab-stops: -103.5pt; text-indent: -41.85pt;"><v:shape id="_x0000_s1035" o:connectortype="straight" style="height: 183.6pt; left: 0; margin-left: 220.95pt; margin-top: 6.5pt; position: absolute; text-align: left; width: 0; z-index: 10;" type="#_x0000_t32"><v:shape id="_x0000_s1034" o:connectortype="straight" style="flip: x; height: 0; left: 0; margin-left: 220.95pt; margin-top: 6.5pt; position: absolute; text-align: left; width: 33pt; z-index: 9;" type="#_x0000_t32"><span lang="IN">Terjadi hilinisasi & fibrosis pada glomerulus<span style="mso-spacerun: yes;"> </span>Erosi tulang rawan, poliferasi synovial & </span></v:shape></v:shape></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; tab-stops: -103.5pt; text-indent: 291.3pt;"><v:shape id="_x0000_s1037" o:connectortype="straight" style="height: 9pt; left: 0; margin-left: 60pt; margin-top: 3.7pt; position: absolute; text-align: left; width: 0; z-index: 12;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><v:shape id="_x0000_s1041" o:connectortype="straight" style="flip: x; height: 29.85pt; left: 0; margin-left: 364.95pt; margin-top: 12.7pt; position: absolute; text-align: left; width: .75pt; z-index: 16;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><span lang="IN">pembentukan panus</span></div><div class="MsoNormal" style="line-height: normal; margin-left: -28.35pt; tab-stops: -103.5pt;"><span lang="IN"><span style="mso-spacerun: yes;"> </span>Pielonefritis, sklerosis arteriola</span></div><div class="MsoNormal" style="line-height: normal; margin-left: -21.3pt; tab-stops: -103.5pt;"><v:shape id="_x0000_s1040" o:connectortype="straight" style="flip: x; height: 29.85pt; left: 0; margin-left: 364.2pt; margin-top: 18.7pt; position: absolute; text-align: left; width: .75pt; z-index: 15;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><v:shape id="_x0000_s1038" o:connectortype="straight" style="flip: x; height: 29.85pt; left: 0; margin-left: 57pt; margin-top: 14.2pt; position: absolute; text-align: left; width: .75pt; z-index: 13;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><span lang="IN"><span style="mso-spacerun: yes;"> </span>atau nefritis kronis<span style="mso-spacerun: yes;"> </span>Degenerasi tulang rawan sendi</span></div><div class="MsoNormal" style="line-height: normal; tab-stops: -103.5pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-left: -21.3pt; tab-stops: -103.5pt;"><span lang="IN"><span style="mso-spacerun: yes;"> </span>Terbentuk batu & asam urat, GGK,<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Terbentuk tofus serta fibrosis &</span></div><div class="MsoNormal" style="line-height: normal; tab-stops: -103.5pt; text-indent: -21.3pt;"><v:shape id="_x0000_s1039" o:connectortype="straight" style="height: 26.7pt; margin-left: 362.7pt; margin-top: 18.2pt; position: absolute; width: 0; z-index: 14;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><span lang="IN"><span style="mso-spacerun: yes;"> </span>Hipertensi, & sklerosis<span style="mso-spacerun: yes;"> </span>ankilosis pada tulang</span></div><div class="MsoNormal" style="line-height: normal; tab-stops: -103.5pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-left: 304.8pt; tab-stops: -103.5pt; text-indent: 4.5pt;"><v:shape id="_x0000_s1046" o:connectortype="straight" style="height: 21.8pt; left: 0; margin-left: 79.65pt; margin-top: 23.15pt; position: absolute; text-align: left; width: 0; z-index: 21;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><v:shape id="_x0000_s1045" o:connectortype="straight" style="height: 21.8pt; left: 0; margin-left: 220.95pt; margin-top: 23.15pt; position: absolute; text-align: left; width: 0; z-index: 20;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><v:shape id="_x0000_s1043" o:connectortype="straight" style="height: 0; left: 0; margin-left: 79.65pt; margin-top: 23.15pt; position: absolute; text-align: left; width: 141.3pt; z-index: 18;" type="#_x0000_t32"><span lang="IN">Perubahan bentuk tubuh </span></v:shape></div><div class="MsoNormal" style="line-height: normal; tab-stops: -103.5pt; text-indent: 318.95pt;"><v:shape id="_x0000_s1047" o:connectortype="straight" style="height: 10.9pt; left: 0; margin-left: 365.7pt; margin-top: 16.05pt; position: absolute; text-align: left; width: 0; z-index: 22;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><span lang="IN">pada tulang & sendi</span></div><div class="MsoNormal" style="line-height: normal; tab-stops: -103.5pt; text-indent: 4.75in;"><v:rect fillcolor="#9bbb59 [3206]" id="_x0000_s1048" strokecolor="#f2f2f2" strokeweight="3pt" style="height: 24pt; left: 0; margin-left: 303.35pt; margin-top: 4.4pt; position: absolute; text-align: left; text-indent: 0; width: 149.35pt; z-index: 23;"> <v:shadow color="#4e6128" offset2="-1pt" offset="1pt" opacity=".5" type="perspective"> <v:textbox style="mso-next-textbox: #_x0000_s1048;"> </v:textbox></v:shadow></v:rect></div><table cellpadding="0" cellspacing="0"><tbody>
<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN">Ggn konsep diri, citra diri</span></div></div></td> </tr>
</tbody></table><v:rect fillcolor="#f79646 [3209]" id="_x0000_s1050" strokecolor="#f2f2f2" strokeweight="3pt" style="height: 25.5pt; left: 0; margin-left: 156.9pt; margin-top: 2.9pt; position: absolute; text-align: left; text-indent: 0; width: 126pt; z-index: 25;"> <v:shadow color="#974706" offset2="-1pt" offset="1pt" opacity=".5" type="perspective"> <v:textbox style="mso-next-textbox: #_x0000_s1050;"> <table cellpadding="0" cellspacing="0"><tbody>
<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN">Hambatan mobilitas fisik</span></div></div></td> </tr>
</tbody></table></v:textbox> </v:shadow></v:rect><v:shape id="_x0000_s1044" o:connectortype="straight" style="flip: x; height: 0; left: 0; margin-left: 35.35pt; margin-top: 19.35pt; position: absolute; text-align: left; width: 21.65pt; z-index: 19;" type="#_x0000_t32"> <v:stroke endarrow="block"> </v:stroke></v:shape><v:rect fillcolor="#4bacc6 [3208]" id="_x0000_s1051" strokecolor="#f2f2f2" strokeweight="3pt" style="height: 23.25pt; left: 0; margin-left: 60pt; margin-top: 5.15pt; position: absolute; text-align: left; text-indent: 0; width: 43.5pt; z-index: 26;"> <v:shadow color="#205867" offset2="-1pt" offset="1pt" opacity=".5" type="perspective"> <v:textbox style="mso-next-textbox: #_x0000_s1051;"> <table cellpadding="0" cellspacing="0"><tbody>
<tr> <td> <div><div class="MsoNormal"><span lang="IN">Nyeri </span></div></div></td> </tr>
</tbody></table></v:textbox> </v:shadow></v:rect><v:rect fillcolor="#4f81bd [3204]" id="_x0000_s1049" strokecolor="#f2f2f2" strokeweight="3pt" style="height: 23.25pt; left: 0; margin-left: -61.15pt; margin-top: 5.15pt; position: absolute; text-align: left; text-indent: 0; width: 86.65pt; z-index: 24;"> <v:shadow color="#243f60" offset2="-1pt" offset="1pt" opacity=".5" type="perspective"> <v:textbox style="mso-next-textbox: #_x0000_s1049;"> <table cellpadding="0" cellspacing="0"><tbody>
<tr> <td> <div><div class="MsoNormal"><span style="mso-ansi-language: EN-US;">Ggn. Pola Tidur<o:p></o:p></span></div></div></td> </tr>
</tbody></table></v:textbox> </v:shadow></v:rect><span lang="IN"><o:p> </o:p></span><br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><br clear="ALL" style="mso-ignore: vglayout;" /> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l45 level1 lfo16; text-align: justify; text-indent: -17.45pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">TANDA DAN GEJALA<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo21; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Nyeri<span style="mso-spacerun: yes;"> </span>tulang sendi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo21; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kemerahan dan bengkak pada tulang sendi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo21; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tofi pada ibu jari, mata kaki dan pinna telinga<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l48 level1 lfo21; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Peningkatan suhu tubuh.<o:p></o:p></span></div></div><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br clear="all" style="mso-break-type: section-break; page-break-before: auto;" /> </span> <div class="Section5"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: 13.65pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gangguan akut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l52 level1 lfo22; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Nyeri hebat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l52 level1 lfo22; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Bengkak dan berlangsung cepat pada sendi yang terserang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l52 level1 lfo22; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sakit kepala <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l52 level1 lfo22; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Demam.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gangguan kronis :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level1 lfo23; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Serangan akut <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level1 lfo23; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Hiperurisemia yang tidak diobati<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level1 lfo23; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Terdapat nyeri dan pegal<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level1 lfo23; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pembe</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">ng</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">kakan sendi membentuk noduler yang disebut tofi (penumpukan monosodium</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">urat dalam jaringan).<o:p></o:p></span></div></div><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br clear="all" style="mso-break-type: section-break; page-break-before: auto;" /> </span> <div class="Section6"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l45 level1 lfo16; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">PENATALAKSANAAN <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 76.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: -40.5pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tujuan : untuk mengakhiri serangan akut secepat mungkin, mencegah serangan berulang, dan pencegahan komplikasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo72; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pengobatan serangan akut dengan Colchicine 0,6 mg (pemberian oral), Colchicine 1,0-3,0 mg (dalam NaCl intravena), phenilbutazone, Indomethacin.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo72; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sendi diistirahatkan (imobilisasi pasien)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo72; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kompres dingin<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo72; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diet rendah purin<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo72; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Terapi farmakologi (Analgesic<span style="mso-spacerun: yes;"> </span>dan antipiretik)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo72; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Colchicines (oral/IV) tiap 8 jam sekali untuk mencegah fagositosis dari Kristal asam urat oleh netrofil sampai nyeri berkurang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo72; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Nonsteroid, obat-obatan anti inflamasi (NSAID) untuk nyeri dan inflamasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo72; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Allopurinol untuk menekan atau mengontrol tingkat asam urat dan untuk mencegah serangan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo72; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Uricosuric (Probenecid dan Sulfinpyrazone) untuk meningkatkan ekskresi asam urat dan menghambat akumulasi asam urat (jumlahnya dibatasi pada pasien dengan gagal ginjal).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 99.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo72; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Terapi pencegahan dengan meningkatkan ekskresi asam urat menggunakan probenezid 0,5 g/hari atau sulfinpyrazone (Anturane) pada pasien yang tidak tahan terhadap benemid atau menurunkan pembentukan asam urat dengan Allopurinol 100 mg 2 kali/hari.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l45 level1 lfo16; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">G.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">KOMPLIKASI<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l64 level1 lfo24; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Erosi, deformitas dan ketidakmampuan aktivitas karena inflamasi kronis dan tofi yang menyebabkan degenerasi sendi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l64 level1 lfo24; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Hipertensi dan albuminuria.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l64 level1 lfo24; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kerusakan tubuler ginjal yang menyebabkan gagal ginjal kronik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l45 level1 lfo16; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">H.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-bidi-font-weight: bold;">PENCEGAHAN</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l32 level1 lfo25; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pembatasan purin</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> : </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Hindari makanan yang mengandung purin yaitu : Jeroan (jantung, hati, lidah ginjal, usus), Sarden, Kerang, Ikan herring, Kacang-kacangan, Bayam, Udang, Daun melinjo.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l64 level1 lfo24; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kalori sesuai kebutuhan</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> : </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Jumlah asupan kalori harus benar disesuaikan dengan kebutuhan tubuh berdasarkan pada tinggi dan berat badan. Penderita gangguan asam urat yang kelebihan berat badan, berat badannya harus diturunkan dengan tetap memperhatikan jumlah konsumsi kalori. Asupan kalori yang terlalu sedikit juga bisa meningkatkan kadar asam urat karena adanya badan keton yang akan mengurangi pengeluaran asam urat melalui urine.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l64 level1 lfo24; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tinggi karbohidrat</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> : </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Karbohidrat kompleks seperti nasi, singkong, roti dan ubi sangat baik dikonsumsi oleh penderita gangguan asam urat karena akan meningkatkan pengeluaran asam urat melalui urine.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l64 level1 lfo24; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Rendah protein</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> : </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Protein terutama yang berasal dari hewan dapat meningkatkan kadar asam urat dalam darah. Sumber makanan yang mengandung protein hewani dalam jumlah yang tinggi, misalnya hati, ginjal, otak, paru dan limpa.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l64 level1 lfo24; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Rendah lemak</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> : </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Lemak dapat menghambat ekskresi asam urat melalui urin. Makanan yang digoreng, bersantan, serta margarine dan mentega sebaiknya dihindari. Konsumsi lemak sebaiknya sebanyak 15 persen dari total kalori.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l64 level1 lfo24; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tinggi cairan</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> : </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Selain dari minuman, cairan bisa diperoleh melalui buah-buahan segar yang mengandung banyak air. Buah-buahan yang disarankan adalah semangka, melon, blewah, nanas, belimbing manis, dan jambu air. Selain buah-buahan tersebut, buah-buahan yang lain juga boleh dikonsumsi karena buah-buahan sangat sedikit mengandung purin. Buah-buahan yang sebaiknya dihindari adalah alpukat dan durian, karena keduanya mempunyai kandungan lemak yang tinggi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l64 level1 lfo24; text-align: justify; text-indent: -13.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tanpa alkohol</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> : </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Berdasarkan penelitian diketahui bahwa kadar asam urat mereka yang mengonsumsi alkohol lebih tinggi dibandingkan mereka yang tidak mengonsumsi alkohol. Hal ini adalah karena alkohol akan meningkatkan asam laktat plasma. Asam laktat ini akan menghambat pengeluaran asam urat dari tubuh.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">ASUHAN KEPERAWATAN PADA KLIEN DENGAN ARTHRITIS GOUT</span></b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo26; text-align: justify; text-indent: -14.15pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pengkajia</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">n<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pengumpulan data klien, baik subjektif ataupun objektif melalui anamnesis riwayat penyakit, pengkajian psikososial, pemeriksaan fisik, dan pemeriksaan diagnosti</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">k.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 53.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo61; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Anamnesis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo62; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Identitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Meliputi nama, jenis jenis kelamin ( lebih sering pada pria daripada wanita ), usia ( terutama pada usia 30- 40), alamat, agama, bahasa yang digunakan, status perkawinan, pendidikan, pekerjaan, asuransi kesehatan, golongan darah, nomor register, tanggal masuk rumah sakit, dan diagnosis medis.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pada umumnya keluhan utama pada kasus gout adalah nyeri pada sendi metatarsofalangeal ibu jari kaki kemudian serangan bersifat poli – artikular. Gout biasanya mengenai satu atau beberapa sendi. Untuk memeperoleh pengkajian yang lengkap tentang nyeri klien, perawat dapat menggunakan metode PQRST.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l62 level1 lfo64; text-align: justify; text-indent: -.25in;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Provoking Incident : hal yang menjadi factor presipitasi nyeri adalah gangguan metabolism puroin yang ditandai dengan hiperurisemia dan serangan sinovitis akut berulang.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l62 level1 lfo64; text-align: justify; text-indent: -.25in;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Quality of pain: nyeri yang dirasakan bersifat menusuk.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l62 level1 lfo64; text-align: justify; text-indent: -.25in;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Region, Radiation, Relief: Nyeri pada sendi metatarsofalangeal ibu jari kaki.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l62 level1 lfo64; text-align: justify; text-indent: -.25in;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Severity (Scale) of pain: Nyeri yangdirasakan antara 1-3 pada rentang pengukuran 0-4. Tidak ada hubungan antara beratnya nyeri dan luas kerusakan yang terlihat pada pemeriksaan radiologi.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l62 level1 lfo64; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Time: Berapa lama nyeri berlangsung, kapan, apakah bertambah buruk pada malam hari atau siang hari.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo62; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Riwayat Penyakit Sekarang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pengumpulan data dilakukan sejak munculnya keluhan dan secara umum mencakup awitan gejala dan bagaimana gejala tersebut berkembang. Penting ditanyakan berapa lama pemakaian obat analgesic, alopurinol.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo62; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Riwayat Penyakit dahulu<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pada pengkajian ini, ditemukan kemungkinan penyebab yang mendukung terjadinya gout (mis: penyakit gagal ginjal kronis, leukemia, hiperparatiroidisme). Masalah lain yang perlu ditanyakan adalah pernahkah klien dirawat dengan masalah yang sama. K</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">a</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">ji adanya pemakaian alcohol yang berlebihan, penggunaan obat diureti</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">k</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo62; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Riwayat penyakit keluarga<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kaji adanya keluarga dari generasi terdahulu yang mempunyai keluhan yang sama dengan klien karena klien gout dipengaruhi oleh factor genetic. Ada produksi/ sekresi asam urat yang berlebihan dan tidak diketahui penyebabnya.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo62; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Riwayat psikososial<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kaji respon emosi klien terhadap penyakit yang dideritanya dan peran klien dalam keluarga dan masyarakat. Respons didapat meliputi adanya kecemasan individu dengan rentang variasi tingkat kecemasan yang berbeda dan berhubungan erat dengan adanya sensasi nyeri, hambatan mobilitas fisik akibat respon nyeri, dan ketidaktahuan akan program pengobatan dan prognosis penyakit dan peningkatan asam urat pada sirkulasi. Adanya perubahan peran dalam keluarga akibat adanya nyeri dan hambatan mobilitas fisik memberikan respon trhadap konsep diri yang maladaptif.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 53.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo61; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pemeriksaan fisik dibagi menjadi dua yaitu pemeriksaan umum dan pemeriksaan setempat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo62; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B1 (Breathing)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Inspeksi: bila tidak melibatkan system pernafasan, biasanya ditemukan kesimetrisan rongga dada, klien tidak sesak nafas, tidak ada penggunaan otot bantu pernafasan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Palpasi : Taktil fremitus seimbang kanan dan kiri.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Perkusi : Suara resonan pada seluruh lapang paru.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Auskultasi : Suara nafashilang/ melemah pada sisi yang sakit, biasanya didapatkan suara ronki atau mengi.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo62; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B2 (Blood)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pengisian kapiler kurang dari 1 detik, sering ditemukan keringat dingin dan pusing karena nyeri. Suara S1 dan S2 tunggal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo62; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B3(Brain)<o:p></o:p></span></div><table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 45.0pt; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 113.4pt;" valign="top" width="151"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l17 level1 lfo63; tab-stops: 13.5pt; text-align: justify; text-indent: -35.55pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>Kepala dan wajah<o:p></o:p></span></div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 27.0pt;" valign="top" width="36"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify; text-indent: -35.55pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">:<o:p></o:p></span></div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 264.8pt;" valign="top" width="353"> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify; text-indent: -35.55pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Ada sianosis.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 113.4pt;" valign="top" width="151"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l17 level1 lfo63; tab-stops: 13.5pt; text-align: justify; text-indent: -35.55pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>Mata<o:p></o:p></span></div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 27.0pt;" valign="top" width="36"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify; text-indent: -35.55pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">:<o:p></o:p></span></div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 264.8pt;" valign="top" width="353"> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify; text-indent: -35.55pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sklera biasanya tidak ikterik, konjungtiva anemis pada kasus efusi pleura hemoragi kronis.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 2; mso-yfti-lastrow: yes;"> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 113.4pt;" valign="top" width="151"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l17 level1 lfo63; tab-stops: 13.5pt; text-align: justify; text-indent: -35.55pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>Leher<o:p></o:p></span></div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 27.0pt;" valign="top" width="36"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify; text-indent: -35.55pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">:<o:p></o:p></span></div></td> <td style="padding: 0in 5.4pt 0in 5.4pt; width: 264.8pt;" valign="top" width="353"> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 40.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify; text-indent: -35.55pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Biasanya JVP dalam batas normal.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo62; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B4 (Bladder)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Produksi urine biasanya dalam batas normal dan tidak ada keluhan pada system perkemihan, kecuali penyakit gout sudah mengalami komplikasi ke ginjal berupa pielonefritis, batu asam urat, dan gagal ginjal kronik yang akan menimbulkan perubahan fungsi pada system ini.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo62; tab-stops: .5in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B5 (Bowel)<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; tab-stops: .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kebutuhan elimknasi pada kasus gout tidak ada gangguan, tetapi tetap perlu dikaji frekuensi, konsistensi, warna, serta bau feses. Selain itu, perlu dikaji frekuensi, kepekatan, warna, bau, dan jumlah urine. Klien biasanya mual, mengalami nyeri lambung. Dan tidak nafsu makan, terutama klien yang memakan obat alnagesik dan antihiperurisemia.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-list: l47 level1 lfo50; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B6 ( Bone ). Pada pengkajian ini di temukan:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.05pt; margin-right: 0in; margin-top: 0in; mso-list: l35 level3 lfo65; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Look. Keluhan nyeri sendi yang merypoakan keluhan utama yang mendorong klien mencari pertolongan (meskipun mungkin sebelumnya sendi sudah kaku dan berubah bentuknya). Nyeri biasanya bertambah dengan gerakan<span style="mso-spacerun: yes;"> </span>dan se</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">d</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">ikit berkurang dengan istirahat. Beberapa gerakan tertentu kadang menimbulkan<span style="mso-spacerun: yes;"> </span>nyeri yang lebih dibandingkan dengan<span style="mso-spacerun: yes;"> </span>gerakan yang lain. Deformitas sendi (pembentukan tofus) terjadi dengan temuan salah satu sendi pergelangan kaki secara perlahan membesar. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.05pt; margin-right: 0in; margin-top: 0in; mso-list: l35 level3 lfo65; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Feel. Ada nyeri tekan pda sendi kaki yang membengkak.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.05pt; margin-right: 0in; margin-top: 0in; mso-list: l35 level3 lfo65; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Move. Hambatan gerak sendi biasanya seamkin bertambah berat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.05pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 53.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l21 level1 lfo61; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pemeriksaan diasnostik. Gambaran radiologis pada stadium dini terlihat perubahan yang berarti dan mungkin terlihat osteoporosis yang ringan. Pada kasus lebih lanju, terlhat erosi tulang seperti lubang</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">-</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">lubang kecil (punch out).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo26; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diagnosa Keperawatan<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-list: l11 level1 lfo53; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Nyeri sendi b. d peradangan sendi, penimbunan kristal pada membrane sinovia, tulang rawan artikular, erosi tulang rawan, prolifera sinovia dan pembentukan panus.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-list: l11 level1 lfo53; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Hambatan mobilisasi fisik b. d penurunaan rentang gerak, kelemahan otot, pada gerakan, dan kekakuan pada sendi kaki sekunder akibat erosi tulang rawan, proloferasi sinovia, dan pembentukan panus.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-list: l11 level1 lfo53; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gangguan citra diri b. d perubahan bentuk<span style="mso-spacerun: yes;"> </span>kaki</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">dan terbenuknya tofus.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo53; text-align: justify; text-indent: -14.2pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Perubahan pola tidur b.d<span style="mso-spacerun: yes;"> </span>nyeri.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l4 level1 lfo26; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">III.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Rencana Dan Implementasi Keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Dk. I : </span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Nyeri sendi b. d peradangan sendi, penimbunan Kristal pada membrane sinovia, tulang rawan arikular, erosi tulang rawan, prolifera sinovia dan pembentukan panus.<o:p></o:p></span></i></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Tujuan keperawatan<span style="mso-tab-count: 1;"> </span>:</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Nyeri berkurang, hilang, teratasi.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -.55pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Kriteria hasil<span style="mso-tab-count: 2;"> </span>:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 163.05pt; margin-right: 0in; margin-top: 0in; mso-list: l43 level1 lfo58; text-align: justify; text-indent: -14.2pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Klien melaporkan penelusuran nyeri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 163.05pt; margin-right: 0in; margin-top: 0in; mso-list: l43 level1 lfo58; text-align: justify; text-indent: -14.2pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">menunjukan perilaku yang lebiih rileks.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 163.05pt; margin-right: 0in; margin-top: 0in; mso-list: l43 level1 lfo58; text-align: justify; text-indent: -14.2pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">memperagakan keterampilan reduksi nyeri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 163.05pt; margin-right: 0in; margin-top: 0in; mso-list: l43 level1 lfo58; text-align: justify; text-indent: -14.2pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Skala nyeri 0 – 1 atau teratasi.<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 19.6pt; width: 586px;"><tbody>
<tr style="height: 19.15pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #7F7F7F; border: solid black 1.0pt; height: 19.15pt; mso-background-themecolor: text1; mso-background-themetint: 128; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.15in;" valign="top" width="302"> <div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">INTERVENSI<o:p></o:p></span></div></td> <td style="background: #7F7F7F; border-left: none; border: solid black 1.0pt; height: 19.15pt; mso-background-themecolor: text1; mso-background-themetint: 128; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 212.6pt;" valign="top" width="283"> <div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">RASIONAL<o:p></o:p></span></div></td> </tr>
<tr style="height: 20.25pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; height: 20.25pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.15in;" valign="top" width="302"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">MANDIRI<o:p></o:p></span></div><ul style="margin-top: 0in;" type="disc"><li class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l70 level1 lfo54; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kaji lokasi, intensitas,an tipe nyeri. Observasi kemajuan nyeri ke daerah yang baru. Kaji nyeri dengan skala0 – 4.<o:p></o:p></span></li>
</ul><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><ul style="margin-top: 0in;" type="disc"><li class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l70 level1 lfo54; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Bantu klien dalam<span style="mso-spacerun: yes;"> </span>mengidentifikasi factor pencetus.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l70 level1 lfo54; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Jelaskan dan bantu klien terkait dengan tindakan pereda nyeri nonfamakologi dan non – invasif.<o:p></o:p></span></li>
</ul><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><ul style="margin-top: 0in;" type="disc"><li class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l70 level1 lfo54; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Ajarkan relaksasi: teknik terkait ketegangan otot rangka yang dapat mengurangi intensitas nyeri.<o:p></o:p></span></li>
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</div><ul style="margin-top: 0in;" type="disc"><li class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l70 level1 lfo54; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Ajarkan metode distraksi selama nyeri akut.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l70 level1 lfo54; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Tingkatkan pengetahuaan<span style="mso-spacerun: yes;"> </span>tentang penyebab nyeri dan hubungan dengan berapa lama nyeri akan berlangsung.<o:p></o:p></span></li>
</ul><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><ul style="margin-top: 0in;" type="disc"><li class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l70 level1 lfo54; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Hindarkan klien meminum alcohol, kafein, dan obat diuretik.<o:p></o:p></span></li>
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</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">KOLABORASI<o:p></o:p></span></div><ul style="margin-top: 0in;" type="disc"><li class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l66 level1 lfo55; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kolaborasi dengan tim medis untuk pemberian alopurinol<o:p></o:p></span></li>
</ul></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 20.25pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 212.6pt;" valign="top" width="283"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l70 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Nyeri merupakan respon subjektif yangbdapat dikaji dengan menggunakan skala nyeri. Klien melaporkan nyeri biasanya di atas tingkat cedera.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l70 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Nyeri dipengaruhi oleh kecemasan dan peradangan pada sendi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l70 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Pendekatan dengan menggunakan relaksasi dan farmakologilain menunjukan keefektifan dalam mengurangi nyeri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l70 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Akan melancarkan peredaran darah sehingga kebutuhan oksigen pada jaringan terpenuhi dan mengurangi nyeri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l70 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mengalikan perhatian klien terhadap nyeri ke hal yang menyenangkan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l70 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">pegetahuan tersebut membatu mengurangi nyeri dan dapat menbatumeningkatkan kepatuhan klien terhadap rencana terapeutik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l70 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">pemakaian alkohol, kafein, dan obat-obatan diuretik akan menambah peningkatan kadar asam urat dalam serum.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l70 level1 lfo54; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Alopurinol menghambat biosentesis asam urat sehingga menurunkan kadar asam urat serum.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Dk. II : </span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Hambatan mobilisasi fisik b. d penurunaan rentang gerak, kelemahan otot, pada gerakan, dan kekakuan pada sendi kaki sekunder akibat erosi tulang rawan, proloferasi sinovia, dan pembentukan panus.</span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></i></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Tujuan keperawatan <span style="mso-tab-count: 1;"> </span>: klien mampu melaksanakan aktifitas fisik sesuai dengan kemampuannya.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -21.8pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Kreteria hasil<span style="mso-tab-count: 1;"> </span>: <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-list: l49 level1 lfo59; text-align: justify; text-indent: -14.15pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">klien ikut dalam program latihan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-list: l49 level1 lfo59; text-align: justify; text-indent: -14.15pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">tidak mengalami kontraktur sendi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-list: l49 level1 lfo59; text-align: justify; text-indent: -14.15pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">kekuatan otot bertambah<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 120.5pt; margin-right: 0in; margin-top: 0in; mso-list: l49 level1 lfo59; text-align: justify; text-indent: -14.15pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">klien menunjukkan tindakan untuk meningkatkan mobilitas dan mempertahankan koordinasi optimal.<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 19.6pt; width: 586px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #7F7F7F; border: solid black 1.0pt; mso-background-themecolor: text1; mso-background-themetint: 128; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.15in;" valign="top" width="302"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">INTERVENSI<o:p></o:p></span></div></td> <td style="background: #7F7F7F; border-left: none; border: solid black 1.0pt; mso-background-themecolor: text1; mso-background-themetint: 128; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 212.6pt;" valign="top" width="283"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">RASIONAL<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.15in;" valign="top" width="302"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">MANDIRI<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-list: l28 level1 lfo56; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kaji mobilitas yang ada dan observasi adanya peningkatan kerusakan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-list: l28 level1 lfo56; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Ajarkan klien melakukan latihan gerak aktif pada ekstermitas yang tidak sakit.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-list: l28 level1 lfo56; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Bantu klien melakukan latihan ROM dan perawatan diri sesuai toleransi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-list: l28 level1 lfo56; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Pantau kemajuan dan perkembangan kemamapuan klien dalam melakukan aktifitas<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">KOLABORASI<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 17.1pt; margin-right: 0in; margin-top: 0in; mso-list: l73 level1 lfo57; text-align: justify; text-indent: -17.1pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kolaborasi dengan ahli fisioterapi untuk latihan fisik klien.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 212.6pt;" valign="top" width="283"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.2pt; margin-right: 0in; margin-top: 0in; mso-list: l73 level1 lfo57; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mengetahui tingkat kemampuan klien dalam melakukan aktifitas.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.2pt; margin-right: 0in; margin-top: 0in; mso-list: l73 level1 lfo57; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Gerakan aktif memberi masa tonus, dan kekuatan otot, serta memperbaiki fungsi jantung dan pernafasan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.2pt; margin-right: 0in; margin-top: 0in; mso-list: l73 level1 lfo57; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Untuk mempertahankan fleksibilitas sendi sesuai kemampauan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.2pt; margin-right: 0in; margin-top: 0in; mso-list: l73 level1 lfo57; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Untuk mendeteksi perkembangan klien.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.2pt; margin-right: 0in; margin-top: 0in; mso-list: l73 level1 lfo57; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kemampuan mobilisasi ekstermitas dapat ditingkatkan dengan latihan fisik dari tim fisioterapi.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Dk. III : Gangguan citra diri b. d perubahan bentuk<span style="mso-spacerun: yes;"> </span>kaki</span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">dan terbenuknya tofus.<o:p></o:p></span></i></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tujuan perawatan<span style="mso-tab-count: 1;"> </span>: Citra diri klien meningkat<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -3.8pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kriteria hasil<span style="mso-tab-count: 2;"> </span>:</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 127.6pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level1 lfo60; text-align: justify; text-indent: -14.2pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Klien mampu men</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">g</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">at</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">a</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">kan atau mengkomunikasikan dengan<span style="mso-spacerun: yes;"> </span>orang terdekat tentang situasi dan perubahan yang terjadi</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 127.6pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level1 lfo60; text-align: justify; text-indent: -14.2pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">mampu menyatakan penerimaan<span style="mso-spacerun: yes;"> </span>diri terhadap situasi</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 127.6pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level1 lfo60; text-align: justify; text-indent: -14.2pt;"><span style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">mengakui dan menggabungkan perubhan dalam konsep diri dengan cara yang akurat tanpa merasakan harga dirinya negatif.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><table align="left" border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-anchor-horizontal: margin; mso-table-anchor-vertical: paragraph; mso-table-left: 19.55pt; mso-table-lspace: 9.0pt; mso-table-rspace: 9.0pt; mso-table-top: .15in; mso-yfti-tbllook: 480;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #7F7F7F; border: solid black 1.0pt; mso-background-themecolor: text1; mso-background-themetint: 128; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 225.15pt;" valign="top" width="300"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">INTERVENSI<o:p></o:p></span></div></td> <td style="background: #7F7F7F; border-left: none; border: solid black 1.0pt; mso-background-themecolor: text1; mso-background-themetint: 128; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 212.6pt;" valign="top" width="283"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">RASIONAL<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 225.15pt;" valign="top" width="300"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">MANDIRI<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kaji perubhan perspsi dan hubungannya<span style="mso-spacerun: yes;"> </span>dengan derajat kletidak mampuan. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Ingantkan kembali realitas bahwa masih dapat menggunakan sisi yang sakit dan belajar mengontrol sisi yang sehat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Bantu dan ajurkan perawatan yang baik dan memperbaiki kebiasaan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Anjurkan orang terdekat untuk mengizinkan klien melakukan sebanyak mungkin hal untuk dirinya.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Bersama klien mencari alternatif koping yang positif.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Dukung prilaku atau usaha peningkata minat atau partisipasi dalam aktifitas rehabilitasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">KOLABORASI<o:p></o:p></span></div><ul style="margin-top: 0in;" type="square"><li class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l51 level1 lfo52; tab-stops: list .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kolaborasi denagn ahli neuropsikologi dan konseling bila da indikasi .<o:p></o:p></span></li>
</ul></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 212.6pt;" valign="top" width="283"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Menetukan bantuan individual dalm menyusun rencana perawatan atau pemilihan intervensi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Membantu klien melihat bahwa<span style="mso-spacerun: yes;"> </span>peraat menerima kedua bagian dari seluruh tubuh dan mulai menerima situasi baru.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Membantu meningkatkan perasaan harga diri dan mengontrol lebih dari satu area kehidupan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Menghidupkan kembali perasaan mandiri dn membatu perkemabangan harga diri serta memengaruhi proses rehabilitasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Dukungan perawat kepada klien dapat meningkat kan rasa percaya diri klien.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Klien dapat beradaptasi terhadap perubahan dan memahami peran individu dimasa mendatang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: .15in; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l42 level1 lfo51; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Dapat memfasilitasi perubahan peran yang penting untuk perkembangan perasaan.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 4.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 9.7pt;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">DK IV :</span></i></b><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Perubahan Pola Tidur b/d Nyeri.<o:p></o:p></i></b></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: -21.8pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kriteria Hasil : Klien dapat memenuhi kebutuhan istirahat dan tidur.<o:p></o:p></span></div><table align="left" border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 6.75pt; margin-right: 6.75pt; width: 584px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #595959; border: solid black 1.0pt; mso-background-themecolor: text1; mso-background-themetint: 166; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 218.05pt;" valign="top" width="291"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">INTERVENSI<o:p></o:p></span></b></div></td> <td style="background: #595959; border-left: none; border: solid black 1.0pt; mso-background-themecolor: text1; mso-background-themetint: 166; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">RASIONAL<span style="color: #404040; mso-themecolor: text1; mso-themetint: 191;"><o:p></o:p></span></span></b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 218.05pt;" valign="top" width="291"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l63 level1 lfo27; text-align: justify; text-indent: -15.85pt;"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Tentukan kebiasaan tidurnya dan perubahan saat tidur.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l63 level1 lfo27; text-align: justify; text-indent: -15.85pt;"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Buat rutinitas tidur baru yang dimasukkan dalam pola lama dan lingkungan baru.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify; text-indent: -15.85pt;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify; text-indent: -15.85pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify; text-indent: -15.85pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l63 level1 lfo27; text-align: justify; text-indent: -15.85pt;"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Tingkatkan regimen kenyamanan waktu tidur, misalnya mandi hangat dan massage.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify; text-indent: -15.85pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l63 level1 lfo27; text-align: justify; text-indent: -15.85pt;"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Gunakan pagar tempat <span style="mso-spacerun: yes;"> </span>tidur sesuai indikasi ; rendahkan tempat tidur jika memungkinkan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l63 level1 lfo27; text-align: justify; text-indent: -15.85pt;"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kolaborasi dalam pemberian obat sedative, hipnotik sesuai dengan indikasi.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l63 level1 lfo27; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mengkaji pola tidurnya dan mengidentifikasi intervensi yang tepat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l63 level1 lfo27; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Bila rutinitas baru mengandung aspek sebanyak kebiasaan lama, stress dan ansietas yang berhubungan dapat berkurang</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"> </span>Membantu menginduksi tidur<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l65 level1 lfo28; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Dapat merasakan takut jatuh karena perubahan ukuran dan tinggi tempat tidur, memberikan kenyamanan pagar tempat untuk membantu mengubah posisi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l65 level1 lfo28; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Tidur tanpa gangguan lebih menim- bulkan rasa segar, dan pasien mungkin tidak mampu untuk kembali ke tempat tidur bila terbangun.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 15.85pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 19.6pt; mso-element-top: 17.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l63 level1 lfo27; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Di berikan untuk membantu pasien tidur atau istirahat.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo26; text-align: justify; text-indent: -21.25pt;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">IV.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Intervensi Keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Hasil akhir yang diharapkan pada asuhan keperawatan klien gout adalah sebagai berikut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo79; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Nyeri berkurang atau terjadi perbaikan tingkat kenyamanan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo79; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Meningkatkan atau mempertahankan tingkat mobilitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo79; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Mengalami perbaikan citra diri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo79; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kebutuhan istirahat dan tidur terpenuhi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l41 level2 lfo1; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.3<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">RHEUMATOID ARTHRITIS<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo31; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">PENGERTIAN<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo33; text-align: justify; text-indent: -14.15pt;"><span class="apple-style-span"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Arthritis rheumatoid adalah penyakit inflamasi nonbakterial yang bersifat sistemik, progresif, cenderung kronis yang menyerang beberapa sistem organ, dan paling sering ditemukan di sendi. (Arif Muttaqin, 2008;322)<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo33; text-align: justify; text-indent: -14.15pt;"><span class="apple-style-span"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Artritis Reumatoid (AR) adalah kelainan inflamasi yang terutama mengenai mengenai membran sinovial dari persendian dan umumnya ditandai dengan dengan nyeri persendian, kaku sendi, penurunan mobilitas, dan keletihan. (Diane C. Baughman. 2000).<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo33; text-align: justify; text-indent: -14.15pt;"><span class="apple-style-span"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Artritis rematoid adalah suatu penyakit inflamasi kronik dengan manifestasi utama poliartritis progresif dan melibatkan seluruh organ tubuh.<span style="mso-spacerun: yes;"> </span>(Arif<span style="mso-spacerun: yes;"> </span>Mansjour. 2000).<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo33; text-align: justify; text-indent: -14.15pt;"><span class="apple-style-span"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Artritis rheumatoid adalah penyakit inflamasi sistemik kronis yang menyerang perifer dan mencakup muskulus, tendon, ligament dan pembuluh darah. (Lippinccott Williams & Wilkins. 2006;478).<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l34 level1 lfo30; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Rematoid Artritis merupakan suatu penyakit inflamasi sistemik kronik yang manifestasi utamanya adalah poliartritis yang progresif, akan tetapi penyakit ini juga melibatkan seluruh organ tubuh.(Hidayat, 2006).<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo33; text-align: justify; text-indent: -14.15pt;"><span class="apple-style-span"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Jadi, Rheumatoid Artritis adalah penyakit inflamasi nonbakterial yang bersifat sistemik kronis, yang melibatkan seluruh organ tubuh tetapi umumnya mengenai membran sinovial dari persendian yang ditandai dengan nyeri persendian, kaku sendi, penurunan mobilitas dan keletihan yang ditandai dengan nyeri persendian dan dengan manifestasi utama poliartritis progresif.<span style="mso-spacerun: yes;"> </span>(Kesimpulan kelompok).<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 14.15pt;"><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Istilah</span></span><span class="apple-converted-space"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> </span></span><span class="apple-style-span"><i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">rheumatism</span></i></span><span class="apple-converted-space"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> </span></span><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">berasal dari bahasa Yunani,</span></span><span class="apple-converted-space"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> </span></span><span class="apple-style-span"><i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">rheumatismos</span></i></span><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">, yang berarti mukus; suatu cairan yang dianggap jahat, mengalir dari otak ke sendi dan struktur lain tubuh sehingga menimbulkan rasa nyeri. </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Reumatoid arthritis (RA) adalah penyakit inflamasi sistemik kronis yang tidak diketahui penyebabnya. Karakteristik RA adalah<span style="mso-spacerun: yes;"> </span>terjadinya kerusakan dan proliferesi pada membran synovial, yang menyebabkan kerusakan pada tulang sendi, ankilosis, dan deformitus. Mekanisme imunologis tampak berperan penting dalam memulai dan timbulnya penyakit ini. Pendapat lain mengatakan, artritis reumatoid adalah gangguan kronik yang menyerang berbagai sistem organ. Penyakit ini adalah salah satu dari sekelompok penyakit jaringan penyambung disfus yang diperantai oleh imunitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-indent: 17.45pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-indent: 17.45pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-indent: 17.45pt;"><br />
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</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-indent: 17.45pt;"><v:shape id="Picture_x0020_8" o:spid="_x0000_s1143" style="height: 202.2pt; left: 0; margin-left: 42.6pt; margin-top: -482.95pt; mso-position-horizontal-relative: text; mso-position-horizontal: absolute; mso-position-vertical-relative: text; mso-position-vertical: absolute; mso-wrap-distance-bottom: 0; mso-wrap-distance-left: 9pt; mso-wrap-distance-right: 9pt; mso-wrap-distance-top: 0; mso-wrap-style: square; position: absolute; text-align: left; visibility: visible; width: 200.1pt; z-index: -3;" type="#_x0000_t75"> <v:imagedata o:title="Rheumatoid Arthritis2" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image011.jpg"> </v:imagedata></v:shape><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center; text-indent: 17.45pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gambar : Artritis r</span><span lang="IN" style="background: black; border: none black 1.0pt; color: black; font-family: "Times New Roman","serif"; font-size: 0pt; layout-grid-mode: line; line-height: 150%; mso-border-alt: none black 0in; mso-fareast-font-family: "Times New Roman"; mso-font-width: 0%; padding: 0in;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">heumatoid pada jari tangan<o:p></o:p></span></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center; text-indent: 17.45pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">(</span><span lang="IN"><a href="http://www.sonicmend.com/_img/rheumatoid_arthritis.jpg"><span style="color: windowtext; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; text-decoration: none; text-underline: none;">http://www.sonicmend.com/_img/rheumatoid_arthritis.jpg</span></a></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">)</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 27.0pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo31; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">INSIDEN<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Artritis reumatoid terjadi kira – kira 2,5 kali lebih sering menyerang wanita daripada pria (price,1995). Menurut<span style="mso-spacerun: yes;"> </span>Noer S (1996) perbandingan antara wanita dan pria sebesar 3 : 1, dan pada wanita usia subur perbandingan mencapai 5 : 1. Jadi perbandingan antara wanita dan pria kira – kira 1 : 2,5 – 3. Insiden meningkat dengan bertambahnya usia, terutama pada wanita. Kacenderungan insiden yang terjadi pada wanita dan wanita subur diperkirakan karena adanya ganguan dalam keseimbangan hormonal (estrogen) tubuh, namun hingga kini belum dapat dipastikan apakah factor hormonal memang merupakan penyebab penyakit ini. Penyakit ini biasanya pertama kali muncul pada usia 25 – 50 tahun, puncaknya adalah antara usia 40 hingga 60 tahun. Penyakit ini menyerang orang – orang diseluruh dunia, dari berbagai suku bangsa. Sekitar satu persen orang<span style="mso-spacerun: yes;"> </span>dewasa menderita Artritis reumatoid yang jelas, dan dilaporkan bahwa di amerika serikat setiap tahun kira – kira 750 kasus baru per satu juta penduduk.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo31; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">C.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">ETIOLOGI<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Penyebab Artritis reumatoid masih belum diketahui secara pasti walaupun banyak hal mengenai patologis penyakit ini telah terungkap. Penyakit Artritis reumatoid belum dapat dipastikan mempunyai hubungan dengan factor genetik . namun, berbagai faktor (termasuk kecenderungan genetik) bis</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">a</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> mempengaruhi reaksi antoimun. Faktor – faktor yang berperan antara lain adalah jenis kelamin, infeksi, keturunan dan lingkungan. Dari penjelasan di atas, dapat disimpulkan bahwa faktor yang berperan dalam timbulnya penyakit Artritis reumatoid adalah jenis kelamin, keturunan, lingkungan, dan infeksi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Dari penelitian muntakhir, diketahui pathogenesis Artritis reumatoid dapat terjadi akibat rantai peristiwa imunologis yang terdapat dalam genetik. Terdapat kaitan dengan pertanda genetik seperti HLA-Dw4 dan HLA-DR5 pada orang kulit putih. Namun pada orang amerika berkulit hitam, jepang, dan Indian Chippewa, hanya ditemukan kaitannya dengan HLA-Dw4.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo31; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">PATOFISIOLOGI<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pada Artritis reumatoid, reaksi autoimun terutama terjadi pada jaringan synovial. Proses fagositosis<span style="mso-spacerun: yes;"> </span>menghasilkan enzim-enzim dalam sendi. Enzim-enzim tersebut akan memecah kolagen sehingga terjadi edema, proliferasi membran synovial, dan akhirnya membentuk panus. Panus akan meghancurkan tulang rawan dan emnimbulkan erosi tulang, akibatnya menghilangkan permukaan sendi yang akan mengalami perubahan generative dengan menghilangnya elastisita otot dan kekuatan kontraksi otot.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Inflamasi mula-mula mengenai sendi-sendi synovial disertai edema, kongesti vascular eksudat fibrin dan inflamasi selular. Peradangan yang berkelanjutan menyebabkan synovial menjadi menebal terutama pada sendi artikular kartilago dari sendi. Pada persendian ini granulasi membentuk pannus atau penutup yang menutupi kartilago. Pannus masuk ke tulang subcondria. Jaringan granulasi menguat karena radang menimbulkan gangguan pada nutrisi kartilago artikuler. Kartilago menjadi nekrosis. Tingkat erosi dari kartilago persendian menentukan tingkat ketidakmampuan sendi. Bila kerusakan kartilago sangat luas maka terjadi adhesi diantara permukaan sendi , karena jaringan fibrosa atau tulang bersatu (akilosis). Kerusakan kartilago dan tulang menyebabkan tendon dan ligament menjadi lemah dan bisa menimbulkan subluksasi atau dislokasi dari persendian. Invasi dari tulang sub condrial bisa menyebabkan osteoporosis setempat. Lamanya rheumatoid arthritis<span style="mso-spacerun: yes;"> </span>berbeda pada setiap orang ditandai dengan masa adanya serangan dan tidak adanya serangan. Sementara orang ada yang sembuh dari serangan pertama dan selanjutnya tidak terserang lagi. Yang lain terutama yang mempunyai factor rematoid, gangguan akan menjadi kronis yang progresif. Pada sebagian kecil individu terjadi progresif yang cepat ditandai kerusakan sendi yang terus menerus dan terjadi vaskulitis yang difus.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.25pt;"><br />
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<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif";">Pathoflow Diagram<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">Inflamasi non-bakterial disebabkan oleh infeksi, endokrin, autoimun, emtabolik, dan factor genetic, serta factor lingkungan<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">Artritis reumatoid<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">Kelainan pada tulang<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">tenosinovitis<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">Kelainan pada jaringan<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">Ekstra-artikular<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><br />
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<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">sinovitis<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">Hyperemia dan<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">pembengkakan<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">Invasi<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">kolagen<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">Ruptur tendo<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">Secara parsial<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">Atau lokal<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span lang="IN" style="font-size: 9.0pt;">Atrofi otot<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span lang="IN" style="font-size: 9.0pt;">Inflamasi keluar<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span lang="IN" style="font-size: 9.0pt;">Ekstra-artikular<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div class="MsoNormal"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">Neuropati perifer<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">gangguan sensori<o:p></o:p></span></b></div></div></td> </tr>
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</div><br clear="ALL" style="mso-ignore: vglayout;" /> <div class="MsoNormal" style="tab-stops: 558.4pt;"><v:rect id="_x0000_s1076" style="height: 26.75pt; margin-left: 304.75pt; margin-top: 17.7pt; position: absolute; width: 84.05pt; z-index: 51;"> <v:textbox style="mso-next-textbox: #_x0000_s1076;"> </v:textbox></v:rect></div><table cellpadding="0" cellspacing="0"><tbody>
<tr> <td> <div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">Kelemahan fisik<o:p></o:p></span></div></div></td> </tr>
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<div class="MsoNormal"><o:wrapblock><v:rect id="_x0000_s1104" strokecolor="#b2a1c7" strokeweight="1pt" style="height: 27.6pt; margin-left: 293.95pt; margin-top: 34.95pt; position: absolute; width: 103.95pt; z-index: 79;"> <v:fill color2="#ccc0d9" focus="100%" focusposition="1" focussize="" type="gradient"> <v:shadow color="#3f3151" offset2="-3pt" offset="1pt" opacity=".5" type="perspective"> <v:textbox style="mso-next-textbox: #_x0000_s1104;"> </v:textbox></v:shadow></v:fill></v:rect></o:wrapblock></div><table cellpadding="0" cellspacing="0"><tbody>
<tr> <td> <div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 9.0pt;">defisit perawatan diri<o:p></o:p></span></b></div></div></td> </tr>
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<tr> <td> <div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 9.0pt;">resiko truma<o:p></o:p></span></b></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">gambaran khas<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">nadul subkutan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><br />
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<tr> <td> <div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">Perubahan bentuk tubuh pada tulang<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">dan sendi<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 9.0pt;">ansietas<o:p></o:p></span></b></div></div></td> </tr>
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<tr> <td> <div><div class="MsoNormal"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">kebutuhan informasi<o:p></o:p></span></b></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">gangguan konsep diri, citra diri<o:p></o:p></span></b></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">Perikarditis, miokarditis,<o:p></o:p></span></div><div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt; line-height: 115%;">Dan radang katup jantung<o:p></o:p></span></div></div></td> </tr>
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<tr> <td> <div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">Kegagalan<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-size: 9.0pt;">fungsi jantung<o:p></o:p></span></div></div></td> </tr>
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</div></div><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br clear="all" style="mso-break-type: section-break; page-break-before: auto;" /> </span><br clear="ALL" style="mso-ignore: vglayout;" /> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo31; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">MANIFESTASI KLINIS<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Adanya beberapa manifestasi klinis yang lazim ditemukan pada klien Artritis reumatoid. Manifestasi ini tidak harus timbul sekaligus pada saat yang bersamaan. Oleh karena penyakit ini memiliki manifestasi klinis yang sangat bervariasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l56 level1 lfo32; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gejala – gejala konstitusional, misalnya lelah, anoreksia, berat badan menurun dan demam. Terkadang dapat terjadi kelelahan yang hebat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l56 level1 lfo32; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Poliartritis simetris, terutama pada sendi periper, termasuk sendi – sendi di tangan, namun biasanya tidak melibatkan sendi –sendi interfalangs distal. Hampir semua sendi diartrodial dapat terserang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l56 level1 lfo32; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kekakuan dipagi hari selama lebih dari satu jam, dapat bersifat generalisata tetapi terutama menyerang sendi – sendi. Kekakuan ini berbeda dengan kekakuan sendi pada osteoartritis, yang biasanya hanya berlangsung selama beberapa menit dan selalu berulang dari satu jam.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l56 level1 lfo32; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Artritis erosive, merupakan ciri khas Artritis reumatoid pada gambaran radiologik. Peradangan sendi yang kronik melibatkan erosi di tepi tulang dan dapat dilihat pada radiogram.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Deformitas<o:p></o:p></span></i></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kerusakan dari struktur – struktur penunjang sendi dengan perjalanan penyakit. Dapat terjadi pergeseran urnal atau deviasi jari, subluksasi sendi matakarpofalangenal, deformitas <i style="mso-bidi-font-style: normal;">boutonniere, </i>dan leher angsa merupakan beberapa deformitas tangan yang sering dijumpai pada klien. Pada kaki terdapat protrusi (tonjolan) kaput metatarsal yang timbul sekunder dari subluksasi matatersal. Sendi – sendi yang sangat besar juga dapat terangsang dan akan mengalami pengurangan kemampuan begerak terutama dalam melkukan gerakan ekstensi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Nodul – nodul reumatoid adalah massa subkutan yang ditemukan pada sekitar sepertiga orang dewasa penderita Artritis reumatoid. Lokasi yang paling sering dari doformitas ini adalah bursa olekranon (sendi siku) atau disepanjang permukaan ekstensor dari lengan, walaupun demikian nodul – nodul ini dapat juga timbul pada tempat – tempat lainnya. Adanya nodul – nodul ini biasanya merupakan suatu petunjuk penyakit yang aktif dan lebih barat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Manifestasi ekstraartikuler, artritis reumatoid juga dapat menyerang juga dapat menyerang organ – organ lain diluar sendi. Jantung (perikarditis), paru<span style="mso-spacerun: yes;"> </span>-paru (pleuritis), mata, dan pembuluh darah dapat rusak.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Manifestasi Ekstraartikuler dari Arthritis Rheumatoid<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 40.85pt; width: 558px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #C6D9F1; border: solid #29384E 1.0pt; mso-background-themecolor: text2; mso-background-themetint: 51; mso-border-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 105.5pt;" valign="top" width="141"> <div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Organ<o:p></o:p></span></div></td> <td style="background: #C6D9F1; border-left: none; border: solid #29384E 1.0pt; mso-background-themecolor: text2; mso-background-themetint: 51; mso-border-alt: solid #29384E .5pt; mso-border-left-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 312.65pt;" valign="top" width="417"> <div align="center" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Manifestasi<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid #29384E 1.0pt; mso-border-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 105.5pt;" valign="top" width="141"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kulit<o:p></o:p></span></div></td> <td style="border-bottom: solid #29384E 1.0pt; border-left: none; border-right: solid #29384E 1.0pt; border-top: none; mso-border-alt: solid #29384E .5pt; mso-border-left-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 312.65pt;" valign="top" width="417"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Nodula subkutan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Vaskulitis, menyebabkan bercak – bercak coklat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Lesi – lesi skimotik.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid #29384E 1.0pt; mso-border-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 105.5pt;" valign="top" width="141"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Jantung<o:p></o:p></span></div></td> <td style="border-bottom: solid #29384E 1.0pt; border-left: none; border-right: solid #29384E 1.0pt; border-top: none; mso-border-alt: solid #29384E .5pt; mso-border-left-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 312.65pt;" valign="top" width="417"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Perikarditis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Temponade pericardium (jarang)<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Lesi peradangan pada miokardium dan katup jantung<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid #29384E 1.0pt; mso-border-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 105.5pt;" valign="top" width="141"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Paru – paru<o:p></o:p></span></div></td> <td style="border-bottom: solid #29384E 1.0pt; border-left: none; border-right: solid #29384E 1.0pt; border-top: none; mso-border-alt: solid #29384E .5pt; mso-border-left-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 312.65pt;" valign="top" width="417"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pleuritis dengan atau tanpa efusi<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Peradangan pada paru – paru<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid #29384E 1.0pt; mso-border-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 105.5pt;" valign="top" width="141"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Mata<o:p></o:p></span></div></td> <td style="border-bottom: solid #29384E 1.0pt; border-left: none; border-right: solid #29384E 1.0pt; border-top: none; mso-border-alt: solid #29384E .5pt; mso-border-left-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 312.65pt;" valign="top" width="417"> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Skleritis<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 5;"> <td style="border-top: none; border: solid #29384E 1.0pt; mso-border-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 105.5pt;" valign="top" width="141"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">System saraf<o:p></o:p></span></div></td> <td style="border-bottom: solid #29384E 1.0pt; border-left: none; border-right: solid #29384E 1.0pt; border-top: none; mso-border-alt: solid #29384E .5pt; mso-border-left-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 312.65pt;" valign="top" width="417"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Neuropati perifer<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sindrom kompresi perifer, termasuk sindrom carpal tunner, neuropati saraf ulnaris, paralisis peronealis, dan abnormalitas vertebra servikal.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 6; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid #29384E 1.0pt; mso-border-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 105.5pt;" valign="top" width="141"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sistemik<o:p></o:p></span></div></td> <td style="border-bottom: solid #29384E 1.0pt; border-left: none; border-right: solid #29384E 1.0pt; border-top: none; mso-border-alt: solid #29384E .5pt; mso-border-left-alt: solid #29384E .5pt; mso-border-top-alt: solid #29384E .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 312.65pt;" valign="top" width="417"> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Anemia (sering)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Osteoporosis generalisata<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sindrom felty<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sindrom sjogren (keratokonjungtivitis sika)<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Amiloidosis (jarang).<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-list: l16 level1 lfo31; text-align: justify; text-indent: -14.2pt;"><span lang="DA" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: DA; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DA" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: DA; mso-fareast-font-family: "Times New Roman";">KRITERIA DIAGNOSTIK<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.25pt;"><span lang="DA" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: DA; mso-fareast-font-family: "Times New Roman";">Kriteria diagnostik AR disusun untuk pertama kalinya oleh suatu komite khusus dari <i style="mso-bidi-font-style: normal;">American Rheumatism Association</i> (ARA) pada tahun 1956. Karena kriteria tersebut dianggap tidak spesifik dan terlalu rumit untuk digunakan dalam klinik, komite tersebut melakukan peninjauan kembali terhadap kriteria klasifikasi AR tersebut pada tahun 1958.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.25pt;"><span lang="DA" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: DA; mso-fareast-font-family: "Times New Roman";">Dengan kriteria tahun 1958 ini ini seseorang dikatakan menderita AR klasik jika memenuhi 7 dari 11 kriteria yang ditetapkan, definit jika memenuhi 5 kriteria, probable jika memenuhi 3 kriteria dan possible jika hanya memenuhi 2 kriteria saja. Walaupun kriteria tahun 1958 ini telah digunakan selama hampir 30 tahun, akan tetapi dengan terjadinya perkembangan pengetahuan yang pesat mengenai AR, ternyata diketahui bahwa dengan menggunakan kriteria tersebut banyak dijumpai kesalahan diagnosis atau dapat me-masukkan jenis artritis lain seperti spondyloarthro-pathy seronegatif, penyakit pseudorheumatoid akibat deposit calcium pyrophosphate dihydrate, lupus erite-matosus sistemik, polymyalgia rheumatica, penyakit Lyme dan berbagai jenis artritis lainnya sebagai AR.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.25pt;"><span lang="DA" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: DA; mso-fareast-font-family: "Times New Roman";">Pembagian AR sebagai <i>classic</i>, <i>definite</i>, <i>probable</i> dan <i>possible</i>, secara klinis juga dianggap tidak relevan lagi. Hal ini disebabkan karena dalam praktek sehari hari, tidak perlu dibedakan penata-laksanaan AR yang <i>classic</i> dari AR <i>definite</i>. Selain itu seringkali penderita yang terdiagnosis sebagai menderita AR <i>probable</i> ternyata menderita jenis artritis yang lain.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.25pt;"><span lang="DA" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: DA; mso-fareast-font-family: "Times New Roman";">Walaupun peranan faktor reumatoid dalam pato-genesis AR belum dapat diketahui dengan jelas, dahulu dianggap penting untuk memisahkan kelompok penderita <i>seropositif</i> dari <i>seronegatif</i>. Akan tetapi pada faktanya, faktor reumatoid seringkali tidak dapat dijumpai pada stadium dini penyakit atau pembentukannya dapat ditekan oleh<i>disease modifying anti-rheumatic drugs</i> (DMARD). Selain itu spesifisitas faktor reumatoid ternyata tidak dapat diandalkan karena dapat pula dijumpai pada beberapa penyakit lain. Dua kriteria tahun 1958 yang lain seperti analisis bekuan musin dan biopsi membran sinovial memerlukan prosedur invasif sehingga tidak praktis untuk digunakan dalam diagnosis rutin.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">Kriteria American Rheumatism Association untuk Artritis Reumatoid, Revisi 1987.<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 40.85pt; width: 576px;"><tbody>
<tr style="height: 18.85pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #DDD9C3; border: solid windowtext 1.0pt; height: 18.85pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; width: 137.85pt;" width="184"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kriteria<o:p></o:p></span></div></td> <td style="background: #DDD9C3; border-left: none; border: solid windowtext 1.0pt; height: 18.85pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; width: 294.5pt;" width="393"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Definisi<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-left: solid windowtext 1.0pt; border: none; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 137.85pt;" valign="top" width="184"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.3pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify; text-indent: -8.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">1. Kaku pagi hari<o:p></o:p></span></div></td> <td style="border-right: solid windowtext 1.0pt; border: none; mso-border-right-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 294.5pt;" valign="top" width="393"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Kekakuan pada pagi hari pada persendian dan disekitarnya, sekurangnya selama 1 jam sebelum perbaikan maksimal<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-left: solid windowtext 1.0pt; border: none; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 137.85pt;" valign="top" width="184"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.3pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify; text-indent: -8.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">2. Artritis pada 3 daerah<o:p></o:p></span></div></td> <td style="border-right: solid windowtext 1.0pt; border: none; mso-border-right-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 294.5pt;" valign="top" width="393"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pembengkakan jaringan lunak atau persendian atau lebih efusi (bukan pertumbuhan tulang) pada sekurang-kurangnya 3 sendi secara bersamaan yang diobservasi oleh seorang dokter. Dalam kriteria ini terdapat 14 persendian yang memenuhi kriteria yaitu PIP, MCP, pergelangan tangan, siku pergelangan kaki dan MTP kiri dan kanan.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-left: solid windowtext 1.0pt; border: none; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 137.85pt;" width="184"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.3pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify; text-indent: -8.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">3.Artritis pada persendian tangan<o:p></o:p></span></div></td> <td style="border-right: solid windowtext 1.0pt; border: none; mso-border-right-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 294.5pt;" valign="top" width="393"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Sekurang-kurangnya terjadi pembengkakan satu persendian tangan seperti yang tertera diatas.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-left: solid windowtext 1.0pt; border: none; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 137.85pt;" valign="top" width="184"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.3pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify; text-indent: -8.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">4. Artritis simetris<o:p></o:p></span></div></td> <td style="border-right: solid windowtext 1.0pt; border: none; mso-border-right-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 294.5pt;" valign="top" width="393"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Keterlibatan sendi yang sama (seperti yang tertera pada kriteria 2 pada kedua belah sisi, keterlibatan PIP, MCP atau MTP bilateral dapat diterima walaupun tidak mutlak bersifat simetris.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 5;"> <td style="border-left: solid windowtext 1.0pt; border: none; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 137.85pt;" valign="top" width="184"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.3pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify; text-indent: -8.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">5. Nodul rheumatoid<o:p></o:p></span></div></td> <td style="border-right: solid windowtext 1.0pt; border: none; mso-border-right-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 294.5pt;" valign="top" width="393"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Nodul subkutan pada penonjolan tulang atau permukaan ekstensor atau daerah juksta-artrikular yang diobservasi oleh seorang dokter.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 6;"> <td style="border-left: solid windowtext 1.0pt; border: none; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 137.85pt;" valign="top" width="184"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.3pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify; text-indent: -8.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">6. Faktor rheumatoid serum<o:p></o:p></span></div></td> <td style="border-right: solid windowtext 1.0pt; border: none; mso-border-right-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 294.5pt;" valign="top" width="393"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Terdapatnya titer abnormal faktor reumatoid serum yang diperiksa dengan cara yang memberikan hasil positif kurang dari 5% kelompok kontrol yang diperiksa.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 7;"> <td style="border-left: solid windowtext 1.0pt; border: none; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 137.85pt;" valign="top" width="184"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 8.3pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify; text-indent: -8.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">7. Perubahan gambaran<o:p></o:p></span></div></td> <td style="border-right: solid windowtext 1.0pt; border: none; mso-border-right-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 294.5pt;" valign="top" width="393"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Perubahan gambaran radiologis yang radiologis khas bagi arthritis reumotoid pada periksaan sinar X tangan posteroanterior atau pergelangan tangan yang harus menunjukkan adanya erosi atau dekalsifikasi tulang yang berlokalisasi pada sendi atau daerah yang berdekatan dengan sendi (perubahan akibat osteoartritis saja tidak memenuhi persyaratan).<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 8; mso-yfti-lastrow: yes; page-break-inside: avoid;"> <td colspan="2" style="border-top: none; border: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext 1.0pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 432.35pt;" valign="top" width="576"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 3.75pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 3.75pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Untuk keperluan klasifikasi, seseorang dikatakan menderita artritis reumatoid jika ia sekurang-kurangnya memenuhi 4 dari 7 kriteria di atas. Kriteria 1 sampai 4 harus terdapat minimal selama 6 minggu. Pasien dengan dua diagnosis tidak dieksklusikan. Pembagian diagnosis sebagai artritis reumatoid klasik, definit, probable atau possible tidak perlu dibuat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 3.75pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 3.75pt; margin-right: 3.75pt; margin-top: 0in; text-align: justify;"><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">* PIP :</span></span><span class="apple-converted-space"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> </span></span><span class="apple-style-span"><i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Proximal Interphalangeal</span></i></span><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">, MCP :</span></span><span class="apple-converted-space"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> </span></span><span class="apple-style-span"><i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Metacarpophalangeal</span></i></span><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">, MTP:</span></span><span class="apple-converted-space"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> </span></span><span class="apple-style-span"><i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Metatarsophalangeal.</span></i></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 21.25pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo31; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">G.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">PENATALAKSANAAN<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tujuan utama dari program pengobatan adalah untuk menghilangkan nyeri dan peradangan, mempertahankan fungsi sendi dan kemampuan maksimal dari klien, serta mencegah dan atau memperbaiki deformitas yang terjadi pada sendi. Penatalaksanaan yang sengaja dirancang untuk mencapai tujuan – jutuan itu meliputi pendidikan, istirahat, latihan fisik dan termoterapi, gizi, serta obat – obatan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pengobatan harus deberikan secara paripurna, karena penyakit sulit sembuh. Oleh karena itu, pengobatan dapat dimulai secara lebih dini. Klien harus diterangkan mengenai penyakitnya dan diberikan dukungan psikologis. Nyeri dikurangi atau bahkan dihilangkan, reaksi inflamasi harus ditekan, fungsi sendi dipertahankan, dan deformitas dicegah dengan obat antiinflamasi nonsteroid, alat penopang ortopedis, dan latihan terbimbing.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pada keadaan akut kadang dibutuhkan pemberian steroid atau imunosupresan. Sedangkan, pada keadaan kronik sinovektomi mungkin berguna bila tidak ada destruksi sendi yang luas. Bila terdapat destruksi sendi atau deformitas dapat dianjurkan dan dilakukan tindakan artrodesis atau artroplastik. Sebaiknya pada revalidasi disediakan bermacam alat bantu untuk menunjang kehidupan sehari – hari dirumah maupun ditempat karja.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Langkah pertama dari program penatalaksanaan Artritis reumatoid adalah memberikan pendidikan kesehatan yang cukup tentang penyakit kepada klien, keluarganya, dan siapa saja yang berhubungan dengan klien. Pendidikan kesehatan yang diberikan meliputi pengertian tentang patofisiologi penyakit, penyebab dan prognosis penyakit, semua komponen program penatalaksanaan termasuk regimen obat yang kompleks, sumber-sumber bantuan untuk mengatasi penyakit, dan metode-metode yang efektif tentang penatalaksanaan yang diberikan oleh tim kesehatan. Proses pendidikan kesehatan ini harus dilakukan secara terus – menerus. Pendidikan dan informasi kesehatan juga dapat diberikan dari batuan klub penderita, badan – badan kemasyarakatan, dan orang – orang lain yang juga menderita Artritis reumatoid, serta keluarga mereka.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 21.25pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Istirahat adalah penting karena Artritis reumatoid biasanya disertai rasa lelah yang hebat. Walaupun rasa lelah tersebut dapat timbul setiap hari, tetapi ada masa – masa dimana klien marasa keadaannya lebih baik atau lebih berat. Kekakuan dan rasa tidak nyaman dapat meningkat apabila beristirahat. Hal ini memungkinkan klien dapat dapat mudah terbangun dari tidurnya pada malam hari karena nyeri. Disamping itu latihan – latihan spesifik dapat bermanfaat dalam mempertahankan fungsi sendi. Latihan ini mencakup gerakan aktif dan pasif pada semua sendi yang sakit, dan sebaiknya dilakukan sedikitnya dua kali sehari. Obat-obatan penghilang nyeri mungkin perlu diberikan sebelum latihan, dan mandi parafin dengan suhu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Dibawah ini adalah contoh-contoh obat yang dapat diberikan :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l44 level1 lfo34; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">NSAIDs<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Obat anti-infalamasi nonsteroid (NSAID) dapat mengurangi gejala nyeri dan mengurangi proses peradangan. Yang termasuk dalam golongan ini adalah ibuprofen dan natrium naproxen. Golongan ini mempunyai risiko efek samping yang tinggi bila di konsumsi dalam jangka waktu yang lama.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l44 level1 lfo34; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kortikosteroid<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Golongan kortikosteroid seperti prednison dan metilprednisolon dapat mengurangi peradangan, nyeri dan memperlambat kerusakan sendi. Dalam jangka pendek kortikosteroid memberikan hasil yang sangat baik, namun bila di konsumsi dalam jangka panjang efektifitasnya berkurang dan memberikan efek samping yang serius.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l44 level1 lfo34; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Obat remitif (DMARD)<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Obat ini diberikan untuk pengobatan jangka panjang. Oleh karena itu diberikan pada stadium awal untuk memperlambat perjalanan penyakit dan melindungi sendi dan jaringan lunak disekitarnya dari kerusakan. Yang termasuk dalam golongan ini adalah klorokuin, metotreksat salazopirin, dan garam emas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
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</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">ASUHAN KEPERAWATAN PADA KLIEN DENGAN RHEUMATOID ARTHRITIS<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">I. Pengkajian</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; tab-stops: 1.75in; text-align: justify; text-indent: 14.2pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; tab-stops: 1.75in; text-align: justify; text-indent: 14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pengkajian merupakan tahap awal dan landasan dalam proses keperawatan. Untuk itu, diperlukan kecermatan dan ketelitian dalam menangani masalah klien sehingga dapat memberi arah terhadap </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l54 level1 lfo78; tab-stops: 45.0pt; text-align: justify; text-indent: 0in;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Anamnesis.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Anamnesis dilakukan untuk mengetahui :</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l74 level1 lfo68; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Identitas </span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">meliputi nama,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">jenis kelamin,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">usia,alamat,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">agama,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">bahasa yang digunakan,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">status perkawainan,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">pendidikan,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">pekerjaan,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">asuransi,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">golongan darah,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">nomor register,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">tanggal masuk rumah sakit,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">dan diagnosis medis.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pada umunya keluhan utama artritis reumatoid adalah nyeri pada daerah sendi yang mengalami masalah.Untuk mempperoleh pengkajian yang lengkap tentang nyeri klien,</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">perawat dapat menggunakan metode PQRST.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level2 lfo71; tab-stops: 1.75in; text-align: justify; text-indent: -22.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Provoking incident</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> : Hal yang menjadi faktor<span style="mso-spacerun: yes;"> </span>presipitasi nyeri adalah peradangan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level2 lfo71; tab-stops: 1.75in; text-align: justify; text-indent: -22.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Quality Of Painn</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Nyeri yang dirasakan atau digambarkan klien bersifat menusuk.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level2 lfo71; text-align: justify; text-indent: -22.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Region,Radition,Relief </span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Nyeri dapat menjalar atau menyebar , dan nyeri terjadi di sendi yang mengalami masalah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level2 lfo71; tab-stops: -297.7pt; text-align: justify; text-indent: -22.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Severity(scale) Of Pain</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Nyeri yang dirasakan ada diantara 1-3 pada rentang skala pengukuran 0-4.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level2 lfo71; tab-stops: -184.3pt; text-align: justify; text-indent: -22.5pt;"><span lang="IN" style="font-family: "Courier New"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";"><span style="mso-list: Ignore;">o<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Time </span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Berapa lama nyeri berlangsung,kapan,apakah bertambah buruk pada malam hari atau siang hari.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 58.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l74 level1 lfo68; tab-stops: 1.75in; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Riwayat penyakit sekarang.</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pengumpulan data dilakukan sejak keluhan muncul.Pada klien artritis reumatoid , stadium awal biasanya ditandai dengan gangguan keadaan umum berupa malaise,penurunan berat badan,rasa capek,sedikit panas,dan anemia. Gejala lokal yang terjadi berupa pembengkakan,nyeri,dan gangguan gerak pada sendi metakarpofalangeal. Perlu dikaji kapan gangguan sensorik muncul.Gejala awal terjadi pada sendi.Persendian yang paling sering terkena adalah sendi tangan,pergelangan tangan,sendi lutut,sendi siku,pergelangan kaki,sendi bahu,serta sendi panggul, dan biasanya bersifat bilateral/simetris.Akan tetapi,kadang artritis<span style="mso-spacerun: yes;"> </span>reumatoid dapat terjadi hanya pada satu sendi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 58.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l74 level1 lfo68; tab-stops: 1.75in; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Riwayat penyakit dahulu.</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pada pengkajian ini,ditemukan kemungkinan penyebab yang mendukung terjadinya artritis reumatoid.Penyakit tertentu seperti penyakit diabetes menghambat proses penyembuhan artritis reumatoid.Masalah lain yang perlu ditanyakan adalah apakah klien pernah dirawat dengan masalah yang sama.Sering klien ini menggunakan obat antireumatik jangka panjang sehingga perlu dikaji jenis obat yang digunakan(NSAID,antibiotik,dan analgesik).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l74 level1 lfo68; tab-stops: 1.75in; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Riwayat penyakit keluarga.</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> Kaji tentang adakah keluarga dari generasi terdahulu yang mengalami keluhan yang sama dengan klien.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l74 level1 lfo68; tab-stops: 1.75in; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Riwayat psikososial.</span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> Kaji respon emosi klien terhadap penyakit dan perannya dalam keluarga dan masyarakat.Klien ini dapat mengalami ketakutan akan kecacatan karena perubahan bentuk sendi dan pandangan terhadap dirinya yang salah(gangguan citra diri).Klien ini juga dapat mengalami penurunan libido sampai tidak dapat melakukan hubungan seksual karena harus menjalani rawat inap dan kelemahan fisik serta nyeri.Klien artritis reumatoid akan merasa cemas tentang<span style="mso-spacerun: yes;"> </span>fungsi tubuhnya sehingga perawat perlu mengkaji mekanisme koping klien. Kebutuhan tidur dan istirahat<span style="mso-spacerun: yes;"> </span>juga harus dikaji,selain lingkungan,lama tidur,kebiasaan,kesulitan,dan pengguanaan obat tidur.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 45.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l54 level1 lfo78; tab-stops: 1.75in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pemeriksaan fisik.Setelah melakukan anamnesis,pemeriksaan fisik sangat berguna untuk mendukung data anamnesis .Pemeriksaan fisik dilakukan per sistem (B1-B6) dengan fokus pemeriksaan B6(<i style="mso-bidi-font-style: normal;">Bone</i>) yang dikaitkan dengan keluhan klien.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 67.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l67 level1 lfo69; text-align: justify; text-indent: -22.5pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B1 (B<i style="mso-bidi-font-style: normal;">reathing</i>).Klien artritis reumatoid tidak menunjukkan kelainan sistem pernapasan pada saat inspeksi.Palpasi toraks menunjukkan taktil fremitus seimbang kanan dan kiri. Pada auskultasi,tidak ada suara napas tambahan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 67.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l67 level1 lfo69; text-align: justify; text-indent: -22.5pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B2 (<i style="mso-bidi-font-style: normal;">Bloo</i>d). Tidak ada iktus jantung pada palpasi.Nadi mungkin meningkat,iktus tidak teraba.Pada auskultasi,ada suara S1 dan S2 tunggal dan tidak ada murmur.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 67.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l67 level1 lfo69; text-align: justify; text-indent: -22.5pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B3(<i style="mso-bidi-font-style: normal;">Brain</i>).Kesadaran biasanya kompos mentis.Pada kasus yang lebih parah,klien dapat mengeluh pusing dan gelisah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo70; tab-stops: 1.75in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kepala dan wajah<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Ada sianosis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo70; tab-stops: 1.75in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Mata<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Skelera biasanya tidak ada ikterik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo70; tab-stops: 1.75in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Leher<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Biasanya JVP dalam batas normal<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo70; tab-stops: 1.75in; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Telinga</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 3;"> </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">:Tes bisik atau Weber masih dalam keadaan normal.Tidak ada Lesi atau nyeri tekan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo70; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Hidun</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">g<span style="mso-tab-count: 2;"> </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Tidak ada deformitas,tidak ada pernapasan</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">cuping</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">hidung.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo70; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Mulut dan faring<span style="mso-spacerun: yes;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Tidak ada pembesaran tonsil,gusi tidak terjadi <span style="mso-tab-count: 1;"> </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><span style="mso-spacerun: yes;"> </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">perdarahan,mukosa mulut tidak pucat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l71 level1 lfo70; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Status menta</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">l<span style="mso-tab-count: 1;"> </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: penampilan dan tingkah laku klien biasanya tidak mengalami</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">perubahan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l14 level1 lfo75; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B4 (<i style="mso-bidi-font-style: normal;">Bladder</i>). Produksi urin biasanya dalam batas normal dan tidak ada keluhan pada sistem perkemihan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l14 level1 lfo75; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B5 (<i style="mso-bidi-font-style: normal;">Bowel</i>). Umumnya klien artritis reumatoid tidak mengalami gangguan eliminasi.Meskipun demikian,perlu dikaji frekuensi,konsitensi,warna serta bau feses.Frekuensi berkemih,kepekatan urin,warna,bau,dan jumlah urin juga harus dikaji.Gangguan gastointestinal yang sering adalah mual,nyeri lambung,yang menyebabkan klien tidak nafsu makan,terutama klien yanmg menggunakan obat reumatik dan NSAID.Peristaltik yang menurun menyebabkan klien jarang defekasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l14 level1 lfo75; text-indent: -21.25pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">B6 (<i style="mso-bidi-font-style: normal;">Bone </i>)<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l69 level1 lfo76; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Look<span style="mso-tab-count: 1;"> </span></span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Didapatkan adanya pembengkakan yang tidak biasa <span style="mso-tab-count: 3;"> </span><span style="mso-spacerun: yes;"> </span>(abnormal ),deformitas pada daerah sendi kecil tangan, pergelangan kaki,dan sendi besar lutut,panggul dan pergelangan tangan.Adanya degenerasi serabut otot memungkinkan terjadinya pengecilan,atrofi otot yang disebabkan oleh tidak digunakannya otot akibat inflamasi sendi.Sering ditemukan nodul subkutan multipel.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l69 level1 lfo76; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Feel<span style="mso-tab-count: 1;"> </span></span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Nyeri tekan pada sendi yang sakit.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 78.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l69 level1 lfo76; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Move<span style="mso-tab-count: 1;"> </span></span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">: Ada gangguan mekanis dan fungsional pada sendi dengan <span style="mso-tab-count: 2;"> </span><span style="mso-spacerun: yes;"> </span>manifestasi nyeri bila menggerakan sendi yang sakit.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Klien</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>sering mengalami kelemahan fisik sehingga mengganggu</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">aktifitas hidup sehari-hari.<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pemeriksaan diagnostik :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo77; text-indent: -14.15pt;"><span lang="IN" style="font-family: Wingdings; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pemeriksaan radiologi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Pada tahap awal, foto rontgen tidak menunjukkan kelainan yang mencolok. Pada tahap lanjut, terlihat rarefaksi korteks sendi yang difus dan disertai trabekulasi tulang, obliterasi ruang sendi yang memberi perubahan degeneratif berupa densitas, iregullaritas permukaan sendi, serta spurring marginal. Selanjutnya bila terjadi destruksi tulang rawan, akan terlihat penyempitan ruang sendi dengan erosi pada beberapa tempat.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 63.8pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">II. <span style="mso-spacerun: yes;"> </span>Diagnosa Keperawatan<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diagnosa keperawatan pada yang dapat ditemukan pada klien rumatoid arthritis <b style="mso-bidi-font-weight: normal;">(doengoes, 2000)</b> adalah sebagai berikut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l55 level1 lfo35; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Nyeri akut kronis berhubungan dengan distensi jaringan akibat akumulasi cairan/ proses inflamasi/ destruksi sendi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l55 level1 lfo35; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kerusakan mobilitas fisik berhubungan dengan deformitas skeletal, nyeri/ ketidaknyamanan, intoleransi terhadap aktivitas atau penurunan kekuatan otot.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l55 level1 lfo35; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gangguan citra tubuh/ perubahan penampilan peran berhubungan dengan perubahan kemampuan untuk melakukan tugas-tugas umum, peningkatan penggunaan energy atau ketidakseimbangan mobilitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l55 level1 lfo35; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kurang perawatan diri berhubungan dengan kerusakan musculoskeletal, penurunan kekuatan, daya tahan, nyeri saat bergerak, atau depresi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l55 level1 lfo35; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Resiko tinggi kerusakan penatalaksanaan pemeliharaan rumah berhubungan dengan proses penyakit degenerative jangka panjang, system pendukung tidak adekuat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l55 level1 lfo35; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kurang pengetahuan/ kebutuhan belajar mengenai penyakit, prognosis, dan pengobatan berhubungan dengan kurang pemajanan/mengingat, kesalahan interpretasi informasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Sementara </span><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">(</span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Carpenito</span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">, </span></i></b><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">1995)</span></i></b><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> </span></i><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">merumuskan diagnosis keperawatan pada klien rheumatoid arthritis adalah sebagai berikut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo36; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kelemahan berhubungan dengan penurunan mobilitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo36; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Resiko tinggi kerusakan membrane mukosa oral berhubungan dengan pengaruh obat dan sindrom sjogren.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo36; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gangguan pola tidur berhubungan dengan nyeri, fibrosistis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo36; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Resiko tinggi isolasi sosial berhubungan dengan kelemahan dan kesulitan ambulasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo36; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gangguan pola seksual berhubungan dengan nyeri, kelemahan, sulit mengatur posisi, dan kurang adekuat lubrikasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo36; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gangguan proses keluarga berhubungan dengan kesulitan/ ketidakmampuan klien.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l59 level1 lfo36; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Ketidakberdayaan berhubungan dengan perubahan fisik dan psikologis akibat penyakit.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">III. Intervensi dan Implementasi Keperawatan<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Rencana asuhan keperawatan pada klien arthritis rheumatoid dibawah ini, disusun berdasarkan diagnosis keperawatan, tindakan keperawatan, dan rasionalisis <span style="mso-spacerun: yes;"> </span>(doenges, 2000).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diagnosa keperawatan I : <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">nyeri akut/kronis berhubungan dengan distensi jaringan akibat akumulasi cairan atau proses inflamasi, destruksi sendi.</i></b></span><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></i></b></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 26.7pt; width: 582px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #DDD9C3; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tindakan<o:p></o:p></span></div></td> <td style="background: #DDD9C3; border-left: none; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Rasional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mandiri :<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kaji keluhan nyeri, skala nyeri serta catat lokasi dan intensitas, factor-faktor yang mempercepat, dan respon rasa sakit non verbal.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Membantu dalam menentukan kebutuhan manajemen nyeri dan efektifitas program.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Berikan matras/ kasur keras, bantal kecil. Tinggikan tempat tidur sesuai kebutuhan.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Matras yang lembut/ empuk, bantal yang besar akan menjaga<span style="mso-spacerun: yes;"> </span>pemeliharaan kesejajaran tubuh yang tepat, menempatkan stress pada sendi yang sakit. Peninggian<span style="mso-spacerun: yes;"> </span>tempat tidur menurunkan tekanan pada sendi yang terinflamasi/nyeri</span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Biarkan klien mengambil posisi yang nyaman waktu tidur atau duduk di kursi. Tingkatkan istirahat di tempat tidur sesuai indikasi<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Pada penyakit yang berat/ eksaserbasi, tirah baring mungkin diperlukan untuk membatasi nyeri cedera.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 5;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Tempatkan/ pantau penggunaan bantl, karung pasir, gulungan trokhanter, bebat, brace.</span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"> </span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mengistirahatkan sendi-sendi yang sakit dan mempertahankan posisi netral. Penggunaan brace dapat menurunkan nyeri dan dapat mengurangi kerusakan pada sendi. Imobilisasi yang lama dapat mengakibatkan hilang mobilitas/ fungsi sendi.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 6;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Anjurkan klien untuk sering merubah posisi,. Bantu klien untuk bergerak di tempat tidur, sokong sendi yang sakit di atas dan bawah, hindari gerakan yang menyentak.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mencegah terjadinya kelelahan umum dan kekakuan sendi. Menstabilkan sendi, mengurangi gerakan/ rasa sakit pada sendi.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 7;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Anjurkan klien untuk mandi air hangat. Sediakan waslap hangat untuk mengompres sendi yang sakit. Pantau suhu air kompres, air mandi, dan sebagainya.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">meningkatkan relaksasi otot, dan mobilitas, menurunkan rasa sakit dan menghilangkan kekakuan pada pagi hari. Sensitivitas pada panas dapat dihilangkan dan luka dermal dapat disembuhkan<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 8;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Berikan masase yang lembut.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">meningkatkan relaksasi/ mengurangi tegangan otot.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 9;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Dorong penggunaan teknik manajemen stres, misalnya relaksasi progresif,sentuhan terapeutik, biofeed back, visualisasi, pedoman imajinasi, hypnosis diri, dan pengendalian napas. <o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Meningkatkan relaksasi, memberikan rasa kontrol nyeri dan dapat meningkatkan kemampuan koping.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 10;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Libatkan dalam aktivitas hiburan sesuai dengan jadwal aktivitas klien.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Memfokuskan kembali perhatian, memberikan stimulasi, dan meningkatkan rasa percaya diri dan perasaan sehat.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 11;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kolaborasi :<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">10.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Beri obat sebelum dilakukan aktivitas/ latihan yang direncanakan sesuai petunjuk.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">10.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Meningkatkan relaksasi, mengurangi tegangan otot/ spasme, memudahkan untuk ikut serta dalam terapi.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 12;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">11.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"> </span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Berikan obat-obatan sesuai petunjuk<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l75 level1 lfo39; text-align: justify; text-indent: -10.9pt;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Asetilsalisilat (Aspirin).<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l75 level1 lfo39; text-align: justify; text-indent: -10.9pt;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">NSAID lainnya, missal ibuprofen (motrin), naproksen, sulindak, proksikam (feldene), fenoprofen.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l75 level1 lfo39; text-align: justify; text-indent: -10.9pt;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">D-penisilamin (cuprimine).<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l75 level1 lfo39; text-align: justify; text-indent: -10.9pt;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Antasida<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -10.9pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l75 level1 lfo39; text-align: justify; text-indent: -10.9pt;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Produk kodein<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">11.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Obat-obatan:<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 37.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l75 level1 lfo39; text-align: justify; text-indent: -14.15pt;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Bekerja sebagai antiinflamasi dan efek analgesik ringan dalam mengurani kekakuan dan meningkatkan mobilitas. ASA harus dipakai secara regular untuk mendukung kadar dalam darah teurapetik. Riset mengindikasikan bahwa ASA memiliki indeks toksisitas yang paling rendah dasi NSAID lain yang diresepkan.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 37.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l75 level1 lfo39; text-align: justify; text-indent: -14.15pt;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Dapat digunakan bila klien tidak memberikan respons pada aspirin atau untuk meningkatkan efek dari aspirin.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 37.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l75 level1 lfo39; text-align: justify; text-indent: -14.15pt;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Dapat mengontrol efek-efek sistemik dari RA jika terapi lainnya tidak berhasil. Efek samping yang lebih berat misalnya trombositopenia, leucopenia, anemia aplastik membutuhkan pemantauan yang ketat. Obat harus diberikan diantara waktu makan, karena absorbs obat menjadi tidak seimbang antara makanan dan produk antasida dan besi.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 37.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l75 level1 lfo39; text-align: justify; text-indent: -14.15pt;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Diberikan bersamaan dengan NSAID untuk meminimalkan iritasi/ ketidaknyamanan lambung.<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 37.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l75 level1 lfo39; text-align: justify; text-indent: -14.15pt;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Meskipun narkotik umumnya adalah kontraindikasi, namun karena sifat kronis dari penyakit, penggunaan jangka pendek mungkin diperlukan selama periode eksaserbasi akut untuk mengontrol nyeri yang berat.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 13;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">12.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Bantu klien dengan terapi fisik, missal sarung tangan paraffin, bak mandi dengan kolam bergelombang.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">12.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Memberikan dukungan hangat/ panas untuk sendi yang sakit.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 14;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">13.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Berikan kompres dingin jika dibutuhkan.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">13.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Rasa dingin dapat menghilangkan nyeri dan bengkak pada periode akut. <o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 15;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">14.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pertahankan unit TENS jika digunakan.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">14.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Rangsang elektrik tingkat rendah yang konstan dapat menghambat transmisi nyeri.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 16; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l60 level1 lfo37; text-align: justify; text-indent: -.25in;"><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">15.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Siapkan intervensi pembedahan, missal sinovektomi.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.95pt;" valign="top" width="289"> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 19.05pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo38; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">15.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Pengangkatan sinovium yang meradang dapat mengurangi nyeri dan membatasi progresi dan perubahan degeneratif.<o:p></o:p></span></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: -14.2pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diagnosa Keperawatan II : <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Kerusakan mobilitas fisik berhubungan dengan deformitas skeletal, nyeri/ ketidaknyamanan, intoleransi terhadap aktivitas atau penurunan kekuatan otot</i></b><i style="mso-bidi-font-style: normal;">.<o:p></o:p></i></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 26.7pt; width: 586px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #DDD9C3; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tindakan<o:p></o:p></span></div></td> <td style="background: #DDD9C3; border-left: none; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Rasional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mandiri :<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l61 level1 lfo40; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Evaluasi/ lanjutkan pemantauan tingkat inflamasi/ rasa sakit pada sendi.</span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Tingkat aktivitas/ latihan tergantung dari perkembangan/ resolusi dari proses inflamasi.</span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l61 level1 lfo40; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Pertahankan istirahat tirah baring/ duduk jika diperlukan. Buat<span style="mso-spacerun: yes;"> </span>jadwal aktivitas yang sesuai dengan toleransi untuk memberikan periode istirahat yang terus menerus dan tidur malam hari yang tidak terganggu.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Istirahat sistemik dianjurkan selama eksaserbasi akut dan seluruh fase penyakit yang penting, untuk mencegah kelelahan, dan mempertahankan kekuatan.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l61 level1 lfo40; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Bantu klien dengan rentang gerak aktif/pasif, demikian juga latihan resistif dan isometris jika memungkinkan<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mempertahankan/ meningkatkan fungsi sendi, kekuatan otot dan stamina umum. Latihan yang tidak adekuat menimbulkan kekakuan sendi, karenanya aktivitas yang berlebihan dapat merusak sendi.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 5;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l61 level1 lfo40; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Ubah posisi klien setiap dua jam dengan bantuan personel yang cukup. Demonstrasikan/ bantu teknik pemindahan dan penggunaan bantuan mobilitas.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Menghilangkan tekanan pada jaringan dan meningkatkan sirkulasi. Mempermudah perawatan diri dan kemandirian klien. Tehnik pemindahan yang tepat dapat mencegah robekan abrasi kulit.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 6;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l61 level1 lfo40; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"> </span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Posisikan sendi yang sakit dengan bantal, kantung pasir, gulungan trokanter, dan bebat, brace.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Meningkatkan stabilitas ( mengurangi resiko cidera ) dan mempertahankan posisi sendi yang diperlukan dan kesejajaran tubuh serta dapat mengurangi kontraktur.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 7;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l61 level1 lfo40; text-align: justify; text-indent: -.25in;"><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Gunakan bantal kecil/tipis di bawah leher.</span></span><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mencegah fleksi leher.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 8;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l61 level1 lfo40; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Dorong klien mempertahankan postur tegak dan duduk, berdiri, dan berjalan.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Memaksimalkan fungsi sendi dan mempertahankan mobilitas.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 9;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l61 level1 lfo40; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Berikan lingkungan yang aman, misalnya menaikkan kursi/kloset, menggunakan pegangan tangga pada bak/pancuran dan toilet, penggunaan alat bantu mobilitas/kursi roda.</span></span><span class="apple-converted-space"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"> </span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Menghindari cidera akibat kecelakaan/ jatuh.<o:p></o:p></span></span></div></td> </tr>
<tr style="height: 97.25pt; mso-yfti-irow: 10;"> <td style="border-top: none; border: solid black 1.0pt; height: 97.25pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kolaborasi :<o:p></o:p></span></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></span><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Konsultasi dengan ahli terapi fisik/okupasi dan spesialis vokasional.<o:p></o:p></span></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 97.25pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span class="apple-style-span"><span lang="IN" style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">9. berguna dalam memformulasikan program latihan/ aktivitas yang berdasarkan pada kebutuhan individual dan dalam mengidentifikasi alat/bantuan mobilitas.<o:p></o:p></span></span></div></td> </tr>
<tr style="mso-yfti-irow: 11;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">10.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Berikan matras busa/<span style="mso-spacerun: yes;"> </span>pengumbah tekanan.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">10. Menurunkan tekanan pada jaringan yang mudah pecah untuk mengurangi risiko imobilisasi / terjadi dekubitus.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 12;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">11. Berikan obat – obatan sesuai indikasi :<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l15 level1 lfo42; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Agen antireumatik, mis garam emas, natrium tiomaleat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l15 level1 lfo42; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Steroid.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">11. Obat – obatan :<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l6 level1 lfo43; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Krisoterapi<span style="mso-spacerun: yes;"> </span>(<span style="mso-spacerun: yes;"> </span>garam emas ) dapat menghasilkan remisi dramatis<span style="mso-spacerun: yes;"> </span>/<span style="mso-spacerun: yes;"> </span>terus – menerus tetapi dapat mengakibatkan inflamasi rebound bila terjadi penghentian atau dapat terjadi efek samping serius, misl krisis nitrotoid seperti pusing, penglihatan kabur, kemerahan tubuh, dan berkembang menjadi syok anafilaktik.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l6 level1 lfo43; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mungkin dibutuhkan untuk menekan inflamasi sistemik akut.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 13; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">12. Siapkan intervensi bedah :<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l58 level1 lfo44; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Atroplasti.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l58 level1 lfo44; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Prosedur pelepasan tunnel, perbaikan tendon,ganglionektomi.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l58 level1 lfo44; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Implan sendi.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">12. Intervensi bedah :<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l57 level1 lfo45; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Perbaikan pada kelemahan periartikuler dan subluksasi dapat meningkatkan stailitas sendi.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l57 level1 lfo45; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Perbaikan berkenaan dengan defek jaringan penyambung, dan mobilitas.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l57 level1 lfo45; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Pergantian mungkin diperlikan untuk memperbaiki fungsi optimal dan mobilitas.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: -35.5pt; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: -35.5pt; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: -35.5pt; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diagnosa Keperawatan III : <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Gangguan citra tubuh / perubahan penampilan peran berhubungan dengan perubahan kemapuan untuk melakukan tugas-tugas umum, peningkatan penggunaan energi atau ketidakseimbangan mobilitas.</i></b></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: -35.5pt; margin-top: 0in; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 26.7pt; width: 586px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #DDD9C3; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tindakan<o:p></o:p></span></div></td> <td style="background: #DDD9C3; border-left: none; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Rasional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mandiri :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Dorongn klien mengungkapakan perasaannya melalui proses penyakit dan harapan masa depan.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Memberikan kesempatan untuk mengidentifikasi rasa takut / kesalahan konsep dan mampu menghadapi masalah secara langsung.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Diskusikan arti dari kehilangan<span style="mso-spacerun: yes;"> </span>/ perubahan pada klien / orang terdekat. Pastikan bagaimana pandangan pribadi klien dalam<span style="mso-spacerun: yes;"> </span>berfungsi dalam gaya hidup sehari – hari, termasuk aspek –aspek seksual.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mengidentifikasi bagaimana penyakit mempengaruhi persepsi diri dan interaksi dengan orang lain akan menentukan kebutuhan terhadap intervensi / konseling lebih lanjut.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Diskusikan persepsi klien ,mengenai bagaimana<span style="mso-spacerun: yes;"> </span>orang terdekat menerima keterbatasan klien.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Isyarat verbal / nonverbal orang terdekat dapat memengaruhi bagaimana klien memandang dirinya sendiri.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Akui dan menerima perasaan berduka, bermusuhan, serta ketergantungan.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Nyeri konstan akan melelahkan, perasaan marah, dan bermusuhan umum terjadi.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 5;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Obesrvasi perilaku klien terhadap kemungkinan menarik diri, menyangkal atau terlalu memperhatikan perubahan tubuh.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Dapat menujukkan emosional atau metode koping maladatif, membutuhkan intervensi<span style="mso-spacerun: yes;"> </span>lebih lanjjut / dukungan psikologis.<o:p></o:p></span></div></td> </tr>
<tr style="height: 72.95pt; mso-yfti-irow: 6;"> <td style="border-top: none; border: solid black 1.0pt; height: 72.95pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Susun batasan pada perilaku maladatif. Bantu klien untuk mengidentifikasi perilaku positif yang dapat membantu mekanisme koping yang adaptif.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 72.95pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Membantu klien untuk mempertahankankontrol diri, yang dapat meningkatkan perasaan harga diri.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 7;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Ikut sertakan klien dalam merencanakan perawatan dan membuat jadwal akitvitas.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Meningkatkan perasaan kompetensi/<span style="mso-spacerun: yes;"> </span>harga diei, mendorong kemandirian, dan mendorong partisipasi dalam terapi.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 8;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Bantu kebutuhan perawat yang diperlukan klie.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mempertahankan penampilan yang dapat meningkatkan citra diri.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 9;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo73; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Berikan respon/ pujian positif bila perlu.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 16.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Memungkinkan klien untu merasa senang terhadap dirinya sendiri. Menguatkan prilaku positif, dan meningkatkan rasa percaya diri.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 10;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kaloborasi :<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">10.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Rujuk pada konseling psikiatri, mis perawat spesialis psikiatri, psikiatri/ psikolog,pekerjaan sosial.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -20.7pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">10. Klien/ orang terdekat mungkin mebutuhkan dukungan selama berhadapan dengan proses jangka panjang/ ketidakmampuan.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 11; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l78 level1 lfo74; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">11.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Berikan obat – obatan sesuai petunjuk, mis antiasietas dan obat – obatan eningkatan alam perasaan<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -20.7pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">11. Mungkin dibutuhkan pada saat munculnya depresi hebat sampai klien mampu mengembangkan kemampuan koping yang lebih efektif.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diagnosa Keperawatan IV : <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">kurang keperawatan diri b.d krusakan muskloskeletal, penurunan kekuatan, daya tahan, nyeri saat bergerak atau depresi.</i></b><i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 26.7pt; width: 586px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #DDD9C3; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tindakan<o:p></o:p></span></div></td> <td style="background: #DDD9C3; border-left: none; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Rasional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mandiri :<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">1. Diskusikan dengan klien tingkat fungsional umum sebelum timbulnya/ eksaserbasi penyakit dan risiko perubahan yang diantisipasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">1. Klien mungkin dapat melanjutkan aktivitas umum dengan melakukan adaptasi yang diperlukan pada keterbatasan saat ini.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">2. Pertahan kan mobilitas, kontrol terhadap nyeri, dan program latihan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">2. Mendukung kemandirian fisik/ emosional klien.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">3. Kaji hambatan kliendalam partisipasi perawatan diri. Identifikasi/ buat rencana untuk modifikasi lingkungan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">3. Menyiapkan klien untuk meningkatkan kemandirian, yang akan meningkatkan harga diri.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kalaborasi :<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">4. Konsultasi dengan ahli terapi okupasi.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">4. Berguna dalam menentukan alat bantu untuk memenuhi kebutuhan individu, misal memasang kancing, menggunakan alat bantu, memakai sepatu , atau menggantungkan pegangan untuk mandi pancuran.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 5;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">5. Mengatur evaluasi kesehatan di rumah sebelum dan setelah pemulang.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">5. Mengidentifikasi masalah-masalah yang mungkin dihadapi karena tingkat ketidakmampuan aktual. Memberikan lebih banyak keberhasilan usaha tim dengan orang lai yang ikut serta dalam perawatan, misaltim terapi okupasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 6; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">6. Membuat jadwal konsul dengan lembaga lainnya, misal pelayanan perawatan di rumah, ahli nutrisi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">6. Klien mungkin membutuhkan berbagi bantuan tambahan untuk partisipasi situasi di rumah.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diagnosa keperawtan V : <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Risiko tinggi kerusakan penatalaksanaan pemeliharaan rumah <span style="mso-spacerun: yes;"> </span>b . d proses penyakit degeneratif jangka panjang, sistem pendukung tidak adekuat.</i></b></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 26.7pt; width: 586px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #DDD9C3; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tindakan<o:p></o:p></span></div></td> <td style="background: #DDD9C3; border-left: none; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Rasional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mandiri :<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">1. Kaji tingkat fungsional fisik klien.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">1.Mengidentifikasi tingkat bantuan/ dukungan yang diperlukan klien.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">2. Evaluasi lingkungan sekitar untuk mengkaji kemampuan klien dalam melakukan perawatan diri sendiri.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">2. menentukan kemungkinan susunan yang ada/ perubahan susunan rumah untuk memenuhi kebutuhan klien.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">3. Tentukan sumber –sumber finansial untuk memenuhi kebutuhan situasi individual. Identifikasi sistem pedukung yang tersedia untuk klien, misalnya membagi perbaikan/ tugas-tugas rumah tangga antara anggota keluarga atau pelayanan.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">3. Menjamin bahwa kebutuhan klien<span style="mso-spacerun: yes;"> </span>akan<span style="mso-spacerun: yes;"> </span>dipenuhi secara terus – menerus.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">4. Identifikasi peralatan yang<span style="mso-spacerun: yes;"> </span>diperlukan untuk mendukung aktivitas klien, misalnya peninggian dudukan toilet, kursi roda.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">4. Memberikan kesempatan untuk mendapatkan peralatan sebelum pulang untuk menunjang aktivitas klien di rumah.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 5;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Kolaborasi :<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">5. Koordinasi evaluasi di rumah dengan ahli terapi okupasi.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">5. Bermanfaat untuk mengidentifikasi peralatan, cara- cara untuk mengubah berbagai tugas dalam mempertahankan kemandirian.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 6; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">6. Identifikasi sumber – sumber komunitas, misal pelayanan pembatu rumah tangga, pelayan sosial ( bila ada).<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">6. Memberkan kemudahan berpindah pada/ mendukung kontinuitas dalam situasi rumah.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Diagnosa keperawatan VI : <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">kurang pengetahuan / kebutuhan belajar mengenai panyakit, prognosis, dan penobatan b . d kurang pemajanan/ mengingat, kesalahan interpretasi informasi.</i></b></span><i style="mso-bidi-font-style: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></i></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-left: 26.7pt; width: 586px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="background: #DDD9C3; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Tindakan<o:p></o:p></span></div></td> <td style="background: #DDD9C3; border-left: none; border: solid black 1.0pt; mso-background-themecolor: background2; mso-background-themeshade: 230; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Rasional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Mandiri :<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">1. Tinjau proses penyakit, prognosis, dan harapan masa depan.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">1. Memberikan pengetahuan di mana klien dapat membuat pilihan berdasarkan informasi yang disampaikan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">2. Diskusikan kebiasaan klien dalam penatalaksanaan proses sakit melalui diet, obat-obatan, serta program diet seimbang, latihan, dan istirahat.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">2. Tujuan kontrol penyakit adalah untuk menekan inflamasi sendi/ jaringan lain guna mempertahankan fungsi sendi dan mencegah deformitas.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">3. Bantu klien dalam merencanakan jadwal aktivitas terintegrasiyang realitis, periodeistirahat,perawatan diri, pemberian obat -obatan,terapi fisik,dan manajemen stres.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">3. Memberikan struktur dan mengurangi ansietas pada wakru menangani proses penyakit kronis yang kompleks.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">4. Tekankan pentingnya melanjutkan manajemen farmakoterapeutik.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">4. Keuntungan dari terapi obat –obatan tergantung ketepatan dosis, misal aspirin harus diberikan secara reguleruntuk mendukung kadar terapeutik darah 18- 25 mg.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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<tr style="mso-yfti-irow: 5;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">5. Rekomendasikan pengunaan aspirin bersalut/ dibuper enterik atau salisilat nonasetil, misal kolin magnesium trisalisilat <o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">5. Preparat bersalut/ dibuper dicerna dengan makanan, meminmimalkan iritasi gaster, mengurangi risiko perdarahan. Produk nonastil sedikit dibutuhkan untuk mengurangi iritasi lambung.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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<tr style="mso-yfti-irow: 6;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">6. Anjurkan kliean untuk mencerna<span style="mso-spacerun: yes;"> </span>obat-obatan dengan makanan,susu atau antasida.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">6. Membatasi iritasi gaster. Penggurangan nyeri akan meningkatkan kualitas tidur san meningkatkan kadar darah serta mengurangi kekuatan di pagi hari.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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<tr style="mso-yfti-irow: 7;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">7. Identifikasi efek samping oabt-obatan yang merugkan, misal tinitus, intoleransi lambung, perdaraha gastrointestinal, dan ruam purpurik.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">7. Memperpanjang dan memaksimalakan dosis aspirrin dapat mengakibatkan takar lajak ( overdosis). Tinitus umumnya mengidentifikan kadar terapeutik darah yang tinggi. Jika terjadi tinitus, dosis umumnya diturunkan menjadi satu tablet setiap tiga hari sampai berhenti.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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<tr style="mso-yfti-irow: 8;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">8. Tekankan pentingnya membaca label produk dan mengurangi penggunaan obat yang dijual bebas tanpa prsetujuan dokter. <o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">8. Banyak produk mengandung salisilat tersembunyi.(misal obat diare, pilek)yang dapat meningkatkan risiko overdosis obat / efek samping<span style="mso-spacerun: yes;"> </span>yang bebahaya.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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<tr style="mso-yfti-irow: 9;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">9. Tinjuan pentingnya diet yang seimbang dengan makanan yang banyak mengandung vitamin, protein, dan zat besi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">9. Meningkatkan perasaan sehat umum dan perbaikan regenerasi sel.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 10;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">10. Dorong klien yang obesitas untuk menurunkan berat badan dan berikan informasi penurunaan<span style="mso-spacerun: yes;"> </span>berat badan sesuai kebutuhan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">10. Penurunan berat badan akan mengurangi tekananan sendi, terutama pinggul, lutut,pergelanagan kaki,dan telapak kaki.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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<tr style="mso-yfti-irow: 11;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">11. Berikan informaasi mengenai alat bantu, missal bermain barang-barang yang bergerak, tongkat untuk mengambil, piring-piring ringan, tempat duduk toilet yang dapat dinaikkan, palang keamanan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">11. Mengurangin paksaan untuk menggunakan sendi dan meungkinkan individu untuk serta secara lebih nyaman dalam aktivitas yang dibutuhkan.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 12;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">12. Diskusikan teknik menghemat energy, missal duduk lebih baik daripada berdiri dalam menyiapkan makanan dan mandi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">12. Mencegah kepenatan, memberikan kemudahan perawatan diri, dan kemandirian.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 13;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">13. Dorong klien untuk mempertahankan posisi tubuh yang benar, baik saat istirahat maupun saat aktivitas, misal menjaga sendi tetap meregang tidak fleksi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">13. mekanika tubuh yang baik harus menjadi bagian dari gaya hidup lklien untuk mengurang tekanan sendi dan nyeri.<o:p></o:p></span></div></td> </tr>
<tr style="height: 75.2pt; mso-yfti-irow: 14;"> <td style="border-top: none; border: solid black 1.0pt; height: 75.2pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">14. Tinjau perlunya infeksi sering pada kulit lainnya dibawah bebet, gips, alat penyokong. Tunjukan pemberian bantalan yang tepat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 75.2pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">14.Mengurangi resiko iritasi / kerusakan kulit.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 15;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">15. Diskusikan pentingnya obat- obatan lanjutan/pemeriksaan laboratorium, misal LED, kadar salisilat, PT.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">15.Terapi obat – obatan membutuhkan pengkajian / perbaikan yang terus- menerus untuk menjamin efek optimal dan mencegah overdosis, serta efek samping yang berbahay, misal aspirin memperpanjang PT, peningkatan risiko perdarahan. Krisoterapi akan menekan trombosit, potensi risiko untuk trombositopenia.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 16;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">16. Berikan konseling seksual sesuai kebutuhan.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">16. Informasi mengenai posisi-posisi yang berbeda dan teknik dan / pilihan lain untuk pemenuhan seksual mungkin dapat meningkatkan hubungan pribadi dan perasaan harga diri / percaya diri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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<tr style="mso-yfti-irow: 17; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">17. Identifikasi sumber-sumber komunikasi, misal yayasan artritis (bila ada).<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 219.7pt;" valign="top" width="293"> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">17. bantuan / dukungan dari orang lain dapat meningkatkan pemulihan maksimal.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l31 level1 lfo66; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">IV.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Evaluasi<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .25in;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Hasil asuhan keperawatan yang diharapkan adalah sebagai berikut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l72 level1 lfo67; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Terpenuhunya penuruna dan peningkatan adaptasi nyeri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l72 level1 lfo67; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tercapainya fungsi sendi dan mencegah terjadinya deformitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l72 level1 lfo67; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tercapainya peningkatan fungsi anggota gerak yang terganggu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l72 level1 lfo67; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tercapainya pemenuhan perawatan diri. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l72 level1 lfo67; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Tercapainya penatalaksanaan pemeliharaan rumah dan mencegah penyakit degeneratif jangka panjang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 35.45pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l72 level1 lfo67; text-align: justify; text-indent: -14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6)<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Terpenuhinya pendidikan dan latihan dalam rehabilitasi.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p> </o:p></span></b><span class="Apple-style-span" style="font-family: Arial, sans-serif; font-size: 13px; line-height: 19px;"> </span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%;">BAB</span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span></b><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%;">III</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%;">PENUTUP<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l46 level2 lfo29; text-align: justify; text-indent: -21.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.1<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Kesimpulan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 14.15pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Gout adalah penyakit metebolik yang ditandai dengan penumpukan asam urat yang nyeri pada tulang sendi, sangat sering ditemukan pada kaki bagian atas, pergelangan dan kaki bagian tengah. Artritis pirai (gout) merupakan suatu sindrom klinik sebagai deposit kristal asam urat di daerah persendian yang menyebabkan terjadinya serangan inflamasi akut.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Penyebab utama terjadinya gout adalah karena adanya deposit / penimbunan kristal asam urat dalam sendi. Penimbunan asam urat sering terjadi pada penyakit dengan metabolisme asam urat abnormal dan Kelainan metaboli</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">k</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> dalam pembentukan purin dan ekskresi asam urat yang kurang dari ginjal.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify; text-indent: 13.5pt;"><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Arthritis rheumatoid adalah penyakit inflamasi nonbakterial yang bersifat sistemik, progresif, cenderung kronis yang menyerang beberapa sistem organ, dan paling sering ditemukan di sendi.</span></span><span class="apple-style-span"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"> </span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Penyebab Artritis reumatoid masih belum diketahui secara pasti walaupun banyak hal mengenai patologis penyakit ini telah terungkap. Penyakit Artritis reumatoid belum dapat dipastikan mempunyai hubungan dengan factor genetik . namun, berbagai faktor (termasuk kecenderungan genetik) bis</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">a</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"> mempengaruhi reaksi antoimun. Faktor – faktor yang berperan antara lain adalah jenis kelamin, infeksi, keturunan dan lingkungan. Dari penjelasan di atas, dapat disimpulkan bahwa faktor yang berperan dalam timbulnya penyakit Artritis reumatoid adalah jenis kelamin, keturunan, lingkungan, dan infeksi.</span><span class="apple-style-span"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p></o:p></span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l46 level2 lfo29; text-align: justify; text-indent: -21.3pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.2<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">S</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">aran<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 21.3pt; text-align: justify; text-indent: 14.7pt;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Diharapkan mahasiswa dapat memahami materi yang telah kami susun ini, dan dapat menginterpretasikan di dalam melakukan tindakan keperawatan dalam praktik, khususnya pada pasien </span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Times New Roman";">yang menagalami gangguan sistem muskuloskeletal : Gout dan Rheumatoid Arthritis, dan mampu memberikan asuhan keperawatan yang sesuai.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 13.5pt;"><br />
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</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 13.5pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p> </o:p></span><span class="Apple-style-span" style="font-family: Arial, sans-serif; font-size: 13px; line-height: 19px;"> </span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 13.5pt;"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;"><o:p> </o:p></span><span class="Apple-style-span" style="font-family: Arial, sans-serif; font-size: 13px; line-height: 19px;"> </span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 150%;">DAFTAR PUSTAKA<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l26 level1 lfo46; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Lukman, Ningsih, Nurna. 2009. <i style="mso-bidi-font-style: normal;">Asuhan Keperawatan Pada Klien Dengan Gangguan Sistem Muskuloskeletal</i>. Jilid 1. Jakarta : Salemba Medika.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l26 level1 lfo46; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Muttaqin, Arif. 2008. Buku Aajar Asuhan Keperawatan Klien Gangguan Muskuloskeletal. Cet.1. Jakarta : EGC.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l26 level1 lfo46; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;">Price, Sylvia.A. 2006. Patofisiologi : Konsep Klinis Proses-proses Penyakit. Ed.6 ; Cet.1 ; Jil.II. Jakarta : EGC.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l26 level1 lfo46; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Setiadi. 2007. <i style="mso-bidi-font-style: normal;">Anatomi dan Fisiologi Manusia</i>. Cet. 1. Yogyakarta : Graha Ilmu.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l26 level1 lfo46; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Suratun. 2008. <i style="mso-bidi-font-style: normal;">Asuhan Keperawatan Klein Gangguan Sistem Muskuloskeletal</i>. Cet. 1.<span style="mso-spacerun: yes;"> </span>Jakarta : EGC.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l26 level1 lfo46; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US;">Syaifiddin. 2006. <i style="mso-bidi-font-style: normal;">Anatomi Fisiologi Untuk Mahasiswa Keperawatan</i>. Ed.3 ; Cet. 1.<span style="mso-spacerun: yes;"> </span>Jakarta : EGC.</span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l26 level1 lfo46; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN"><a href="http://www.daviddarling.info/images/muscles_human_body_back.jpg"><span style="color: windowtext;">http://www.daviddarling.info/images/muscles_human_body_back.jpg</span></a></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l26 level1 lfo46; text-align: justify; text-indent: -14.2pt;"><span lang="IN" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><img alt="*" height="11" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="11" /><span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN"><a href="http://www.daviddarling.info/images/muscles_human_body_front.jpg"><span style="color: windowtext;">http://www.daviddarling.info/images/muscles_human_body_front.jpg</span></a></span><span lang="IN" style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 13.5pt;"><br />
</div>Ian zkate pakpahanhttp://www.blogger.com/profile/10259135788220046244noreply@blogger.com1tag:blogger.com,1999:blog-2556652656898751244.post-64468870821452659892010-10-17T12:13:00.001+07:002010-10-19T06:19:24.594+07:00ASKEP OSTEOMIOLITIS DAN BURSITIS<div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 22pt; line-height: 115%;">ASUHAN KEPERAWATAN PADA KLIEN DENGAN GANGGUAN SISTEM MUSKULOSKELETAL: OSTEOMIOLITIS DAN BURSITIS <o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 115%;">disusun untuk memenuhi tugas mata ajaran KMB III<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span class="Apple-style-span" style="font-family: 'Times New Roman', serif;"><br />
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</o:p></span></b></div><div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 115%;"><o:p><br />
</o:p></span></b></div><div align="center" class="MsoNormal" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 115%;"><o:p><br />
</o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">BAB II<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">TINJAUAN TEORITIS<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> <o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l27 level1 lfo1; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">I.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Anatomi Fisiologi System Musculoskeletal <o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diantara karakteristik yang membedakan manuasia dengan makhluk lain ialah kemampuan mempertahankan postur tubuhnya bias tegak dan bergerak yang diatur oleh system musculoskeletal. System musculoskeletal terdiri dari tulang, otot, tulang, rawan (kartilago), ligament, tendon, facia, bursae, dan persendian.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">A. Anatomi dan Fisiolofi Tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1. Anatomi Tulang <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tulang terdiri dari intra sel, baik berupa sel yang hidup maupun sel yang tidak hidup. Bahan-bahan tersebut berasal dari embrio hialin tulang rawan melalui osteogenesis kemudian menjadi tulang, proses ini oleh sel-sel yang disebut osteoblas. Kualitas kerasnya tulang merupakan hasil deposit kalsium.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Secara garis besar, tulang dibagi menjadi enam macam yaitu; (lihat Gambar 1.1)<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a. Tulang panjang (long bone), <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Misalnya femur, tibia, fibula, ulna, dan humerus. Daerah batas atas disebut diafisis dan daerah yang berdekatan dengan garis epifisis disebut metafisis. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b. Tulang pendek (short bone), misalnya tulang-tulang karpal.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c. Tulang pipih (falt bone), misalnya tulang parietal, iga, scapula, dan pelvis.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d. Tulang tak beraturan (irregular bone), misalnya tulang vertebra.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e. Tulang sesamoid, misalnya tulang patella. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f. Tulang sutura (sutural bone), ada di atap tengkorak.<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><img height="219" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image004.png" v:shapes="Picture_x0020_2" width="315" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gambar 1.1 Klasifikasi bentuk-bentuk tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tulang terdiri atas daerah yang kompak pada bagian luar yang diebut korteks dan bagian dalam (endosteum) yang bersifat spongiosa berbentuk trabekula dan diluarnya dilapisi oleh periosteum (Gambar 1.2). perosteum pada anak lebih tebal dari pada orang dewasa, yang memungkinkan penyembuhan tulang pada anak lebih cepat dibandingkan orang dewasa.</span></div><a name='more'></a><o:p></o:p><br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><img height="197" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image006.png" v:shapes="Picture_x0020_3" width="259" /> <img height="196" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image008.png" v:shapes="Picture_x0020_5" width="280" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gambar 1.2 Endosteum dan Periosteum Gambar 1.3 Struktur Tulang Panjang <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2. Histology Tulang <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berdasarkan histologinya, pertumbuhan tulang terbagi menjadi 2 jenis:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a) Tulang imatur (non-lamelar bone, woven bone, fiber bone), terbentuk pada perkembangan embrional dan tidak terlihat lagi pada usia 1 tahun. Tulang imatur mengandung jaringan kolagen,<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b) Tulang matur (mature bone, lamellar bone), ada dua jenis, yaitu tulang kortikal (kortikal bone, dense bone, compact bone) dan tulang trabekular (cancellous bone, trabecular bone, spongiosa).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Secara histologis, perbedaan tulang matur dan imatur terutama dalam jumlah sel, jaringan kolagen, dan mukopolisakarida. Diafisis atau batang merupakan bagian tengah tulang yang berbentuk silinder. Bagian ini tersusun dari tulang kortikal yang memiliki kekuatan yang besar. Metafisis adalah bagian tulang yang melebar di dekat ujung akhir batang. Daerah ini terutama disusun oleh tulang trabekular atau tulang spongiosa yang mengandung sumsum merah. Sumsum merah terdapat juga di bagian epifisis dan diafisis tulang. Pada anak-anak, sumsum merah mengisi sebagian besar bagian dalam dari tulang panjang, tetapi kemudian diganti oleh sumsum tulang kuning sejalan dengan semakin dewasanya anak tersebut. Pada orang dewasa, aktivitas hemaptopoietik menjadi terbatas hanya pada sternum dan Krista iliaka walaupun tulang yang lain masih berpotensi aktif lagi bila diperlukan. Sumsum kuning yang terdapat pada diafisis tulang orang dewasa terutama terdiri atas-sel-sel lemak.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><img height="259" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image010.png" v:shapes="Picture_x0020_6" width="438" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gambar 1.4 Anatomi Tulang dan Pertumbuhan Tulang normal.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Histoligi yang spesifik dari lempeng epifisis atau lempeng pertumbuhan ini merupakan factor yang penting untuk memahami cedera pada anak (gambar 1.4). Lapisan sel paling atas letaknya dekat epifis disebut sel istirahat. Lapisan berikutnya adalah zona proliferasi. Pada zona ini terjadi pembelahan aktif sel dan disinilah mulainya pertumbuhan tulang panjang. Sel-sel yang aktif ini didorong kearah batang tulang, ke dalam daerah hipertrofi, tempat sel-sel ini membengkak, menjadi lemah, dan secara metabolic menjadi tidak aktif. Didalam daerah kalsifikasi provisional inilah sel-sel mulai menjadi keras dan menyerupai tulang normal. Bila daerah proliferasi mengalami kerusakan, peertumbuhan dapat terhenti karena retardasi pertumbuhan longitudinal anggota gerak tersebut atau terjadi deformitas progresif bila hanya sebagai lempengan tulang yang mengalami kerusakan berat. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3. Fisiologi Sel Tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tulang adalah suatu jaringan dinamis yang tersusun dari tiga jenis sel : osteoblas, osteosit, dan osteoklas (lihat gambar 1.2)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a) Osteoblas membangun tulang dengan membentuk kolagen tipe I dan proteoglikan sebagai matriks tulang atau osteoid melalui suatu proses yang disebut osifikasi. Ketika sedang aktif menghasilkan jaringan osteoid, osteoblas menyekresikan sejumlah besar fosfatase alkali yang memegang peranan penting dalam mengendapkan kalsium dan fosfat ke dalam matriks tulang. Sebagian dari fosfatase alkai akan memasuki aliran darah sehingga kadar fosfatase alkali di dalam darah dapat menjadi indicator yang baik tentang tingkat pembentukan tulang setelah mengalami patah tulang atau pada kasus metastsis kanker tulang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b) Osteosit adalah sel tulang dewasa yang bertindak sebagai suatu lintasan untuk pertukaran kimiawi melalui tulang yang padat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c) Osteoklas adalah sel besar berinti banyak yang memungkinkan mineral dan matriks tulang dapat diabsorbsi. Tidak seperti osteoblas dan osteosit, osteoklas mengikis tulang. Sel ini menghasilkan enzim proteolitik yang memecahkan matriks dan beberapa asam yang melarutkan mineral tulang sehingga kalsium dan fosfat terlepas ke dalam aliran darah. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dalam keadaan normal, tulang mengalami pembentukan dan absorbsi pada suatu tingkat yang konstan, kecuali pada masa pertumbuhan kanak-kanak yang lebih banyak terjadi pembentukan daripada absorbsi tulang. Proses ini penting untuk fungsi normal tulang. Keadaan ini membuat tulang dapat berespon terhadap tekanan yang meningkat dan mencegah terjadi patah tulang.Bentuk tulang dapat disesuaikan untuk menanggung kekuatan mekanis yang semakin meningkat. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><img height="248" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image012.png" v:shapes="Picture_x0020_7" width="404" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gambar 1.5 Anatomi Tulang dan Pertumbuhan Tulang normal.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">B. Anatomi sendi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sendi adalah tempat pertemuan dua tulang atau lebih. Tulang-tulang ini dipadukan dengan berbagai cara, misalnya dengan kapsula sendi, pita fibrosa, ligament, tendon, fasia, atau otot. Ada tiga tipe sendi sebagai berikut.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1. Sendi fibrosa (sinartrodial), merupakan sendi yang tidak dapat bergerak. Sendi fibrosa tidak memiliki lapisan tulang lainnyya dihubungkan oleh jaringan penyambung fibrosa. Salah satu contohnya sutura pada tulang-tulang tengkorak. Contoh yang ke dua disebut sindesmosis yang teridi dari suatu membrane interoseus atau suatu ligament di antara tulang. Serat-serat ini memungkinkan sedikit gerakan, tetapi bukan gerakan sejati. Perletakan tulang tibia dan fibula bgian distal adalah contoh tipe sendi fibrosa.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2. Sendi kartilaginosa (amfiartriodial), merupakan sendi yang dapat sedikit bergerak. Sendi kartilaginosa adalah sendi yang ujung-ujung tulangnya dibungkus oleh tulang rawan hialin, disokong oleh ligament dan hanya dapat sedikit bergerak. Tipe sendi kartilaginosa terdiri dari.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kotak 1.1 Dua tipe sendi kartilaginosa.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-hyphenate: none; mso-list: l33 level1 lfo2; tab-stops: .25in list .75in; text-align: justify; text-indent: -.3in;"><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sinkondrosis adalah sendi-sendi yang diliputi tulang rawan hialin. Sendi-sendi kostokondral adalah contoh sindrokordosis.<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-hyphenate: none; mso-list: l33 level1 lfo2; tab-stops: .25in list .75in; text-align: justify; text-indent: -.3in;"><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Simfisis adalah sendi yang tulang-tulangnya memilki hubungan fibrokartilago dan selapis tipis tulang rawan hialin yang menyelimuti permukaan sendi. Simfisis pubis dan sendi-sendi pada tulang punggung adalah contohnya. <o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-hyphenate: none; mso-list: l33 level1 lfo2; tab-stops: .25in list .75in; text-align: justify; text-indent: -.3in;"><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sendi sinovial (siartrodial), merupakan sendi yang dapat digerakan degan bebas. Sendi ini memiliki rongga sendi dan permukaan sendi tulang rawan hialin. (gambar 1.7)<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><img height="248" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image014.png" v:shapes="Picture_x0020_8" width="377" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gambar 1.7. Struktur sendi normal. A , diagram sederhana sendi. B, potongan sederhana dari sendi lutut <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">C. Otot <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pembentukan dari sinsitium serat otot dengan system protein kontraktil yang kompleks melibatkan suatu seri intraksi seluler dan proses biosintesa yang unik pada jaringan ini. Otot skelet berasal dari mesoderm primitive dan pada minggu ketiga kehamilan segimen akan terbentuk. Miotuba pertama dapat dikenali pada sekitar minggu kelima. Ditemukannya kontak saraf pada serat otot yagn berkembang ini merupakan stadium kritis dalam perkembangan otot. Cabang syaraf bercabang kembali diantara otot yang berkembang selama minggu ke sebelas dari kehidupan intra uterus.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pertumbuhan otot skelet timbul sebagai akibat peningkatan jumlah serta otot dan sebagai akibat meningkatnya ukuran masing-masing serat otot pertambahan jumlah terbesar terjadi pada akhir masa awal fetal, awal masa neonatus dan masa pasca natal tampaknya berhubungan dengan kebutuhan fungsional. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Terdapat tiga varetas jaringan: Otot serat lintang (Volunter), Otot polos (Involunter) dan otot jantung.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">D. Cartilago<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Tulang rawan terdiri dari serat-serat yang dilekatkan pada suatu gelatin yang kuat tetapi flaksibel tidak memiliki vaskuler. Nutrisi mencapai kartilago melalui proses difusi gel/ perkat dari kapiler yang berkata pada perichondrium (serabut yang membentuk kartilago) melalui cairan sinovial.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">E. Ligament (Simpay)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ligament adalah suatu susunan serabut yang terdiri dari jaringan ikat keadaannya kenyal dan fleksibel. Ligament mempertemukan kedua ujung tulang dan mempertahankan stabilitas. Ligament pada daerah tertentu melengket kepada jaringan lunak untuk mempertahankan struktur.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">F. Tendon <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tendon adalah jaringan fibrosa yang padat yang merupakan ujung dari otot dan menempel pada tulang. Tendon merupakan akstensi dari selaput fibrosa yang membungkus otot dan bersambung dengan priostium. Selaput tendon berbentuk selubung dari jaringan ikat yang menyelubungi tendon tertentu, terutama pada pergelangan tangan dan tumit. Selubung imi bersambung dengan membrane synovia yang menjamin pelumasan sehingga mudah bergerak.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">G. Fascia<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Fasia adalah suatu permukaan jaringan penyambung longgar yang didapatkan langsung dibawah kulit, sebagai fascia super ficial atau sebagai pebungkus tebal jaringan penyambung fibrous yang membungkus otot, saraf dan pembuluh darah yang demikian disebut fascia dalam.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">H. Bursae <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursae adalah kantung kecil dari jaringan ikat disuatu tempat dimana digunakan diatas bagian yang bergerak. Burase dibatasi oleh membrane synovial dan mengandung cairan synovial.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursae adalah bantalan diantara bagian-bagian yang bergerak seperti pada elekranon bursae, terletak diantara processus elekranon dan kulit. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">OSTEOMIELITIS<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengertian<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Osteomielitis adalah suatu penyakit infeksi yang terjadi pada tulang. Infeksi yang mengenai tulang lebih sulit disembuhkan dari pada infeksi yang terjadi pada jaringan lunak karena terbatasnya asupan darah, respon jaringan terhadap inflamasi, tingginya tekanan jaringan dan pembentukan tulang baru disekeliling jaringan tulang mati atau involukrum(suratun. 2008)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Osteomielitis akut adalah infeksi tulang panjang yang disebabkan oleh infeksi lokal akut atau trauma tulang <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Osteomielitis adalah infeksi tulang, lebih sulit disembuhkan bila dibanding jaringan lunak karena terbatasnya jaringan asupan darah, respon jaringan terhadap inflamasi, tingginya tekanan jaringan dan pembentukan involukrum(Smeltzer, 2002)<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l23 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kesimpulan osteomielitis adalah infeksi pada tulang dan sumsum tulang yang disebabkan oleh antara lain staphylococcus aureus.(kelomok 5) <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Etiologi</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> <b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Staphylococcus aureus, meruakan penyebab 70-80% osteomielitis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Proteus<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pseudomonas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Escherichia coli <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">penyebaran hematogen <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">salmonella<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">nfeksi (misl: tonsil yang terinfeksi,gigi terinfeksi, infeksi saluran napas atas)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Infeksi dapat terjadi melalui;<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo5; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penyebaran hematogen dari fokus infeksi ditempat lain: tonsil yang terinfeksi, infeksi gigi, infeksi saluran napas bagian atas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo5; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penyebaran infeksi jaringan lunak: ulkus dekubitus yang terinfeksi atau ulkus vaskuler. <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l18 level1 lfo5; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kontaminasi langsung dengan tulang: fraktur terbuka, cidera traumatik (luka tembak, pembedahan tulang).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
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</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klasifikasi:<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l28 level1 lfo6; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Osteomielitis primer<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l28 level1 lfo6; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">ostemielitis primer penyebaranya secara hematogen dimana mikroorganisme berasal dari fokus ditempat lain dan beredar melalui sirkulasi darah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l28 level1 lfo6; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Osteomielitis sekunder(osteomielitis perkontinuitatum)<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l28 level1 lfo6; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">terjadi akibat penyebaran kuman dari srkitarnya akibat dari bisul, luka fraktur, dan sebagainya.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PATOFISIOLOGI<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Osteomielitis setelah pembedahan ortopedi dapat terjadi pada tiga bulan pertama (akut fulminan – stadium 1) yang sering berhubungan dengan penumpukan hematoma atau infeksi superfisial infeksi lambat terjadi antara 4-24 bulan setelah pembedahan (stadium 2) dan osteomielitis yang terjadi dalam waktu lama terjadi 24 bulan atau lebih setelah pembedahan ( stadium 3)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Respon awal dari infeksi adalah inflamasi, peningkatan vaskularisasi,dan edema. Dua atau tiga hari setelah pembedahan, dapat terjadi trombosis pada pembulu darah tersebut , yang mengakibatkan iskemia dengan nekrosis tulang berhubungan dengan peningkatan tekanan jaringan dan medula. Infeksi kemudian berkembang kekavitas medularis dan kebawah periosteum dan dapat menyebar ke jaringan lunak atau sendi sekitar. Bila proses infeksi dapat dikontrol lebih awal, pembentukan abses tulang dapat dicegah.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Biasanya abses dapat keluar secara spontan, namun lebih sering harus dilakukan insisi dan drainase oleh ahli bedah. Abses yang terbentuk dalam dindingnya membentuk daerah jaringan mati (sequestrum) tidak mudah mencair dan mengalir keluar. Selain itu rongga juga tidak dapat mengempis dan sembuh sepertinya terjadi pada jaringan lunak tetapi yang terjadi adalah pertumbuhan tulang baru (involukrum) yang mengelilingi sequestrum infeksius kronis yang ada tetap rentan mengeluarkan abses kambuhan sepanjang hidup klien, dan ini dinamakan osteomielitis tipe kronik.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pencegahan osteomielitis:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l22 level1 lfo7; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penangan infeksi lokal dapat menurunkanangka penyebaran hematogen.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l22 level1 lfo7; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penanganan infeksi jariingan lunak dapat mengontrol erosi tulang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l22 level1 lfo7; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lingkungan operasi dan teknik operasi dapat menurunkan insiden osteomielitis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l22 level1 lfo7; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemberian antibiotik profilaksis pada pasien pembedahan <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l22 level1 lfo7; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tehnik perawatan luka pasca operasi aseptik.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><img height="198" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image016.png" v:shapes="Picture_x0020_9" width="349" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gambar 2. Perubahan patofisiologis pada osteomyelitis yang disebabkan oleh infeksi daerah sekitar.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PATOFLOW<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e/ Mikroorganisme pathogen/ trauma<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 41px; left: 69px; position: absolute; top: -7px; width: 16px;"><img height="41" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image017.png" v:shapes="_x0000_s1027" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p> </o:p></span></div><br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">invasi jaringan lunak dan tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 40px; left: 66px; position: absolute; top: -9px; width: 16px;"><img height="40" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image018.png" v:shapes="Straight_x0020_Arrow_x0020_Connector_x0020_11" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p> </o:p></span></div><br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="height: 16px; left: 0px; margin-left: 101px; margin-top: 3px; position: absolute; width: 40px;"><img height="16" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image019.png" v:shapes="_x0000_s1028" width="40" /></span><span style="height: 16px; left: 0px; margin-left: 279px; margin-top: 4px; position: absolute; width: 48px;"><img height="16" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image020.png" v:shapes="_x0000_s1031" width="48" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">reaksi inflamasi demam, kemerahan MK: hipertermi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: .5in;"><span style="position: relative;"><span style="height: 73px; left: 69px; position: absolute; top: -13px; width: 16px;"><img height="73" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image021.png" v:shapes="_x0000_s1029" width="16" /></span></span><span style="height: 23px; left: 0px; margin-left: 186px; margin-top: 0px; position: absolute; width: 16px;"><img height="23" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image022.png" v:shapes="_x0000_s1030" width="16" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">terjadi vaskularisasi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="height: 16px; left: 0px; margin-left: 187px; margin-top: 2px; position: absolute; width: 51px;"><img height="16" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image023.png" v:shapes="_x0000_s1033" width="51" /></span><span style="height: 16px; left: 0px; margin-left: 88px; margin-top: 3px; position: absolute; width: 50px;"><img height="16" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image024.png" v:shapes="_x0000_s1038" width="50" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">edema Nyeri MK: gangguan rasa nyaman nyeri<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(terjadi penekanan edema)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 35px; left: 72px; position: absolute; top: -4px; width: 16px;"><img height="35" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image025.png" v:shapes="_x0000_s1032" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p> </o:p></span></div><br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Menurunya aliran darah<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 42px; left: 72px; position: absolute; top: -10px; width: 16px;"><img height="42" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image026.png" v:shapes="_x0000_s1035" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p> </o:p></span></div><br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">iskemik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 35px; left: 72px; position: absolute; top: -4px; width: 16px;"><img height="35" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image027.png" v:shapes="_x0000_s1034" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p> </o:p></span></div><br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="height: 4px; left: 0px; margin-left: 80px; margin-top: 23px; position: absolute; width: 268px;"><img height="4" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image028.png" v:shapes="Straight_x0020_Connector_x0020_51" width="268" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Nekrosis jaringan tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 37px; left: 74px; position: absolute; top: -6px; width: 282px;"> </span></span></div><table align="left" cellpadding="0" cellspacing="0"><tbody>
<tr> <td height="0" width="0"></td> <td width="16"></td> <td width="250"></td> <td width="16"></td> </tr>
<tr> <td height="1"></td> <td align="left" rowspan="3" valign="top"><img height="37" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image029.png" v:shapes="_x0000_s1037" width="16" /></td> </tr>
<tr> <td height="35"></td> <td></td> <td align="left" valign="top"><img height="35" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image030.png" v:shapes="_x0000_s1039" width="16" /></td> </tr>
<tr> <td height="1"></td> </tr>
</tbody></table><br />
<br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pembentukan involukrum Pembentukan squestrum dan pus<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 60px; left: 78px; position: absolute; top: -6px; width: 276px;"> </span></span></div><table align="left" cellpadding="0" cellspacing="0"><tbody>
<tr> <td height="0" width="0"></td> <td width="16"></td> <td width="244"></td> <td width="16"></td> </tr>
<tr> <td height="2"></td> <td colspan="2"></td> <td align="left" rowspan="2" valign="top"><img height="37" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image031.png" v:shapes="_x0000_s1040" width="16" /></td> </tr>
<tr> <td height="35"></td> <td align="left" rowspan="2" valign="top"><img height="58" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image032.png" v:shapes="_x0000_s1044" width="16" /></td> </tr>
<tr> <td height="23"></td> </tr>
</tbody></table><br />
<br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 2.5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">MK: Resti penyebrab infeksi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Terbentuk abses pada tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 39px; left: 79px; position: absolute; top: -10px; width: 16px;"><img height="39" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image033.png" v:shapes="_x0000_s1036" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p> </o:p></span></div><br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Abses sub periosteal<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 34px; left: 79px; position: absolute; top: -8px; width: 16px;"><img height="34" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image034.png" v:shapes="_x0000_s1042" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p> </o:p></span></div><br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="height: 4px; left: 0px; margin-left: 84px; margin-top: 25px; position: absolute; width: 237px;"><img height="4" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image035.png" v:shapes="_x0000_s1046" width="237" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Drainase pus<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 49px; left: 79px; position: absolute; top: -13px; width: 244px;"> </span></span></div><table align="left" cellpadding="0" cellspacing="0"><tbody>
<tr> <td height="0" width="0"></td> <td width="16"></td> <td width="212"></td> <td width="16"></td> </tr>
<tr> <td height="10"></td> <td align="left" rowspan="3" valign="top"><img height="49" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image036.png" v:shapes="_x0000_s1041" width="16" /></td> </tr>
<tr> <td height="37"></td> <td></td> <td align="left" valign="top"><img height="37" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image037.png" v:shapes="_x0000_s1043" width="16" /></td> </tr>
<tr> <td height="2"></td> </tr>
</tbody></table><br />
<br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Vaskularisasi baik vaskularisasi kurang baik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 39px; left: 306px; position: absolute; top: -8px; width: 16px;"><img height="39" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image038.png" v:shapes="_x0000_s1048" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p> </o:p></span></div><br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 64px; left: 76px; position: absolute; top: -30px; width: 16px;"><img height="64" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image039.png" v:shapes="_x0000_s1049" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Kematian jaringan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="position: relative;"><span style="height: 43px; left: 304px; position: absolute; top: -9px; width: 16px;"><img height="43" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image040.png" v:shapes="_x0000_s1047" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pembentukan jaringan baru <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="position: relative;"><span style="height: 37px; left: 73px; position: absolute; top: -7px; width: 16px;"><img height="37" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image041.png" v:shapes="_x0000_s1050" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> lumpuh/ amputasi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="position: relative;"><span style="height: 35px; left: 304px; position: absolute; top: -7px; width: 16px;"><img height="35" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image042.png" v:shapes="_x0000_s1051" width="16" /></span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Sembuh<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> <b style="mso-bidi-font-weight: normal;">MK: potensial cidera, cemas<o:p></o:p></b></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Perubahan konsep diri<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><img height="288" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image044.png" v:shapes="Picture_x0020_10" width="512" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gambar 1. Perbandingan antara tulang sehat dan tulang yang terinfeksi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><img height="206" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image046.png" v:shapes="Picture_x0020_11" width="451" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gambar 3. Osteomyelitis pada pria berusia 84 tahun, foto CT Scantampak sagital (a) dan axial (b) memperlihatkan fraktur pada tulang metatarsal dan sesamoid. Selain itu terdapat reaksi periosteal dan erosi pada caput metatarsal yang mengindikasikan adanya osteomyelitis.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Manifestasi klinis:<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo8; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jika infeksi hematogen, pasien demam tinggi pasien mengigil , denyut nadi cepat, dan rmalaise umum.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo8; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Setelah infeksi menyebar dari rongga sumsum kekorteks tulang, akan mengenai periostenum dan jaringan lunak. Bagian yang terinfeksi menjadi nyeri, bengkak, dan sangat nyeri tekan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo8; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jika infeksi terjadi akibat pemyebaran infeksi disekitarnya atau kontaminasi langsung, tidak dapat gejala ada gejala septikemia. Gejalanya yaitu daerah infeksi membengkak, hengat, nyeri, dan nyeri tekan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l6 level1 lfo8; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Osteomelitis kronis ditandai oleh pus yang selalu mengalir keluar dari sinus atau mengalami periode berulang nyeri, inflamasi, pembengkakan dan pengeluaran pus.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">KOMPLIKASI <o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Komplikasi osteomyelitis dapat terjadi akibat perkembangan infeksi yang tidak terkendali dan pemberian antibiotik yang tidak dapat mengeradikasi bakteri penyebab. Komplikasi osteomyelitis dapat mencakup infeksi yang semakin memberat pada daerah tulang yang terkena infeksi atau meluasnya infeksi dari fokus infeksi ke jaringan sekitar bahkan ke aliran darah sistemik. Secara umum komplikasi osteomyelitis adalah sebagai berikut:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a. Abses Tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b. Bakteremia<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c. Fraktur Patologis<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d. Meregangnya implan prosthetik (jika terdapat implan prosthetic)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e. Sellulitis pada jaringan lunak sekitar.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f. Abses otak pada osteomyelitis di daerah kranium.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan diaknostik:<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1. Pada awalnya, pemeriksaan sinar X menunjukan pembenkakan jaringan lunak. Sekitar 2 minggu terdapat daerah ireguler, nekrosis tulang, pengangkatan periosteum dan embentukan tulang baru.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2. Pemindaian untuk mengindentifikasi area infeksi. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3. MRI dapat membantu diagnostik definiti awal.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4. Pemeriksaan darah memperlihatkan peningkatan leokosit dan peningkatan laju endap darah.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5. Kultur darah dan abses diperlukan untuk menentukanjenis antibiotik yang sesuai.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan penunjang<o:p></o:p></span></b></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo9; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan darah<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sel darah putih meningkat sampai 30.000 L gr/dl disertai peningkatan laju endapan darah.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo9; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan titer antibodi – anti staphylococcus<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan Kultur darah untuk menentukan bakteri (50% positif) dan diikuti dengan uji sensitivitas.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo9; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan feses<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan feses untuk kultur dilakukan apabila terdapat kecurigaan infeksi oleh bakteri Salmonella.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo9; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan Biopsi tulang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo9; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan ultrasound<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan ini dapat memperlihatkan adanya efusi pada sendi.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo9; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan radiologis<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan photo polos dalam 10 hari pertama tidak ditemukan kelainan radiologik, setelah dua minggu akan terlihat berupa refraksi tulang yang bersifat difus.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penatalaksanaan terhadap osteomielitis:<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a) Intervensi non operatif<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1. Daerah yang terkena diimobilisasi untuk mengurangi ketidaknyamanan dan mencegah terjadinya fraktur.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2. Lakukan rendaman salin hangat selama 20 menit beberapa kali sehari untuk meningkatkan aliran darah.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3. Sasaran awal terapi adalah mengontrol dan menghentikan proses infeksi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4. Berdasarkan hasil kultur, dimulai pemberian antibiotik intravena, jika infeksi tampak terkontrol dapat diberikan per oral dan dilanjutkan sampai 3 bulan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5. Pembedahan dilakukan jika tidak menunjukan respon terhadap antibiotik.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6. Lakukan irigasi dengan larutan salin fisiologi steril 7-8 hari pada jaringan purulen dan jaringan nekrotik diangkat. Terapi antibiotik dilanjutkan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b) Intervensi operatif<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1. Sequestrektomi <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Karena tulang tidak bias mengalami penyembuhan pada keadaan terdapat nya jarinngan necrotic,sequestra dibuang melalui melalui debridement pada tulang yang mengalami infeksi sehingga terjadi revaskularisasi pada jaringan tulang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2. Bone grafts <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Terdapat tiga fase yang dilakukan pembedahan, mengeksisi tulang yang mengalami nekrotik, memasang tulang grafts tulang dan menutupi kulit tulang yang sering diambil oleh dokter adalah tulang ileum posterior dari klien sendiri, tulang diletakan pada tempat yang telah dibuat dan dilakukan balutan dilakukan dalam ruangan operasi dibawah kondisi yang steril, perawatan luka setiap harinya dilakukan hingga sekitar 2 minggu sambil grafts yang dipasang stabil.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3. Bone segment transfer<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pada umumnya transfer tulang dilakukan pada gangguan skeletal yang meluas umumnya tempat donor difibula dan iliaka. Grafts tulang ini dapat mengenai oto atau kulit.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.0pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l33 level1 lfo2; tab-stops: list 27.0pt; text-align: justify; text-indent: -13.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Amputasi <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bila prosedur pembedahan tidak berhasil atau kurang akurat maka tindakan amputasi adalah pilihan terakhir. Konsekuensi bagi perawatan sebagai komplek s tetapi yang paling sering adalh memunculkan masalah konsep diri klien terutama body imagenya.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">ASUHAN KEPERAWATAN <o:p></o:p></span></b></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo10; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengkajian <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Pasien dengan gejala akut dapat mengalami nyeri lokal, pembengkakan eritema, dan demam. Gejala kekambuhan meliuti keluarnya pus dari sinus disertai nyeri, pembengkakan, dan demam sedang. Kaji adanya faktor risiko yang mencsngkup lansia diabetes dalam terapi kortikosteroid jangka panjang, cidera, infeksi atau bedah ortopedi sebelumnya. Pasien selalu menghindar jika diberi tekanan didaerah yang sakit dan melakukan gerakan perlindungan. Pemeriksaan fisik memperlihatkan adanya daerah inflamasi, pembengkakan nyata, hangat, dan nyeri tekan cairan purulean dapat terlihat dan peningkatan suhu tubuh. Pada osteomielitis, kronik peningkatan suhunya minimal yang terjadi pada sore dan malam <o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo10; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan fisik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Area sekitar tulang yang terinfeksi menjadi bengkak dan terasa lembek bila dipalpasi. Bias juga terjadi eriteme atau kemerahan dan panas efek sistemik menunjukan adany demam biasanya diatas 380C,takikardi, irritable, lemah ,bengkak, maupun eritema.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo10; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasien sering kali merasa ketakutan, kawatir infeksinya tidak dapat sembuh takut<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">diamputasi, biasanya pasien dirawat lama dirumah sakit sehingga perawat perlu mengkaji perubahan –perubahan kehidupan khususnya hubungannya dengan keluarga, pekerjaan aatu sekolah. Klien bias merasa terisolir dari yang lain dan terjadi perubahan konsep diri.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo10; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan diagnostic<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hasil laboratorium menunjukan adanya lekositosis dan laju endap darah meningkat. 50% pasien yang mengalami infeksi hematogenous secara dini adanya osteomielitis maka dilakukan scanning tulang. Elain itu dapat pula dengan biopsy tulang atau MRI.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DIAGNOSA KEPERAWATAN <o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berdasarkan pengkajian data , diagnosis keperawatan yang timbul meliputi:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1. Nyeri yang berhubungan dengan inflamasi dan pembengkakan <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2. Hambatan mobilitas fisik yang berhubungan dengan nyeri dan keterbatasan beban berat badan. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3. Risiko penyebaran infeksi : pembentukan abses tulang. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4. Kurang pengetahuan mengenai program pengobatan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 2.75pt; width: 666px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border-right: none; border: solid black 1.0pt; mso-border-bottom-alt: solid black .25pt; mso-border-left-alt: solid black .25pt; mso-border-top-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 140.25pt;" valign="top" width="187"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Diagnosa keperawatan</div></td> <td style="border-right: none; border: solid black 1.0pt; mso-border-bottom-alt: solid black .25pt; mso-border-left-alt: solid black .25pt; mso-border-top-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 146.25pt;" valign="top" width="195"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Tujuan keperawatn</div></td> <td style="border: solid black 1.0pt; mso-border-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 213.05pt;" valign="top" width="284"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Intervensi keperawatan</div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-bottom: solid windowtext 1.0pt; border-left: solid black 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .5pt; mso-border-left-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 140.25pt;" valign="top" width="187"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Nyeri berhubungan dengan inflamasi dan pembengkakan </div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: solid black 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .5pt; mso-border-left-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 146.25pt;" valign="top" width="195"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Nyeri dapat teratasi</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: solid black 1.0pt; border-right: solid black 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .5pt; mso-border-left-alt: solid black .25pt; mso-border-right-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 213.05pt;" valign="top" width="284"><div class="TableContents" style="layout-grid-mode: char; margin-left: .5in; mso-list: l0 level1 lfo11; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Kaji tingkat dan intervensi nyeri</div><div class="TableContents" style="margin-left: .5in; mso-list: l0 level1 lfo11; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>lakukan imobilisasi dengan bidai untuk mengurangi dan spasme otot.</div><div class="TableContents" style="margin-left: .5in; mso-list: l0 level1 lfo11; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Tinggikan ekstermitas yang nyeri hal tersebut dapat mengurangi pembengkakan dan nyeri yang terjadi.</div><div class="TableContents" style="margin-left: .5in; mso-list: l0 level1 lfo11; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Pantau status neurovaskuler ekstermitas yang terkena.</div><div class="TableContents" style="margin-left: .5in; mso-list: l0 level1 lfo11; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Ajarkan tehnik relaksasi untuk mengurangi persepsi nyeri.</div><div class="TableContents" style="margin-left: .5in; mso-list: l0 level1 lfo11; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Kolaborasi dalam pemberian analgetik sesuai program terapi.</div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .25pt; mso-border-top-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 140.25pt;" valign="top" width="187"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Hambatan mobilisasi fisik yang berhubungan dengan nyeri dan keterbatasan beban berat badan..</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .25pt; mso-border-left-alt: solid black .25pt; mso-border-top-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 146.25pt;" valign="top" width="195"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Dapat melakukan mobilitas fisik</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .25pt; mso-border-left-alt: solid black .25pt; mso-border-top-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 213.05pt;" valign="top" width="284"><div class="TableContents" style="layout-grid-mode: char; margin-left: .5in; mso-list: l1 level1 lfo12; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Lakukan imobilisasi dengan mengunakan bidai karena tulang lemah akibat proses infeksi.</div><div class="TableContents" style="margin-left: .5in; mso-list: l1 level1 lfo12; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Jelaskan mengunakan alat bantu jika akan melakukan aktivitas untuk menghindari stres pada tulang akibat tumpuan beban berat badan.</div><div class="TableContents" style="margin-left: .5in; mso-list: l1 level1 lfo12; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Jelaskan pada pasie pentingnya pembatasan aktivitas</div><div class="TableContents" style="margin-left: .5in; mso-list: l1 level1 lfo12; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>anjurkan partisipasi aktif dalam kehidupan sehari-hari sesuai kemampuan untuk mempertahankan rasa sehat secara umum.</div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .25pt; mso-border-top-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 140.25pt;" valign="top" width="187"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Resiko penyebaran infeksi: pembentukan abses tulang.</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .25pt; mso-border-left-alt: solid black .25pt; mso-border-top-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 146.25pt;" valign="top" width="195"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Tidak terjadi penyebaran infeksi.</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .25pt; mso-border-left-alt: solid black .25pt; mso-border-top-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 213.05pt;" valign="top" width="284"><div class="TableContents" style="layout-grid-mode: char; margin-left: .5in; mso-list: l2 level1 lfo13; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Pantau respon terhadap terapi antibiotik </div><div class="TableContents" style="margin-left: .5in; mso-list: l2 level1 lfo13; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>observasi tempat pemasangan infus</div><div class="TableContents" style="margin-left: .5in; mso-list: l2 level1 lfo13; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>pantau tanda vital, peningatan suhu merupakan indikator terjadinya penyebaran infeksi. </div><div class="TableContents" style="margin-left: .5in; mso-list: l2 level1 lfo13; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Pantau adanya tanda-tanda penyebaran infeksi. </div><div class="TableContents" style="margin-left: .5in; mso-list: l2 level1 lfo13; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Pantau nutrisi diet protein seimbang, vitamin C, dan vitamin D untuk menyakinkan adanya keseimbangan nitrogen dan merangsang penyembuhan.</div><div class="TableContents" style="margin-left: .5in; mso-list: l2 level1 lfo13; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Pantau hasil peperiksaan leukosit dan laju endap darah (LED)serta biakan darah.</div><div class="TableContents" style="text-align: justify;"><br />
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<tr style="mso-yfti-irow: 4; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .25pt; mso-border-top-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 140.25pt;" valign="top" width="187"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Kurang pengetahuan mengenaiprogram pengobatan</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .25pt; mso-border-left-alt: solid black .25pt; mso-border-top-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 146.25pt;" valign="top" width="195"><div class="TableContents" style="layout-grid-mode: char; text-align: justify;">Pengetahuan pasein meningkat.</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .25pt; mso-border-left-alt: solid black .25pt; mso-border-top-alt: solid black .25pt; padding: 2.75pt 2.75pt 2.75pt 2.75pt; width: 213.05pt;" valign="top" width="284"><div class="TableContents" style="layout-grid-mode: char; margin-left: .5in; mso-list: l3 level1 lfo14; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Jelaskan tentang penyakitnya</div><div class="TableContents" style="margin-left: .5in; mso-list: l3 level1 lfo14; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>jelaskan pada pasein dan keluargar tentang program pengobatan yang diberikan.</div><div class="TableContents" style="margin-left: .5in; mso-list: l3 level1 lfo14; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Jelaskan pentingnya diet protein seimbang serta vitamin C dan D. </div><div class="TableContents" style="margin-left: .5in; mso-list: l3 level1 lfo14; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>lingkungan rumah harus kondusif terhadap promosi kesehatan dan sesuai dengan terapeutik </div><div class="TableContents" style="margin-left: .5in; mso-list: l3 level1 lfo14; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>jelaskan pentingnya imobilisasi dan cara pengunaan alat bantu</div><div class="TableContents" style="margin-left: .5in; mso-list: l3 level1 lfo14; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Ajarkan cara perawatan luka steril dan tehnik kompres hangat.</div><div class="TableContents" style="margin-left: .5in; mso-list: l3 level1 lfo14; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Pasien diminta untuk melakukan observasi dan melaporkan jika terjadi peningkatan suhu,keluarnya pus, bau, dan bertambahnnya inflamasi.</div><div class="TableContents" style="margin-left: .5in; mso-list: l3 level1 lfo14; tab-stops: list .5in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings;">u<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span>Jelaskan waktu untuk kontrol kembali kerumah sakit.</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">BURSITIS<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengertian <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo15; tab-stops: .25in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis adalah peradangan pada bursae yang disertai rasa nyeri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo15; tab-stops: .25in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis adalah peradangan bursae, sedikit cairan rongga yang berbentuk kantong diantara dua jaringan lunak pada persendian. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo15; tab-stops: .25in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursa adalah kantong datar yang mengandung cairan sinovial yang memudahkan pergerakan normal dari beberapa sendi dan berfungsi sebagai bantalan sendi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo15; tab-stops: .25in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis adalah peradangan bursa, yang terjadi pada tempat perlekatan tendon atau otot dengan tulang oleh sebab yang belum diketahui dengan pasti.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo15; tab-stops: .25in; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jadi Bursitis adalah suatu keadaan dimana terjadi peradangan pada bursae yang disertai rasa nyeri dan tidak diketahui penyebabnya secara pasti.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">persendian yang terserang adalah bahu, siku, pinggul, panggul, lutut,jari kaki, dan tumit. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursa bahu adalah tempat yang aling sering terserang pada beberaa keadaan, bursitis didahului oleh tendonsitis.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Etiologi:<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> penyebab bursitis sering kali tidak diketahui, tetapi dapat disebabkan oleh penguna sebagian anggota tubuh yang berlebihan selama bertahun-tahun, cidera, penyakit guot, pseudogout, artristis reumatiod dan infeksi bursitis terbagi menjadi dua : yaitu bursitis akut dan kronik ang biasanya disebabkan ttrauma, terkilir, dan peregangan sendi yang berlebihan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penyebabnya sering kali tidak diketahui, tetapi burnitis dapa disebabkan oleh :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo16; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Cedera <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo16; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gout<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo16; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pseudogout<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo16; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Arthritis rematoid<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo16; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Infeksi akut dan kronik sekitar sendi misalnya karena luka tembus.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo16; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Trauma terus menerus(berulang) dan strain<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo16; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Akibat kondisi arthritis<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Yang paling mudah terkena bursitis adalah bahu, bagian tubuh lainnya yang juga terkena bursitis adalah sikut, pinggul, lutut, jari kaki, dan tumit.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursa yang sering terkena adalah :<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l31 level1 lfo17; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursa sub akromial dan bursa deltoid pada bahu yaitu bursa yang paling penting dalam tubuh, inflamasi pada bursa ini menimbulkan perasaan nyeri akut serta pergerakan yang terbatas terutama gerakan abduksi pada sendi bahu, dan nyeri menetap pada insersi deltoid terutama pada malam hari. Sering kali sekunder akibat robeknya bungkus rotator yang terjadi tanpa di ketahui.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l31 level1 lfo17; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bunion bursitis yaitu daerah pembengkakan yang mengeras pada permukaan metakarpofalangeal I. penanggulangan dengan aspirasi cairan pada bagian yang membengkak dan suntikan kortikosteroid local.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l31 level1 lfo17; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis Achilles yang terdapat pada perlekatan tendon Achilles dengan tulang kallaneus (retrokalkaneal bursa) dan di antara bursa tersebut dan kulit (bursa sub kutaneous). Menimbulkan rasa nyeri di daerah tersebut terutama pada kalkaneus posterior. Mudah untuk melakukan suntikan kortikosteroid dan xilokain pada daerah pembengkakan di sini, tetapi harus hati-hati tidak boleh ada bolus pada tendon untuk menghindari risiko rupture.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l31 level1 lfo17; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Heel spur bursitis. Menimbulkan rasa nyeri pada daerah tumit. Suntikan local kortikosteroid dan atau lidokain sangat membantu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l31 level1 lfo17; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Anserin bursitis, sering disalah tafsirkan sebagai osteortritis karena dijumpai pada wanita tua bertubuh gemuk, yaitu berupa rasa nyeri, tegang (tender) dan kadang-kadang membengkak dan terasa panas di daerah lutut bagian medial inferior, distal garis sendi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l31 level1 lfo17; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis pre patellar (house maid’s knee dengan keluhan yang khas pada lutut, yaitu rasa nyeri sewaktu berlutut, terasa kaku, bengkak dan berwarna merah pada bagian anterior lutut (patela). Penyebab yang paling sering karena lutut sering bertumpu pada lantai. Berbeda dengan sinovitis pada lutut yang menimbulkan pembengkakan di daerah belakang bagian pinggir lutut.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l31 level1 lfo17; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis olekranon, terdapat pada puncak siku (tip). Hal ini sering terjadi pada posisi dengan menggunakan siku atau sering jalan tiarap. Walaupun inflamasinya jelas tetapi kadang-kadang rasa nyeri hanya minimal. Juga dapat timbul pada artristis rheumatoid, gout, akibat trauma dan infeksi. Pencegahan dilakukan dengan memakai alas karet busa untuk protektif. Kalau perlu dapat diberi suntikan local kortikosteroid.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l31 level1 lfo17; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis kalkaneal, ada 3 bursa di sekeliling kalkanrus yang dapat mengalami inflamasi dan menimbulkan rasa sakit yaitu : Bursitis retro kalkaneal pada bagian anterior Achilles.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Bursitis post kalkaneal pada bagian posterior Achilles <o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l10 level1 lfo18; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis sub kalkaneal pada bagian inferior tulang kalkaneus. Bursitis yang berulang-ulang ditempat ini dapat mengakibatkan tebdnitis pada Achilles dan dapat mengakibatkan rupture tendon<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l10 level1 lfo18; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis pada ibu jari metakarpofangeal I, kelingking dan tumit. Hal ini terutama di sebabkan ukuran sepatu yang tidak sesuai.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l10 level1 lfo18; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">§<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis hip (pada pinggul), ada 3 yang terpenting yaitu :<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">bursitis trokanter, pada inseri otot gluteus medius di trokanter femur, menimbulkan rasanyeri padabagian lateral pinggul sebelah bawah trokanter dan dapat menjalar ke bawah, ke kaki atau lutut Rasa nyeri istimewa pada malam hari dan bertamnah nyeri kalau dibengkokkan, rotasi interna atau kalau mendapat penekanan di daerah trokanter tersebut dijumpai otot-otot menegang kaku. Dan pada foto roentgen terlihat adanya deposit kalsium. Penanggulangan dengan suntikan local lidocain 1%.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Bursitis iliopektineal, menimbulkan rasa nyeri dan tegang di daerah lateral segi tiga skarpa (daerah segi tiga yang dibatasi oleh ligament inguinal, <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tanda dan Gejala<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gejala utama pada bursitis pada umunya berupa:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo19; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">pembengkakan lokal,<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo19; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">panas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo19; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">merah<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo19; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">nyeri. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis menyebabkan nyeri dan cenderung membatasi pergerakan, tetapi gejala yang khusus tergantung kepada lokasi bursa yang meradang. Jika bursa di bahu meradang, maka jika penderita mengangkat lengannya untuk memakai baju akan mengalami kesulitan dan merasakan nyeri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klasifikasi:<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .25in;"><i style="mso-bidi-font-style: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis akut<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l16 level1 lfo20; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">terjadinya secara mendadak.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l16 level1 lfo20; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jika disentuh atau digerakan akan timbul nyari didaerah yang meradang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l16 level1 lfo20; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kulit diatas bursa tampak kemerahan dan membengkak.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l16 level1 lfo20; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis akut yang disebabkan oleh suatu infeksi atau gaut menyebabkan nyeri yang luar biasa dan daerah yang terkena tampah kemerahan dan teraba hangat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis akut terjadi secara mendadak.Jika disentuh atau digerakkan, akan timbul nyeri di daerah yang meradang. Kulit diatas bursa tampak kemerahan dan membengkak. Bursitis akut yang disebabkan oleh suatu infeksi atau gout menyebabkan nyeri luar biasa dan daerah yang terkena tampak kemerahan dan teraba hangat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .25in;"><i style="mso-bidi-font-style: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis kronik<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l9 level1 lfo21; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Merupakan akibat dari seranganbursitis akut sebelumna atau cidera yang berulang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l9 level1 lfo21; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pada akhirnya dinding bursa akan menebal dan didalamnya terkumpul endaan kalsium adat yang meneruai kapur.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l9 level1 lfo21; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursa yang telah mengalami kerusakan sangat peka terhadap peradangan tambahan .<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis kronis merupakan akibat dari serangan bursitis akut sebelumnya atau cedera yang berulang. Pada akhirya, dinding bursa akan menebak dan di dalamnya terkumpul endapan kalsium padat yang menyerupai kapur. Bursa yang telah mengalami kerusakan sangat peka terhadap peradangan tanbah. Nyeri menahun dan pembengkakan bisa membatasi pregerakan, sehingga otot mengalami penciutan (atrofi) dan menjadi lemah. Serangan bursitis kronis berlangsung selama beberapa hari sampai beberapa minggu dan sering kambuh.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PATOFISIOLOGI<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Garis sinovial dari pundi bursa meradang, akibat nya cairan sinovial diproduksi lebih banyak, sehingga bursa membengkak. Kadang-kadang terkumpul sisa kalsium. Pembengkakan disertai nyeri dan terbatasnya gerakan seni atau ekstermitas.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Adapun nyeri yang sering terkena atau bursitis yang sering terjadi adalah:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1) Sendi bahu ( yang paling sering terserang) yaitu bursa subdeltoid dan subkromial ang menimbulkan rasa nyari akut serta argarakan yang terbatas pada sendi bahu. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2) Sendi Achilles, yaitu adanya erlekatan tendon Achilles dengan tulang kalkaneus terutama pada kalkaneus posterior.keadaan tersebut dinamakan bursitis archilles.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3) Tuamit, yang disebut Heal Spur Bursitis ang menimbulkan nyeri ada tumit.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4) Bursitis prepatelar dengan gejala nyeri sewaktu berlutut dan rasa kaku, bengkak, dan kemerahan pada bagian anterior lutut. Keadaan ini biasanya terjadi bila sering berlutut.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5) Bursitis olec ranon yang terjadi pada puncak siku<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6) Bursitis pada panggul<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7) Bursitis pada pergelangan kaki.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><img height="227" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image048.png" v:shapes="Picture_x0020_12" width="267" /></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> <img height="221" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image050.png" v:shapes="Picture_x0020_13" width="300" /><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Manifestasi klinis:<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tanda dan gejala bursitis dapat dibedakan kedalam kondisi akut dan kronik:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l15 level1 lfo22; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis akut<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l21 level1 lfo23; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Nyeri hebat dan dapat menyebar pada sekitar sendi/ bursa yang terinfeksi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l21 level1 lfo23; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Teraba lunak pada area terinfeksi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l21 level1 lfo23; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lingkup gerak sendi (ROM) terbatas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l15 level1 lfo22; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bursitis kronis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l4 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Nyeri terjadi pada saat pergerakan ekstermitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l4 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kulit berwarna kemerahan dan panas <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l4 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Terjadi pembengkakan dan teraba lunak.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Tanda dan gejala bursitis menurut long( 1996), adalah rasa nyeri yang dalam pada daerah bursa, nyeri bila digerakkan, nyeri terasa bila sendi yang terserang di gerakan dan keterbatasan gerakan aktif dan pasif. Demikian pula pendapat smeltzer (2002), manifestasi klinis bursitis berupa nyeri dalam bahu, dan nyeri pada gerakan rotasi lengan. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Bursitis menyebabkan nyeri dan cenderung membatasi pergerakan tetapi gejalanya yang khusus bergantung pada lokasi bursa yang meradang. Jika bursa dibahu di bahu meradang maka saat penderita mengangkat lengannya untuk memakai baju akan mengalami kesulitan dan merasakan nyeri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Hampir semua kasus bursitis subakromial didahului oleh tendonitis dan tenosinovitis rotator cuff , tendon biseps, dan pembungkusnya atau suat proses inflamasi pada tulang atau sendi, penyebaran inflamasi kebursa merupakan peristiwa sekunder.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Komplikasi <o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l20 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Terjadinya Bursitis kronis <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l20 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Terlalu banyak suntikan steroid selama waktu singkat dapat menyebabkan cedera pada tendon sekitarnya. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tes diognostik:<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l17 level1 lfo26; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Laboratorium: leukosit meningkat<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l17 level1 lfo26; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">X-Ray : untuk mengetahui lasnya sendi yang terserang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penatalaksanaan:<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l14 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan kompres dingin dengan fase akut, untuk menekan rasa tidak nyaman dan nyeri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l14 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hindarkan dari panas, karena dapat meningkatkan produk cairan pada bursa saat fase peradangan. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l14 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan obat-obat antiradang sesuai indikasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l14 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Adrenokortikosteroid dapat disuntikan kedalam bursa sesuai indikasi <o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l14 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pembedahan dapat dilakukan bila ada indikasi ( massa kalsium) <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Terapi fisik dilakukan untuk mengembalikan fungsi sendi. Latihan sendi bisa membantu mengembalikan kekuatan otot dan daya jangka sendi. Bursitis dapat kambuh jika penyebabnya tidak diatasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">B. Konsep Keperawatan<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">I. Pengkajian<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1. Biodata : Jenis kelamin, dan usia<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2. Keluhan utama : Nyeri, pembengkakan, panas, merah.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3. Riwayat penyakit sekarang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4. Riwayat penyakit dahulu : Apakah klien pernah menderita artitis rematoid, gaut, apakah pernah cedera atau koma<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5. Riwayat penyakit keluarga<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6. Pola mobilitas fisik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7. Pola perawatan diri<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dalam pemenuhan perawatan diri (mandi, gosok gigi, mencuci rambut) mengalami keterbatasan karena nyeri tersebut.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l29 level1 lfo28; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">8.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Konsep diri<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dengan penyakit bursitis akut maupun kronis sering mengalami nyeri sehingga gambaran dirinya terganggu.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">II. DIAGNOSA KEPERAWATAN<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">A. Gangguan rasa nyaman (nyeri) yang berhubungan dengan agen pencedera : Disertai jaringan oleh akumulasi cairan / proses inflamasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Setelah dilakukan tindakan keperawatan dalam waktu 3 x 24 jam nyeri berkurang atau hilang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kriteria hasil:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l7 level1 lfo29; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien mengatakan nyeri berkurang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l7 level1 lfo29; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien tampak dan mampu tidur atau istirahat dengan tepat.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: .2in; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 480;"><tbody>
<tr style="height: 20.3pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; height: 20.3pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 206.2pt;" valign="top" width="275"><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">INTERVENSI<o:p></o:p></span></b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; height: 20.3pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 235.65pt;" valign="top" width="314"><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">RASIONAL<o:p></o:p></span></b></div></td> </tr>
<tr style="height: 332.2pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; height: 332.2pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 206.2pt;" valign="top" width="275"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l13 level1 lfo30; tab-stops: list .3in; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji lokasi, intensitas dan derajat nyeri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l13 level1 lfo30; tab-stops: list .3in; text-align: justify; text-indent: -.45in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan posisi yang nyaman.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l13 level1 lfo30; tab-stops: list .3in; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan kasur busa atau bantal air pada bagian yang nyeri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-list: l13 level1 lfo30; tab-stops: list .3in; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ajarkan teknik relaksasi dan distraksi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l13 level1 lfo30; tab-stops: list .3in; text-align: justify; text-indent: -.45in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kolaborasi pemberian aspirin.<o:p></o:p></span></div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 332.2pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 235.65pt;" valign="top" width="314"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo30; tab-stops: list 21.8pt; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Membantu dalam menentukan kebutuhan manajemen nyeri dan keafektifan program.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo30; tab-stops: list 21.8pt; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pada penyakit berat / eksaserbasi, tirah baring mungkin diperlukan untuk membatasi nyeri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo30; tab-stops: list 21.8pt; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengistirahatkan sendi-sendi yang sakit dan mempertahankan posisi netral.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo30; tab-stops: 6.05pt list 21.8pt; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meningkatkan relaksasi / mengurangi tegangan otot.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 12.8pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-list: l13 level2 lfo30; tab-stops: list 21.8pt; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Aspirin bekerja sebagai anti dan efek analgetik ringan dalam mengurangi kekakuan dan meningkatkan mobilitas.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">B. Gangguan inteloriensi aktifitas yang berhubungan dengan kelemahan/ keletihan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan : Klien dapat melakukan aktifitasnya setelah dilakukan tindakan keperawatan 3x 24 jam.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kriteria hasil :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l19 level1 lfo31; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dapat melakukan aktifitas sehari-hari sesuai dengan tingkat kemampuan<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l19 level1 lfo31; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dapat mengidentifikasikan faktor-faktor yang menurunkan toleriansi aktifitas<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 480;"><tbody>
<tr style="height: 21.05pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; height: 21.05pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 225.2pt;" valign="top" width="300"><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">INTERVENSI<o:p></o:p></span></b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; height: 21.05pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 225.6pt;" valign="top" width="301"><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">RASIONAL<o:p></o:p></span></b></div></td> </tr>
<tr style="height: 257.95pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; height: 257.95pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 225.2pt;" valign="top" width="300"><ol start="1" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l26 level1 lfo32; tab-stops: list .5in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Evaluasi laporan kelemahan, perhatikan ketidak mampuan untuk berpartisipasi dalam aktifitas sehari-hari<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l26 level1 lfo32; tab-stops: list .5in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan lingkungan tenang dan periode istirahat tanpa gangguan<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l26 level1 lfo32; tab-stops: list .5in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pertahankan istirahat tirah baring / duduk jika diperlukan<o:p></o:p></span></li>
</ol><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><ol start="4" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-list: l26 level1 lfo32; tab-stops: list .5in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan lingkungan yang aman<o:p></o:p></span></li>
</ol></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 257.95pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 225.6pt;" valign="top" width="301"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-list: l26 level2 lfo32; tab-stops: list 21.8pt; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien menunjukkan kelemahannya berkurang dan dapat melakukan aktifitasnya<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 3.8pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-list: l26 level2 lfo32; tab-stops: list 21.8pt; text-align: justify; text-indent: -68.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menghemat energi untuk aktifitas<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-list: l26 level2 lfo32; tab-stops: list 21.8pt; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Istirahat sistemik dianjurkan selama eksaserbasi dan seluruh fase penyakit yang penting mencegah kelemhan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-list: l26 level2 lfo32; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menghindari cedera akibat kecelakaan <o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">C. Gangguan inteloriensi aktifitas yang berhubungan dengan kelemahan/ keletihan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan : Klien dapat melakukan aktifitasnya setelah dilakukan tindakan keperawatan 3x 24 jam.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kriteria hasil :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l34 level1 lfo33; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dapat melakukan aktifitas sehari-hari sesuai dengan tingkat kemampuan<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l34 level1 lfo33; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dapat mengidentifikasikan faktor-faktor yang menurunkan toleriansi aktifitas.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><table align="left" border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 5.4pt; margin-left: 6.75pt; margin-right: 6.75pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-anchor-horizontal: column; mso-table-anchor-vertical: paragraph; mso-table-left: left; mso-table-lspace: 9.0pt; mso-table-overlap: never; mso-table-rspace: 9.0pt; mso-table-top: .05pt; mso-yfti-tbllook: 480;"><tbody>
<tr style="height: 21.15pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid windowtext 1.0pt; height: 21.15pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 224.1pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; mso-element-anchor-horizontal: column; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-top: .05pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">INTERVENSI<o:p></o:p></span></b></div></td> <td style="border-left: none; border: solid windowtext 1.0pt; height: 21.15pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 224.5pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; mso-element-anchor-horizontal: column; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-top: .05pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">RASIONAL<o:p></o:p></span></b></div></td> </tr>
<tr style="height: 258.6pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; height: 258.6pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 224.1pt;" valign="top" width="299"><ol start="1" style="margin-top: 0in;" type="1"><li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: column; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-top: .05pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l5 level1 lfo34; tab-stops: list .5in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kajian keterbatasan klien dalam peraatan diri.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: column; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-top: .05pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l5 level1 lfo34; tab-stops: list .5in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pertahankan mobilitas, control terhadap nyeri dan program latihan.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: column; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-top: .05pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l5 level1 lfo34; tab-stops: list .5in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji hambatan terhadap partisipasi dan perawatan diri.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: column; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-top: .05pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l5 level1 lfo34; tab-stops: list .5in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Konsul dengan ahli terapi okulasi.<o:p></o:p></span></li>
</ol></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 258.6pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 224.5pt;" valign="top" width="299"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: column; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-top: .05pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l5 level2 lfo34; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mungkin dapat melanjutkan aktifitas umum dengan melakukan adaptasi yang dilakukan pada saaat ini.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: column; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-top: .05pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l5 level2 lfo34; tab-stops: list 21.8pt; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mendukung kemandirian fisik / emosional.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: column; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-top: .05pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l5 level2 lfo34; tab-stops: list 21.8pt; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menyiapkan untuk meningkatkan kemandirian, yang akan meningkatkan harga diri.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.8pt; margin-right: 0in; margin-top: 0in; mso-element-anchor-horizontal: column; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-top: .05pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; mso-list: l5 level2 lfo34; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berguna untuk menentukan alat bantu utnuk memenuhi kebutuhan individu.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">BAB III<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PENUTUP<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; mso-list: l5 level7 lfo34; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">A.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Simpulan<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penyakit dengan gangguan system muskulus skeletal sehubungan dengan peradangan seperti osteomielitis dan bursitis dapat menimbulkan gejala atau keluhan yang progresif antara lain; nyeri hebat, kulit kemerahan, bahkan sampai terjadi deformitas tulang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Oleh karena itu sebagai tenaga kesehatan harus memahami dulu konsep asuhan keperawatan sebelum memberikan asuhan keperawatan, sehingga asuhan keperawatan yang diberikan sesuai dengan konsep yang ada, efektif dan efesien <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dengan demikien keperawatan kesehatan mesyarakat dapat ditingkatkan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: 4.5pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">B.Saran<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-indent: 4.5pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> </span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Semoga apa yangkami sajikan dapat bermanfaat dalam melakukan asuhan keperawatan pada klien dengan gangguan muskuluskeletal: Osteomiolitis dan Bursitis.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DAFTAR PUSTAKA<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l32 level1 lfo35; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Arif, Mutaqin.2008. Buku Ajar Asuhan Keperawatan Klien dengan Gangguan Sistem<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Muskuluskeletal, cet 1. Jakarta : EGC.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l32 level1 lfo35; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Brunner,Suddarth, (2001) Buku Ajar Keperawatan-Medikal Bedah, Edisi 8 Volume 3, EGC : Jakarta<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l32 level1 lfo35; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Doenges, Marilynn E, dkk, (2000), Penerapan Proses Keperawatan dan Diagnosa<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Keperawatan, EGC ; Jakarta.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l32 level1 lfo35; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">http://harnawatiaj.wordpress.com<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l32 level1 lfo35; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">htt:/wwwMediacastur. Com<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l32 level1 lfo35; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lukman.2009. Asuhan keperawatan pada klien dengan gangguan sistem muskuluskeletal. Salemba media. Jakarta .<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l32 level1 lfo35; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rumahorto,hotman,Skp.Ms.2000.Anatomi Fisiologi Sistem Muskuluskeletal, Bandung, Akper Pajajaran<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l32 level1 lfo35; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Suratun,2008. Seri Asuhan Keperawatan: klien dengan gangguan system muskuluskeletal.Cet 1; EGC,Jakarta.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div>Ian zkate pakpahanhttp://www.blogger.com/profile/10259135788220046244noreply@blogger.com1tag:blogger.com,1999:blog-2556652656898751244.post-7628023608758801412010-10-17T12:10:00.001+07:002010-10-17T20:43:56.550+07:00KATETERISASI<div align="center" class="MsoNormal" style="text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 26pt; line-height: 115%;">KATETERISASI</span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 26pt; line-height: 115%;"><o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
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</div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRtT766o9gGAwLQ6Qc5UQKPkogalGRbfjwBdXGrJ9lWA21V70vvqGdXIjKAjUZ3R7s-KlV-QaRk5pJexdy5LsuNzD3xH99a1XpRVpBRcppBVbNzXZdM5WY6oFEGsvi8V6DekykjrFl0i8/s1600/DAH+AH+CAPE.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRtT766o9gGAwLQ6Qc5UQKPkogalGRbfjwBdXGrJ9lWA21V70vvqGdXIjKAjUZ3R7s-KlV-QaRk5pJexdy5LsuNzD3xH99a1XpRVpBRcppBVbNzXZdM5WY6oFEGsvi8V6DekykjrFl0i8/s1600/DAH+AH+CAPE.jpg" /></a></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-size: 14pt; line-height: 115%;"><o:p><br />
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</span></div><div align="center" class="MsoNormal" style="text-align: center;">KELAS SANTA TERESA</div><div align="center" class="MsoNormal" style="text-align: center;"><br />
</div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-size: 18pt; line-height: 115%;">PROGRAM STUDI DIII KEPERAWATAN<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-size: 18pt; line-height: 115%;">SEKOLAH TINGGI ILMU KESEHATAN SANTO BORROMEUS <o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-size: 18pt; line-height: 115%;">2010<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-size: 18pt; line-height: 115%;"><br />
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</span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l14 level1 lfo1; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">A.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengertian </span><span style="font-family: 'Times New Roman', serif;">kateterisasi</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 71.25pt; mso-add-space: auto; mso-list: l21 level1 lfo28; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Kateter adalah peralatan bedah yang berbentuk tubuler dan lentur yang dimasukkan ke dalam rongga tubuh untuk mengeluarkan atau memasukan cairan (Kamus dorland. 1998 ; 196)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 71.25pt; mso-add-space: auto; mso-list: l21 level1 lfo28; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Chateterization adalah pemasangan kateter ke dalam saluran atau rongga tubuh (Dorland, 1998 ; 197)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 71.25pt; mso-add-space: auto; mso-list: l21 level1 lfo28; text-align: justify; text-indent: -.25in;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kateterisasi kandung kemih adalah : memasukan selang plastic atau karet melalui uretra ke dalam kandung kemih. </span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(Perry, potter, 2005. 1710)</span><span style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: 35.25pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">kesimpulan :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif;">Kateterisasi kandung kemih dilakukan dengan memasukan selang plastik atau karet melalui uretra ke dalam kandung kemih. Kateter juga menjadi alat untuk mengkaji haluaran urine per jam pada klien yang hemodinamiknya tidak stabil.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l14 level1 lfo1; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif;">B.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Tipe Kateterisasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-list: l6 level1 lfo29; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Kateter inweling atau intermiten untuk retensi merupakan dua bentuk insersi kateter. Pada teknik intermiten, kateter lurus yang sekali pakai dimasukkan cukup panjang untuk mengeluarkan urine dari kandung kemih (5-10 menit).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-list: l6 level1 lfo29; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Kateter menetap atau Foley tetap ditempat untuk periode waktu yang lebih lama sampai klien mampu berkemih dengan tuntas dan spontan atau selama pengukuran akurat per jam dibutuhkan. Kateter foley menetap memiliki balon kecil yang dapat digembungkan, yang melingkari kateter tepat dibawah ujung kateter. </span><span lang="DE" style="font-family: 'Times New Roman', serif;">Apabila digembungkan, balon bertahan dipintu masuk kandung kemih untuk menahan selang kateter tetap di tempatnya. Kateter menetap untuk retensi memiliki dua atau tiga lumen di dalam badan kateter. Satu lumen mengeluarkan urine melalai kateter ke kantung pengumpul. Lumen kedua membawa air steril ke dan dari dalam balon saat lumen digembungkan atau dikempeskan. Lumen ketiga dapat digunakan untuk memasukan cairan atau obat-obatan kedalam kandung kemih. </span><span style="font-family: 'Times New Roman', serif;">Menentukan jumlah lumen adalah dengan menghitung jumlah drainase dan tempat injeksi pada ujung kateter.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-list: l6 level1 lfo29; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif;">Kateter coude digunakan pada klien pria, yang mungkin mengalami pembesaran prostat, yang mengobstruksi sebagian ureter. </span><span style="font-family: 'Times New Roman', serif;">Kateter ini lebih kaku dan lebih midah terkontrol daripada kateter yang ujungnya lurus.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l14 level1 lfo1; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif;">C.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Indikasi kateterisasi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;">Kateterisasi Intermiten<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l18 level1 lfo16; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Meredakan rasa tidak nyaman akibat distensi kandung kemih, ketentuan untuk menurunkan distensi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l18 level1 lfo16; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Mengambil spesimen urine yang steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l18 level1 lfo16; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Mengkaji residu urine setelah pengosongan kandung kemih<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l18 level1 lfo16; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Penatalaksanaan jangaka panjang klien yang mengalami cidera medula spinal, degenerasi neuromuskular, atau kandung kemih yang tidak kompeten<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: 35.45pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;">Kateterisasi Menetap Jangka Pendek<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l33 level1 lfo17; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Obstruksi pada aliran urine (mis, pembesaran prostata)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l33 level1 lfo17; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Perbaikan kandung kemih, uretra dan struktur disekelilingnya melalui pembedahan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l33 level1 lfo17; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Mencegah obstruksi uretra akibat adanya bekuan darah<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l33 level1 lfo17; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Mengukur haluaran ureine padaklien yang menderita penyakit kritis<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l33 level1 lfo17; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Irigasi kandung kemih secara intermiten <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: 35.45pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;">Kateterisasi Menetap Jangka Panjang<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l29 level1 lfo18; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Retensi urine yang berat disertai ISK yang berulang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l29 level1 lfo18; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Ruam kulit, atau luka iritasi akibat kontak dengan uriene<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l29 level1 lfo18; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif;">Penderita penyakit terminal yang merasa nyeri ketika linen tepat tidur diganti<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: 'Times New Roman', serif;"><o:p> </o:p></span><span class="Apple-style-span" style="font-family: 'Times New Roman', serif;"> </span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;">PEMASANGAN KATETER<o:p></o:p></span></b></div><div class="MsoListParagraph" style="line-height: 150%; mso-list: l23 level1 lfo38; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;">Pengertian :<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-align: justify;"><span style="font-family: 'Times New Roman', serif;">Memasukan selang karet atau plastic ke dalam vesika urinaria (kandung kemih) melalui uretra<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l23 level1 lfo38; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan :</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l13 level1 lfo37; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menghilangkan distensi kandung kemih</span><span style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l13 level1 lfo37; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sebagai penatalaksanaan kandung kemih yang inkompeten</span><span style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l13 level1 lfo37; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mendapatkan spesimen urine steril</span><span style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l13 level1 lfo37; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengkaji jumlah residu urine, jika kandung kemih tidak mampu sepenuhnya dikosongkan</span><span style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l23 level1 lfo38; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;">Indikasi :<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l44 level1 lfo44; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnostik (secepatnya dilepas)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l15 level1 lfo42; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 78.0pt; text-align: justify; text-indent: 20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengambil sample urin untuk kultur urin<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l15 level1 lfo42; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 78.0pt; text-align: justify; text-indent: 20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengukur residu urine<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l15 level1 lfo42; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 78.0pt; text-align: justify; text-indent: 20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memasukan bahan kontras untuk pemeriksaan radiology<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l15 level1 lfo42; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 78.0pt; text-align: justify; text-indent: 20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Urodinamik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-list: l15 level1 lfo42; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 78.0pt; text-align: justify; text-indent: 20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Monitor produksi urine atau balance cairan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l44 level1 lfo44; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Terapi (dilepas setelah tujuan dicapai)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l28 level1 lfo43; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 78.0pt; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Retensi urine<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l28 level1 lfo43; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 78.0pt; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Self interniten kateterisasi (CIC)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l28 level1 lfo43; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 78.0pt; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memasukan obat-obatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l28 level1 lfo43; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 78.0pt; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Viversi urine<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; mso-list: l28 level1 lfo43; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 78.0pt; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sebagai splin<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l23 level1 lfo38; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Persiapan</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Alat :</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tray kateterisasi steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sarung tangan steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sarung tangan bersih<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Duk steril, satu fenestrated<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pelumas <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Larutan pembersih antiseptic<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bola kapas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Forsep <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kateter straight atau inwelling<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Spuit yang sudah terisi dengan larutan untuk menggembungkan balon pada kateter inwelling<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wadah atau basin (biasanya bagian dasar dari tray)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wadah specimen<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lampu senter<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selang drainase sterildan kantung pengumpul<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Plester, gelang karet, dan peniti<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selimut mandi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bantalan tahan air<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kantung sampah <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Basin dengan air hangat dan sabun<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l9 level1 lfo30; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Handuk mandi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasien :<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l27 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengucapkan salam terapeutik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l27 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memperkenalkan diri<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l27 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menjelaskan pada klien dan keluarga tentang prosedur dan tujuan tindakan yang akan dilaksanakan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l27 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penjelasan yang disampaikan dimengerti klien/keluarganya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l27 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selama komunikasi digunakan bahasa yang jelas, sistematis serta tidak mengancam.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l27 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien/keluarga diberi kesempatan bertanya untuk klarifikasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l27 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Privasi klien selama komunikasi dihargai.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l27 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">8.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memperlihatkan kesabaran , penuh empati, sopan, dan perhatian serta respek selama berkomunikasi dan melakukan tindakan<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l27 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">9.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Membuat kontrak (waktu, tempat dan tindakan yang akan dilakukan)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lingkungan :</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 53.45pt; mso-add-space: auto; mso-list: l22 level1 lfo36; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tutup skerem untuk menjaga privasi klien<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 53.45pt; mso-add-space: auto; mso-list: l22 level1 lfo36; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Minta keluarga untuk menunggu di luar<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l23 level1 lfo38; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Prosedur :<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemasangan kateter menetap atau kateter lurus<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: .5in; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Langkah<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rasional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -13.65pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji status klien :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l5 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Waktu terakhir kali berkemih<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l5 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tingkat kesadaran atau tahap perkembangan klien<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l5 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Keterbatasan mobilitas dan fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l5 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Usia<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l5 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kondisi patologis yang dapat merusak jalan masuk kateter (mis. Pembesaran prostat)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l5 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Alergi<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l5 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meninjau ulang program dokter untuk kateterisasi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dapat mengindikasikan derajat kepenuhan kandung kemih<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menunjukan kemampuan klien untuk bekerja sama selama prosedur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mempengaruhi cara memposisikan klien dan mengindikasikan adanya kebutuhan untuk dibantu<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menentukan ukuran kateter yang akan digunakan. Nomor 8-10 biasanya digunakan untuk anak-anak dan nomor 14-16 untuk wanita. Nomor 12 dapat dipertimbangkan untuk wanita muda. Nomor 16-18 digunakan untuk pria, kecuali dokter memprogramkan ukuran yang lebih besar<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Obstruksi mencegah jalan masuk kateter melalui uretra ke dalam kandung kemih.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menentukan alergi terhadap antiseptic, plester, atau karet (lateks)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kateterisasi memerlukan resep dokter. Dokter dapat memprogramkan kateterisasi setelah pembedahan atau setelah melahirkan jika klien belum berkemih selama 8 jam. Kateterisasi juga dapat diprogramkan untuk penampungan specimen atau memonitor klien yang sedang kritis secara akurat<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menyiapkan peralatan dan suplai yang dibutuhkan :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sarung tangan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Duk steril, 1 duk berlubang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lubrikan steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Larutan pembersih antiseptic<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bola kapas atau kasa berbentuk bujur sangkar<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Forsep<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Spuit yang sudah diisi dengan air steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">h.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kateter dengan ukuran dan tipe yang benar untuk prosedur (intermitten atau menetap)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">i.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lampu senter<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">j.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selimut mandi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">k.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Alas penyerap yang kedap air<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">l.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tempat sampah<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">m.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sarung tangan sekali pakai, baskom berisi air hangat, sabun, lap badan, dan handuk<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">n.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selang drainase steril dan kantung penampung (dapat belum ditempelkan ke kateter), plester, peniti pengaman, pita elastic<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">o.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wadah atau baskom steril (biasanya di bawah troli)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l4 level1 lfo4; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">p.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wadah specimen steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Prosedur dianggap steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meminimalkan trauma uretra<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Digunakan untuk menggembungkan balon kateter menetap<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Membantu melihat meatus urinarius pada klien wanita<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memberikan privasi pada klien<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah kotornya sprei tempat tidur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeliharaan kebersihan perineum sebelum memasang kateter akan mengurangi resiko ISK. Memberikan kesempatan untuk memeriksa meatus uretra wanita atau meretraksi prepusium pada pria yang belum disirkumsisi. Klien yang mampu, dapat melakukan perawatan perineum secara mandiri<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Apabila kateter menetap akan diinsersi, plester, pita elastic, atau penjepit akan membantu memfiksasi posisi kateter, sehingga mencegah trauma pada sfingter uretra eksterna<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menjadi wadah aliran urine jika kateter intermitten digunakan atau kateter indwelling tidak terlebih dahulu dipasang pada kantung urine<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Untuk menampung specimen urine<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -14.2pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menjelaskan prosedur kepada klien. Jelaskan sensasi tekanan yang akan dirasakan selama kateter dimasukan. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengurangi ansietas dan meningkatkan kerja sama.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -13.65pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Atur supaya ada perawat tambahan untuk membantu, jika perlu<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mungkin diperlukan untuk membantu memposisikan klien yang dependen. Meningkatkan penggunaan mekanika tubuh yang benar dan aman<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 5;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tinggikan tempat tidur sampai ketinggian yang nyaman untuk melakukan pekerjaan<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meningkatkan penggunaan mekanika tubuh yang benar<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 6;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Cuci tangan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengurangi penularan infeksi<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 7;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -13.65pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Posisi perawat menghadap klien, berdiri di sebelah kiri tempat tidur, jika anda akan menggunakan tangan kanan (berdiri di sebelah kanan tempat tidur jika anda akan menggunakan tangan kiri). Bersihkan meja di sisi tempat tidur dan atur peralatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Keberhasilan insersi kateter dapat dicapai, jika posisi perawat nyaman dan semua peralatan mudah dijangkau<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 8;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -13.65pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">8.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Naikkan sisi pengaman tempat tidur pada sisi yang berlawanan dengan tempat anda berdiri<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meningkatkan keamanan klien<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 9;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -13.65pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">9.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tutup gorden atau bilik ruangan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memberikan privasi dan meningkatkan relaksasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 10;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 13.65pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; tab-stops: 20.7pt; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">10.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Letakkan alas kedap air di bawah klien <o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah mengotori seprei tempat tidur<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 11;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">11.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Atur posisi klien :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level1 lfo5; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wanita <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bantu untuk mengambil posisi dorsal rekumben (telentang dengan lutut ditekuk). Minta klien untuk merelaksasi paha sehingga paha dapat dirotasi ke arah luar (tungkai dapat ditopang dengan bantal)., atau posisikan klien dalam posisi berbaring miring (sim) dengan menekuk lututnya, apabila klien tidak mampu mengambil posisi telentang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l20 level1 lfo5; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pria<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bantu untuk mengambil posisi dengan paha sedikit diabduksi<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memungkinkan untuk melihat struktur perineum dengan baik. Ubah posisi jika klien tidak dapat mengabduksi tungkai pada sendi pinggul. Posisi ini juga dapat lebih nyaman untuk klien. Sanggah klien dengan bantal jika perlu, untuk mempertahankan posisi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Posisi telentang mencegah ketegangan otot abdomen dan panggul.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 12;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">12.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selimuti klien :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo6; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wanita : selimuti klien dengan selimut mandi. Tempatkan selimut dalam bentuk limas di atas klien. Satu sudut pada bagian leher, satu sudut pada setiap lengan dan sudut terakhir di atas perineum. Tinggikan gaun di atas panggul.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l19 level1 lfo6; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pria : selimuti badan bagian atas dengan selimut mandi dan tutupi ekstremitas bagian bawah dengan sprei tempat tidur sehingga hanya bagian genetalia yang terpajan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hindari pajanan bagia-bagian tubuh yang tidak perlu dan pertahankan kenyamanan.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 13;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">13.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kenakan sarung tangan sekali pakai. Bersihkan daerah perineum dengan air dan sabun, sesuai kebutuhan, keringkan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengurangi keberadaan mikroorganisme<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 14;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">14.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lepas dan buang sarung tangan yang telah dipakai. Cuci tangan<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah penularan mikroorganisme<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 15;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">15.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Posisikan lampu untuk menyinari daerah perineum. (apabila menggunakan senter, minta seorang asisten untuk memegangnya)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memungkinkan identifikasi yang akurat dan terlihatnya meatus uretra dengan baik <o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 16;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">16.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Buka peralatan kateterisasi dan kateter (apabila dikemas terpisah) sesuai dengan petunjuk penggunaannya <o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah transfer mikroorganisme dari permukaan tempat kerja ke peralatan steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 17;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">17.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kenakan sarung tangan steril<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memungkinkan penanganan peralatan steril tanpa kontaminasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 18;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">18.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Atur suplai di atas daerah yang steril. Buka bagian dalam kemasan steril yang berisi kateter. Tuangkan larutan antiseptic steril ke dalam wadah yang berisi bola kapas steril. Buka paket yang berisi lubrikan. Pindahkan wadah specimen (penutup harus dipasang longgar di atasnya) dan spuit yang sudah terlebih dahulu diisi, dari kompartemen pengumpul pada troli ke lapangan yang steril. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mempertahankan asepsis bedah dan mengatur daerah tempat kerja. Semua aktivitas yang membutuhkan penggunaan kedua tangan anda harus diselesaikan, sebelum membersihkan meatus uretra.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 19;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">19.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sebelum menginsersi kateter menetap, tes balon dengan menginjeksi cairan dari spuit yang telah berisi cairan, ke dalam katup balon. Balon harus menggembung maksimal tanpa bocor. Tarik kembali cairan dan tinggalkan spuit di pintu masuk kateter, jika memungkinkan. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memeriksa integritas balon. Balon yang bocor atau tidak menggembung dengan tepat tidak boleh digunakan.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 20;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">20.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pasang duk steril :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l36 level1 lfo7; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wanita : buat sisi bagian atas duk membentuk manset di atas kedua tangan perawat. Tempatkan duk di atas tempat tidur di antara paha klien. Selipkan ujung yang dibentuk manset tepat di bawah bokong, berhati-hatilah supaya sarung tangan tidak menyentuh permukaan yang terkontaminasi. Angkat duk dteril bolong dan biarkan duk tetap tidak terlipat tanpa menyentuh obyek nonsteril. Tempatkan duk pada perineum sehingga labia terlihat dan pastikan untuk tidak menyentuh permukaan yang terkontaminasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l36 level1 lfo7; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pria : tempatkan duk di atas paha tepat di bawah penis. Angkat duk bolong. Buka lipatan duk dan pasang di atas penis dengan celah yang bolong ditempatkan di atas penis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Permukaan luar duk yang menutupi tangan anda tetap steril sampai duk menyentuh bokong. Duk steril yang menyentuh sarung tangan steril adalha steril. Mempertahankan sterilitas permukaan tempat bekerja<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 21;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">21.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tempatkan peralatan steril dan isinya pada duk steril di antara paha klien, dan buka wadah specimen urine (jika diperlukan), menjaga permukaan bagian dalam tetap steril.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memungkinkan akses ke peralatan menjadi mudah selama insersi kateter<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 22;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">22.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Oleskan lubrikan di sepanjang sisi ujung kateter :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level1 lfo8; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wanita : 2,5 sampai 5 cm<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l38 level1 lfo8; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pria : 7,5 sampai 12,5 cm<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memungkinkan kemudahan insersi ujung kateter ke meatus uretra<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 23;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">23.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bersihkan meatus uretra :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo9; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wanita :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dengan tangan yang tidak dominan, retraksi labia dengan hati-hati sehingga keseluruhan meatus uretra ter;ihat. Pertahankan posisi tangan yang tidak dominan ini selama pelaksanaan prosedur.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dengan tangan yang dominan, ambil bola kapas dengan forsep dan bersihkan daerah perineum, mengapusnya dari arah depan ke belakang, dari klitoris ke anus. Gunakan bola kapas yang baru untuk setiap apusan : pada sepanjang daerah yang dekat dengan lipatan labia, sepanjang daerah yang jauh dari lipatan labia, dan secara langsung pada meatus<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l25 level1 lfo9; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pria :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l2 level1 lfo11; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Apabila klien tidak disirkumsisi, retraksi prepusium dengan tangan yang tidak dominan. Pegang batang penis, tepat di bawah glans. Retraksikan meatus uretra dengan menggunakan ibu jari dan jari telunjuk. Pertahankan tangan yang tidak dominan pada posisi ini selama proses insersi kateter.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l2 level1 lfo11; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dengan tangan yang dominan, ambil bola kapas dengan forsep dan bersihkan penis. Mulai dari meatus. lanjutkan sampai ke arah bawah batang penis dengan menggunakan gerakan melingkar. Ulangi proses ini 3 kali, dengan mengganti bola kapas setiap kali proses.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memungkinkan visualisasi seluruh meatus. Retraksi penuh mencegah kontaminasi meatus selama proses pembersihan. Menutupnya labia selama proses pembersihan menyebabkan perlunya pengulangan prosedur karena daerah tersebut telah terkontaminasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Upaya membersihkan mengurangi jumlah mikroorganisme di meatus uretra. Penggunaan sebuah bola kapas tunggal untuk setiap apusan mencegah transfer mikroorganisme. Gerakan pembersihan dimulai dari daerah yang kontaminasinya paling kecil ke daerah yang kontaminasinya paling luas. Tangan dominan tetap steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meminimalkan peluang terjadinya ereksi. (apabila ereksi terjadi, hentika prosedur). Lepasnya prepusium atau turunnya penis selama proses pembersihan menyebabkan perlunya pengulangan proses karena daerah tersebut telah terkontaminasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengurangi jumlah mikroorganisme di meatus dan pembersihan bergerak dari daerah yang kontaminasinya minimal ke daerah yang kontaminasinya maksimal. Tangan dominan tetap steril<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 24;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">24.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ambil kateter dengan tangan dominan yang telah mengenakan sarung tangan sekitar 5 cm dari ujung keteter. Pegang ujung kateter dan lekuk dengan longgar di telapak tangan yang tidak dominan. Letakan ujung distal kateter di wadah penampang urine (jika kateter belum dipasang ke saluran atau kantung urine)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penampungan urine mencegah kotornya seperi tempat tidur dan memungkinkan pengukuran haluaran urine yang akurat.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 25;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">25.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Insersi kateter :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l43 level1 lfo12; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wanita : peganag kateter di tangan yang dominan dan tangan yang tidak dominan melanjutkan tindakan meretraksi labia.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo13; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Minta klien mengambil nafas dalam, insersi kateter melalui meatus secara perlahan. (apabila tidak ada urine yang muncul setelah selang diinsersi beberapa sentimeter, kateter mungkin masuk ke dalam vagina, biarkan di tempat, kemudian ambil dan insersi kateter lain kemudian lepaskan kateter yang pertama.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo13; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Masukkan kateter sekitar 5 sampai 7,5 cm pada orang dewasa, 2,5 cm pada anak, atau sampai urine keluar. Apabila menginsersi kateter menetap, masukkan lagi 5 cm setelah urine keluar. Apabila ada tahanan, jangan memaksa kateter untuk masuk.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l7 level1 lfo13; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lepaskan labia dan pegang kateter dengan aman menggunakan tangan yang tidak dominan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l43 level1 lfo12; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pria : tinggikan penis ke posisi perpendicular terhadap tubuh klien dan berikan sinar ke arah atas penis yang telah ditarik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level1 lfo14; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Minta klien untuk berusaha keras untuk mengedan ke bawah seperti pada saat berkemih, insersi kateter melalui meatus secara perlahan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level1 lfo14; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Masukkan kateter 17,5 sampai 22,5 cm pada orang dewasa, 5 sampai 7,5 cm pada anak kecil, atau sampai urine keluar. Apabila ada tahanan, tarik kateter dan jangan memaksanya masuk ke uretra. Apabila menginsersi kateter menetap, masukan lagi sepanjang 5 cm setelah urine keluar<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l42 level1 lfo14; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lepaskan penisdan tahan kateter dengan kuat menggunakan tangan yang tidak dominan <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Relaksasi sfingter eksterna membantu insersi kateter. </span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(kateter di vagina tidak lagi steril). Meninggalkan kateter yang pertama akan mencegah salah masuknya kateter kedua ke dalam vagina<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Uretra waita berukuran pendek. Urine yang keluar mengindikasikan bahwa ujung kateter berada di dalam kandung kemih atau uretra bagian bawah. Balon kateter menetap harus dimasukan ke dalam kandung kemih. Insersi yang dipaksakan dapat membuat trauma pada uretra<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kontraksi kandung kemih atau sfingter dapat menyebabkan kateter keluar secara tidak sengaja.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Relaksasi sfingter eksterna membantu insersi kateter<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Uretra pada pria dewasa berukuran panjang. Urine yang keluar mengindikasikan bahwa ujung kateter berada di dalam kandung kemih atau uretra. Pemasukan kateter yang lebih jauh akan memastikan penempatan kateter di dalam kandung kemih. Tahanan pada jalan masuk kateter dapat disebabkan oleh striktur atau pembesaran prostat. Memastikan bahwa balon telah masuk ke dalam kandung kemih.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kontraksi kandung kemih atau afingter dapat menyebabkan keluarnya kateter yang tidak disengaja.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 26;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">26.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kumpulkan specimen urine sesuai kebutuhan. Isi mangkuk atau botol specimen sampai tingkat tertentu (20-30 ml) dengan memegang bagian pangkal kateter di tangan yang dominan, di atas mangkuk (atau kumpulkan specimen dari kantung drainase yang steril). Dengan tangan yang dominan, tekuk kateter untuk menghentikan sementara aliran urine dan kemudian lepaskan kateter untuk memungkinkan sisa urine di dalam kandung kemih keluar ke dalam penampang pengumpul. Tutup mangkuk specimen dan letakkan di pinggir untuk diberi label. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memungkinkan diperolehnya specimen steril untuk analisis kultur<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 27;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">27.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Biarkan kandung kemih benar-benar kosong (kecuali kebijakan lembaga membatasi volume maksimal urine yang keluar pada setiap kateterisasi)<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Urine yang tertahan dapat menjadi reservoir pertumbuhan mikrooganisme. (pengosongan volume dengan cepat dan dalam jumlah yang besar dapat menyebabkan pembuluh darah membesar serta menimbulkan syok hipovolemik)<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 28;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">28.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lepaskan kateter intermitten sekali pakai. Tarik kateter dengan perlahan dan lembut sampai terlepas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meminimalkan rasa tidak nyaman klien<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 29;"> <td style="border-bottom: solid black 1.0pt; border-left: solid black 1.0pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 226.0pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">29.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gembungkan balon kateter menetap :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo15; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Saat memegang kateter di meatus urinarius dengan tangan yang tidak dominan, pegang pangkal kateter, letakan diantara 2 jari<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo15; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dengan menggunakan tangan yang dominan, pasang spuit (jika belum terpasang) ke tempat injeksi pada pangkal kateter.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo15; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Injeksi sejumlah total larutan secara perlahan. Apabila klien mengeluh nyeri yang tiba-tiba, aspirasi larutan dan masukkan kateter lebih jauh. Jangan menginjeksikan cairan melebihi ukuran balon.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 38.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l8 level1 lfo15; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Setelah menggembungkan balon sampai maksimal, lepaskan kateter dari tangan yang tidak dominan dan tarik dengan perlahan untuk merasakan adanya tahanan. Kemudian masukkan kateter sedikit lagi ke dalam kandung kemih. Lepaskan spuit.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 216.8pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kateter harus ditahan pada saat spuit dimanipulasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pintu masuk injeksi terhubung dengan lumen yang menuju ke balon<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Balon di dalam kandung kemih digembungkan. Apabila posisi balon di dalam uretra tidak tepat, nyeri terjadi selama proses penggembungan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penggembungan balon menahan ujung kateter di tempatnya, di atas pintu masuk kandung kemih untuk mencegah kateter terlepas. Menarik kateter dengan perlahan memastikan selang terpasang dan tertahan dengan benar. Memasukkan kateter lebih jauh, meminimalkan tekanan pada leher kandung kemih<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
<tr style="height: 19.5pt; mso-yfti-irow: 30; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid windowtext 1.0pt; height: 19.5pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 225.75pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">30.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sambungkan pangkal kateter ke selang panampung dan kantung drainase, kecuali sudah disambungkan. Tempatkan kantung pada posisi terantung. Jangan letakkan kantung di kerangka pengaman tempat tidur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 20.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 19.5pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 217.05pt;" valign="top" width="289"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">System tertutup untuk drainase urine dibuat. Posisi kantung drainase yang menggantung meningkatkan aliran urine menjauhi kandung kemih. Kantung yang ditempatkan pada pengaman tempat tidur, ketinggiannya dapat berada di atas ketinggian kandung kemih, pada saat pengaman tersebut dinaikan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"><br />
</div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">IRIGASI KATETER<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l26 level1 lfo40; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengertian :<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l37 level1 lfo45; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pencucian kateter urine untuk mempertahankan kepatenan kateter urine menetap dengan larutan steril yang diprogramkan oleh dokter. Karena darah, pus, atau sedimen dapat terkumpul di dalam selang dan menyebabkan distensi kandung kemih serta menyebabkan urine tetap berada di tempatnya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l37 level1 lfo45; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">memasukan larutan kedalam kandung kemih untuk membersihkan atau memasukan obat. tujuan : memberikan larutan kedalam kandung kemih; membersihkan atau memasukan obat kedalam kandung kemih. kebijakan : dilakukan pada pasien<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l26 level1 lfo40; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan :<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l31 level1 lfo41; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Untuk mempertahankan kepatenan kateter urine <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l31 level1 lfo41; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah terjadinya distensi kandung kemih karena adanya penyumbatan kateter urine, misalnya oleh darah dan pus <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l31 level1 lfo41; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Untuk membersihkan kandung kemih <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l31 level1 lfo41; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify; text-indent: -20.7pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Untuk mengobati infeksi lokal <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l26 level1 lfo40; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Persiapan :<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Alat :<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l32 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Latutan irigasi steril (sesuai yang diresepkan dokter)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l32 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selang irigasi (dengan atau tanpa konektor- Y)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l32 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pole IV<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l32 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kapas antiseptic<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l32 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wadah metric<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l32 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Konektor Y<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l32 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selimut mandi (tidak harus)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l32 level1 lfo31; text-align: justify; text-indent: -21.25pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sarung tangan<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">IRIGASI PADA KATETER TERTUTUP DAN KATETER TERBUKA<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Langkah<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rasional<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji program dokter untuk tipe irigasi dan larutan irigasi yang digunakan <o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memastikan pemilihan peralatan yang tepat.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji warna urine dan adanya lendir atau sedimen<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menetukan adanya perdarahan , infeksi , atau terkelupasnya jaringan yang dialami klien<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tentukan tipe kateter yang akan dipasang :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 32.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo20; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tiga lumen (satu lumen untuk menggembungkan balon, satu lumen untuk memasukkan larutan irigasi, dan satu lumen untuk aliran keluar urine)<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 32.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l3 level1 lfo20; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dua lumen (satu lumen untuk menggembungkan balon, satu lumen untuk aliran keluar urine)<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menentukan kepatenan selang drainase<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memastikan bahwa selang drainase tidak tergulung, diklem dengan cara yang tidak tepat, atau tertekuk di bawah ketinggian kandung kemih<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 5;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengkaji jumlah urine di dalam kantung drainase<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Volume cairan di dalam kantung urine setelah irigasi dikurangi volume cairan di dalam kantung urine sebelum irigasi, untuk memastikan bahwa semua bahan irigasi telah keluar<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 6;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengumpulkan peralatan dan perlengkapan yang dibutuhkan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 32.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l34 level1 lfo21; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Metode intermitten tertutup<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo22; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(1)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Larutan irigasi steril pada suhu ruangan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo22; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(2)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wadah yang memiliki ukuran <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo22; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(3)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Spuit steril dengan berkapasitas 30 sampai 50 ml<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo22; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(4)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jarum steril dengan ukuran 19 sampai 22,1 inci<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo22; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(5)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Swab antiseptik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo22; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(6)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klem untuk kateter atau selang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l40 level1 lfo22; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(7)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selimut mandi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 32.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l34 level1 lfo21; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Metode kontinu tertutup<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo23; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(1)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Larutan irigasi steril , sesuaikan suhu dalam kantung dengan suhu ruangan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo23; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(2)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selang irigasi dan klem (dengan atau tanpa penghubung Y)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo23; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(3)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tiang IV<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo23; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(4)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Swab antiseptik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo23; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(5)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penghubung Y (pilihan) <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l24 level1 lfo23; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(6)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selimut mandi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 32.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l34 level1 lfo21; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Metode terbuka<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(1)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Set irigasi steril disertai troli/ penampangnya <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(2)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bulb spuit atau spiut tipe piston berkapasitas 60 ml<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(3)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Basin penampung yang steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(4)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Duk kedap air<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(5)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Wadah larutan yang steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(6)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Swab antiseptik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(7)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sarung tangan steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(8)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sesuaikan larutan irigasi pada suhu ruangan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 50.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(9)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Plester atau pita elastis untuk memfiksasi kembali kateter<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l0 level1 lfo24; text-align: justify; text-indent: -24.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">(10)<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selimut mandi<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Larutan yang dingin dapat menyebabkan spasme kandung kemih<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Digunakan untuk memasukkan bahan irigasi ke dalam kandung kemih<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menghambat aliran urine di kateter pada saat bahan dimasukkan irigasi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Larutan yang dingin dapat menyebabkan spasme kandung kemih<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klem mengatur aliran irigasi. Penghubung Y memungkinkan selang terhubung dengan dua kantung<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dapat menghubungkan selang irigasi ke kateter yang memiliki dua buah lumen<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jangan mennggunakan metode ini apabila terdapat metode lain karena metode ini meningkatkan resiko infeksi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memberikan dorongan yang penting untuk mengeluarkan bekuan darah<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Duk dapat mencegah seprei tempat tidur menjadi kotor<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menjaga sistem tetap steril<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Larutan yang dingin meneyababkan spasme kandung kemih<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 7;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jelaskan prosedur dan tujuan kepada klien<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Membantu klien bersikap santai dan kooperatif selama prosedur<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 8;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">8.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Cuci tangan dan kenakan sarung tangan untuk metode tertutup<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mancegah penularan mikroorganisme<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 9;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 14.2pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -14.2pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">9.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan klien privasi dengan menarik gorden tempat tidur. Lipat kain yang menutupi kateter sehingga kateter terpapar. Tutupi bagian atas pinggang klien dengan selimut mandi.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meningkatkan kenyamanan klien<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 10;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">10.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji abdomen bagian bawah untuk melihat adanya distensi kandung kemih<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mendeteksi adanya kesalahan fungsi keteter atau hambatan pada drainase urine<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 11;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">11.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Posisikan klien pada posisi dorsal rekumben atau telentang<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meningkatkan kenyamanan klien dan membuat keteter mudah dijangkau. Meningkatkan aliran larutan irigasi ke dalam kandung kemih.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 12;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">12.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Irigasi intermitten tertutup:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Siapkan larutan irigasi steril sesuai program di dalam gelas ukur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hisap larutan steril ke dalam spuit dengan menggunakan teknik aseptik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klem kateter retensi menetap pada bagian bawah pintu masuk injeksinya yang lunak<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bersihkan pintu masuk injeksi pada kateter menetap dengan menggunakan swab antiseptik (pintu masuk yang sama digunakan untuk pengumpulan spesimen)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Masukkan jarum spuit melalui pintu masuk pada sudut 30 derajat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Injeksikan cairan secara perlahan ke dalam kateter dan ke dalam kandung kemih<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l16 level1 lfo25; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lepaskan spuit, klem, dan biarkan larutan mengalir ke dalam kantung drainase urine. PILIHAN: pertahankan selang tetap diklem dan biarkan larutan berada di dalam kendung kemih untuk sementara waktu ( 20-30 menit). </span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jangan lupa melepaskan klem kateter.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memastikan bahwa cairan irigasi tetap steril<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sumbatan pada keteter menimbulkan tahanan sehingga bahan irigasi dapat dengan kuat dimasukkan ke dalam kateter.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengurangi penularan infeksi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memastikan bahwa ujung jarum memasuki lumen kateter<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tekanan perlahan yang diberikan secara kontinu membuat bekuan darah dan sedimen terlepas tanpa menimbulkan trauma pada dinding kandung kemih<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memungkinkan drainase mengalir karena dipengaruhi gaya gravitasi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 13;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">13.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Irigasi kontinu tertutup:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo26; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dengan menggunakan teknik aseptik, masukkan ujung selang irigasi steril ke dalam kantung larutan irigasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo26; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tutup klem pada selang dan gantung kantung larutan irigasi pada tiang IV<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo26; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Buka klem dan biarkan larutan mengalir melalui selang, pertahankan ujung selang tetap steril. Tutup klem.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo26; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bersihkan porta irigasi pada kateter berlumen tiga atau sambungkan penghubung-Y yang steril ke kateter berlumen dua dan kemudian sambungkan ke selang irigasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo26; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pastikan bahwa kantung drainase dan selang terhubung dengan kuat ke pintu masuk darinase pada keteter berlumen tiga atau ke sambungan lain pada penghubung-Y<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo26; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Untuk aliran yang intermitten, klem selang sistem drainase, buka klem selang irigasi dan biarkan cairan yang diprogramkan mengalir memasuki kandung kemih (100 ml adalah jumlah yang normal pada orang dewasa). Tutup klem selang irigasi dan kemudian buka klem selang drainase<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l12 level1 lfo26; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Untuk irigasi kontinu, hitung kecepatan tetesan larutan irigasi dan kemudian kemudian atur klem pada selang sistem irigasi dengan tepat. Pastikan bahwa klem pada selang darinase terbuka dan periksa volume drainase di dalam kantung drainase. Pastikan bahwa selang drainase paten dan hindari melekuknya selang.<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah masuknya mikroorganisme<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengeluarkan udara dari selang<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penghubung-Y atau kateter dengan tiga lumen merupakan alat untuk mengirigasi larutan memasuki kandung kemih. Sistem harus tetap steril.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memastikan bahwa urine dan larutan yang digunakan untuk irigasi akan keluar dari kandung kemih.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Caiaran yang masuk melalui kateter menuju ke kandung kemih, membilas sistem. Cairan keluar setelah irigasi selesai.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memastikan proses irigasi yang kontinu dan merata pada sistem kateter. Mencegah akumulasi larutan di dalam kandung kemih, yang dapat menyebabkan distensi kandung kemih dan kemungkinan cedera.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 14;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">14.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Irigasi terbuka:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Buka penampang irigasi yang steril, bentangkan area yang steril, tuangkan larutan steril yang dibutuhkan ke dalam wadah steril dan letakkan kembali tutup wadah larutan yang besar<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kenakan sarung tangan steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Letakkan duk kedap air steril di bawah kateter<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Aspirasi 30 ml larutan ke dalam spuit irigasi steril<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pindahkan baskom pengumpul steril ke dekat paha klien<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lepaskan kateter dari selang drainase sehingga urine dapat mengalir ke dalam baskom pengumpul steril. Tutup ujung selang drainase dengan tutup pelindung yang steril. Letakkan selang ini di tempat yang aman.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Insersi ujung spuit ke dalam lumen kateter dan masukkan larutan secara perlahan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">h.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lepaskan spuit, rendahkan kateter, dan biarkan larutan mengalir keluar ke dalam baskom. Ulangi memasukkan larutan dan keluarkan lagi beberapa kali sampai cairan drainase menjadi jernih.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">i.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Apabila larutan tidak kembali, minta klien untuk berbaring miring dengan posisi tubuh menghadap Anda. Apabila upaya mengubah posisi tidak juga membantu, masukkan kembali spuit dan aspirasi larutan dengan perlahan<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l11 level1 lfo27; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">j.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Setelah irigasi selesai dilakukan, lepaskan penutup pelindung dari selang, bersihkan ujungnya dengan swab alkohol ( atau larutan yang direkomendasikan lembaga), dan pasang kembali sistem drainase<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mematuhi prinsip asepsis bedah<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengurangi penularan mikroorganisme<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah sprei tempat tidur menjadi kotor<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menyiapkan bahan irigasi untuk dimasukkan ke dalam kateter<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah sprei tempat tidur menjadi kotor dan mencegah supaya tidak samapi ke lapangan steril<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mempertahankan kesterilan bagian dalam lumen kateter dan selang drainase serta mengurangi kemungkinan masuknya agens patogen ke dalam kandung kemih<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Instilasi secara perlahan mengurangi insiden spasme kandung kemih, tetapi dapat membersihkan kateter dari obstruksi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Memungkinkan drainase mengalir akibat gaya gravitasi. Memungkinkan kateter dibilas secara adekuat<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan posisi dapat memindahkan ujung kateter di dalam kandung kemih, meningkatkan kemungkinan bahwa cairan yang dimasukkan akan mengalir kembali keluar<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menguarangi masuknya mikroorganisme ke dalam sistem<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 15;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">15.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Letakkan kembali kateter ke tubuh klien dengan menggunakan plester atau pita elastic<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah trauma pada jarinagan uretra<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 16;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">16.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bantu klien untuk mendapatkan posisi yang nyaman<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meningkatkan relaksasi dna istirahat<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 17;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">17.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rendahkan tempat tidur sampai posisi terendah<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Meningkatkan keamanan klien<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 18;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">18.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Buang perlengkapan yang terkontaminasi, lepas sarung tangan, dan cuci tangan. Pasang sisi pengaman tempat tidur jika perlu<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mencegah penyebaran infeksi<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 19;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">19.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hitung cairan yang digunakan untuk mengirigasi kandung kemih dan kateter dan kurangi dari volume total drainase yang dialirkan keluar<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menentukan haluaran urine yang akurat<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 20;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">20.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji karakteristik haluaran urine: viskositas, warna dan adanya materi (mis., sedimen, bekuan darah)<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengevaluasi hasil irigasi<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 21; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l30 level1 lfo19; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">21.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Catat tipe dan jumlah larutan yang digunakan sebagai bahan irigasi, jumlah bahan yang kembali sebagai darinase, dan karakteristik drainase tersebut<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 232.15pt;" valign="top" width="310"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mendokumentasikan prosedur dan respons klien<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">BLADER TRAINING<o:p></o:p></span></b></div><div class="MsoListParagraph" style="line-height: 150%; mso-list: l35 level1 lfo39; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengertian :<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Suatu latihan yang digunakan dalam rangka melatih otot-otot kandung kemih.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; mso-list: l35 level1 lfo39; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan :<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengembalikan pola kebiasaan berkemih<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l35 level1 lfo39; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hal yang perlu disiapkan :<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l17 level1 lfo32; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tentukan pola waktu biasanya klien berkemih sendiri. Bila tidak dapat dibuat pola berkemih, rencanakan waktu ke toilet, misalnya 1-2 jam sekali<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l17 level1 lfo32; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Usahakan agar intake cairan sekitar 2-3 liter/hari<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l17 level1 lfo32; text-align: justify; text-indent: -21.25pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Posisi berkemih yang normal dan nyaman<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l35 level1 lfo39; text-align: justify; text-indent: -.25in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Prosedur :<o:p></o:p></span></b></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Langkah<o:p></o:p></span></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rasional <o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level1 lfo33; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sesuai dengan pola berkemih yang telah ditentukan, usahakan agar klien mempertahankannya saat klien merasa ingin berkemih baik urgen atau tidak. Kontraksi atau relaksasi secara teratur akan meningkatkan tonus otot bladder dan meningkatkan control volunteer<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level1 lfo33; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan cairan sekitar 30 menit sebelum waktu BAK sesuai pola tersebut sebanyak ± 600-800 cc. <o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intake cairan ini untuk membantu proses produksi urine yang adekuat, sehingga merangsang reflex miksi<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level1 lfo33; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lakukan program latihan untuk meningkatkan tonus otot abdomen dan pelvis melalui latihan kegel’s caranya :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l41 level1 lfo34; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Posisi klien duduk atau berdiri dengan kaki diregangkan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l41 level1 lfo34; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kontraksikan rectum, uretra, dan vagina (pada wanita) kea rah atas dalam. Lalu tahan selama 5 detik. Kontraksi seharusnya dirasakan pada panggul<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 39.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l41 level1 lfo34; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ulangi latihan tersebut 5-6 kali pada tahap awal dengan interval waktu. Setelah otot semakin kuat tingkatkan jumlah latihan sampai akhirnya dapat melakukan sampai 200 kali tiap hari<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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<tr style="mso-yfti-irow: 4; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 21.3pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l39 level1 lfo33; text-align: justify; text-indent: -21.3pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Cobakan klien untuk memulai dan menghentikan aliran urine<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"><br />
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</div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><cite><span style="font-family: Calibri, sans-serif;">linrin.blogspot.com/2009/12/<b>irigasi</b>-kandung-kemih.html</span></cite><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>Ian zkate pakpahanhttp://www.blogger.com/profile/10259135788220046244noreply@blogger.com1tag:blogger.com,1999:blog-2556652656898751244.post-59301403919573030492010-10-17T12:07:00.002+07:002010-10-19T06:32:13.531+07:00ASKEP GANGGUAN KELENJAR PARATIROID<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 18pt; line-height: 150%;">ASKEP KLIEN DENGAN GANGGUAN KELENJAR PARATIROID<o:p></o:p></span></b></div><div class="MsoNormal"><br />
</div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-size: 12pt; line-height: 115%;"><v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas> <v:path gradientshapeok="t" o:connecttype="rect" o:extrusionok="f"> <o:lock aspectratio="t" v:ext="edit"> </o:lock></v:path></v:stroke></v:shapetype><v:shape id="Picture_x0020_12" o:spid="_x0000_i1025" style="height: 312pt; mso-wrap-style: square; visibility: visible; width: 351.75pt;" type="#_x0000_t75"> <v:imagedata o:title="logo stikes" src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image001.jpg"> </v:imagedata></v:shape></span><span lang="DE" style="font-size: 12pt; line-height: 115%;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
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</div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="DE" style="font-size: 14pt; line-height: 115%;">oleh<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="DE" style="font-size: 12pt; line-height: 115%;">KELAS SANTA TERESA<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
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</div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="DE" style="font-size: 18pt; line-height: 115%;">PROGRAM STUDI DIII KEPERAWATAN<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="DE" style="font-size: 18pt; line-height: 115%;">SEKOLAH TINGGI ILMU KESEHATAN SANTO BORROMEUS <o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="DE" style="font-size: 18pt; line-height: 115%;">2010<o:p></o:p></span><br />
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</span></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">ASUHAN KEPERAWATAN KLIEN DENGAN GANGGUAN KELENJAR PARATIROID<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l5 level1 lfo1; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">A.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">HIPERPARATIROID<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: 13.65pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hiperparatiroid didefenisikan sebagai hiperfungsi kelenjar paratiroid yang mengakibadkan penigkatan kadar PTH dalam darah yang bersirkulasi dan fosfat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: 6.55pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: 6.55pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PATOFISIOLAGI<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: 13.65pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hiperparatiroidisme dapat bersifat primer atau skunder ,dimana kasus biasanya berhubungan dengan gagal ginjal kronis. Pada 80% hiperparatiroidisme primer disebabkan oleh adenomaparatiroid jinak 18% kasus diakibadkan hiperplasia keljar paratiroid:dan 2% kasus disebapkan oleh karsinoma paratiroid. Adenoma atau karsinoma paratiroid ditandai oleh pembesaran satu kelenjar ,dengan kelenjar lainya tetap normal. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: 6.55pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hiperlasia paratiroid sekunder dapat dibedakan dengan hiperplasia primer , karna kempat kelenjar membesar secara simetris. Perbesaran kelenjar paratiroid dn hiperfungsinya adalah mekanisme kompensasi yang dicetuskan oleh retensi fosfat dan hiperkalsemia yang berkaitan dengan penyakit ginjal kronis. Osteomalasia yang disebapkan oleh hipovitaminosis D ,seperti pada reketsia ,dapat mengakibatkan dampak yang sama.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: 6.55pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hiperparatiroidisme ditandai oleh kelebihan PTH dalam sirkulasi . PTH terutama bekerja pada tulang dan ginjal . dalam ginjal. Dalam tulang , PTH meningkatkan resopsi tulang dan menigkatkan kalsium dari lumen tubulus ginjal, dengan demikian mmengurangi ekskresian kalsium dalam urine. PTH juga menigkatkan pembentukan nbentuk vitamin D3 aktif dalam ginjal,yang selanjutnya memudahkan pengambilan kalsium dari makanan dan usus. Sehingga hiperkalsemia dan hipofistfatemia kompensatori adalah abnormalitas biokimia yang dideteksi melalui analisis darah. Konsentrasi PTH serum juga menigkat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: 6.55pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gejala klinis hiperparatiroidisme behibungan dengan penigkatan aktivitas PTH. Tulang menunjukan tanda-tanda dekalsifikasi dan rentan terhadap fraktur. Hiperkalsemia mengarah pada penumpukan garam kalsium dalam ginjal dan pembentukan batu ginjal. Mungkin juga terdapat klasifikasi okular dan kulit. Kelebihan kalsium menyebabkan letargi ,kelemahan otot, defeks konduksi pada jantung. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: 6.55pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengobatan pada hoperparatiroidisme promer mencakup bedah eksplorasi leher dan reseksi kelenjar yang mengalami hiperfungsi atau tumor. Hiperparatiroidisme sekunder dapat juga diatasi dengan tindakan bedah , namun pada tindakan yang sama lebih penting u tuk memperbaiki kelainan metabolik yang menyebapkan hipersekresi PTH. Tidak ada perlunya buru-buru melakukan oprasi paratiroid. Setelah plantasi ginjal ,kelenjar akan kembali keukuran normal dan gangguan metabolik akan menghilang. Jika plantasi tidak menormalkan keseimbangan kalsium dan fosfat ,maka dokter akan menduga bahwa hiperfungsi paratiroid nampaknya trejadi secara autonomus. Kasus demikian, seperti yang disebutkan hiperparatiroidisme tersier ,jarang terjadi. <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: 6.55pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l5 level1 lfo1; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">B.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PENATALAKSANAAN KLIEN DENGAN HIPERPARATIRIODISME<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l39 level1 lfo2; mso-text-indent-alt: -.25in; text-align: justify; text-indent: -1.0in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span>I.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PENGKAJIAN <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tidak tedapat manifestasi yang jelas tentang hiperparatiroidisme hiperkalsemia resultan. Klien mungkin menujukan perubahan psikologis , seperti latergi, mengantuk , penurunan memory, labilitas emosional , semua menivestasi yang tampak pada hiperkalsemia.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.65pt; mso-add-space: auto; mso-list: l24 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Riwayat kesehatan klien .<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.65pt; mso-add-space: auto; mso-list: l24 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Riwayat kesehatan dalam keluarga.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.65pt; mso-add-space: auto; mso-list: l24 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Keluhan utama antara lain:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 121.65pt; mso-add-space: auto; mso-list: l34 level1 lfo4; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sakit kepala ,kelemahan , latargi, dan kelelahan otot.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 121.65pt; mso-add-space: auto; mso-list: l34 level1 lfo4; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan pencernaan seperti mual,muntah ,anorexia, opstipasi, dan nyeri lambung yang akan disertai penurunan berat badan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 121.65pt; mso-add-space: auto; mso-list: l34 level1 lfo4; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Depresi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 121.65pt; mso-add-space: auto; mso-list: l34 level1 lfo4; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Nyeri tulang dan sendi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.65pt; mso-add-space: auto; mso-list: l24 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Riwayat trauma / fraktur tulang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.65pt; mso-add-space: auto; mso-list: l24 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Riwayat radiasi daerah leher dan kepala.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.65pt; mso-add-space: auto; mso-list: l24 level1 lfo3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan fisik yang mencakup:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 121.65pt; mso-add-space: auto; mso-list: l18 level1 lfo5; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Observasi dan palpasi adanya devormitas tulang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 121.65pt; mso-add-space: auto; mso-list: l18 level1 lfo5; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Amati wana kulit , apakah tampak pucat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 121.65pt; mso-add-space: auto; mso-list: l18 level1 lfo5; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan tingkat kesadaran.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.65pt; mso-add-space: auto; mso-list: l24 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bila kadar kalsium tetap tinggi ,maka akan tanpak tanda psikosis organic seperti binggung bahkan koma dan bila tidak di tangani kematian akan mengancam.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.65pt; mso-add-space: auto; mso-list: l24 level1 lfo3; text-align: justify; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">8.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan diaknostik termasuk:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 121.65pt; mso-add-space: auto; mso-list: l7 level1 lfo6; text-align: justify; text-indent: -.25in;"><span style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan laboratorium: dilakukan untuk mengetahui kadar kalsium dalam plasma yang merupakan pemeriksaan terpenting dalam menentukan pemeriksaan terpenting dalam menegakan kondisi hiperparatiroidisme. Hasil pemeriksaan laboratorium pada hiperparatiroidisme primer akan ditemukan penigkatan kadar kalsium serum,kadar kalsium posfat anorganik menurun semetara kadar kalsium dan fosfat urin meningkat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 121.65pt; mso-add-space: auto; mso-list: l7 level1 lfo6; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">Ø<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan radiologi: akan tanpak penipisan tulang dan terbentuk kista dan trabekula pada tulang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l39 level1 lfo2; mso-text-indent-alt: -.25in; tab-stops: 46.5pt; text-align: justify; text-indent: -1.0in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span>II.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DIOAGNOSA KEPERAWATAN<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa keperawatan utama yang dapat dijumpai pada klien dengan hiperparatiroidisme antara lain:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l32 level1 lfo7; tab-stops: 46.5pt; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Resiko terhadap cidera yang berhubungan dengan demineralisasi tulang yang mengakibatkan fraktur patologi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l32 level1 lfo7; tab-stops: 46.5pt; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan elimainasi urine yang berhubungan dengan keterlibatan ginjal sekunder terhadap hiperkalsemia dan hiperfostfatemia .<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l32 level1 lfo7; tab-stops: 46.5pt; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan nutrisi yang berhubungan dengan anoreksia dan mual.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 120.5pt; mso-add-space: auto; mso-list: l32 level1 lfo7; tab-stops: 46.5pt; text-align: justify; text-indent: -21.25pt;"><span lang="DE" style="font-family: Wingdings; font-size: 12pt; line-height: 150%;">ü<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Konstipasi yang berhubungan dengan efek merugikan dari hiperkalsemia pada saluran gastrointestinal.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l39 level1 lfo2; mso-text-indent-alt: -.25in; tab-stops: 46.5pt; text-align: justify; text-indent: -1.0in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span>III.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">RENCANA TINDAKAN KEPERAWATAN<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DIAGNOSA KEPERAWATAN.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Resiko terhadap cidera yang berhubungan dengan demineralisasi tulang yang mengakibatkan fraktur patologi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Turjuan :<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien tidak akan menderita cedera ,seperti yang akan ditunjukkan oleh tidak terdapatnya fraktur patologis.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi keperawatan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l3 level1 lfo8; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lindungi klien dari kecelakaan jatuh, karena klien rentang mengalami fraktur patologis, bahkan oleh benturan ringan sekalipun. Bila klien mengalami penurunan kesedaran pasanglah tirali tempat tidurnya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l3 level1 lfo8; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hindarkan klien dari posisi yang menetap, ubah posisi klien dengan hati-hati.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l3 level1 lfo8; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bantu klien memenuhi kebutuhan sehari-hari selama terjadi kelemahan fisik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l3 level1 lfo8; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Atur aktivtas yang tidak melelahkan klien.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l3 level1 lfo8; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ajarkan cara melindungi diri dari trauma fisik seperti mengubah posisi tubuh , dan cara berjalan serta menghindari perubahan posisi yang tiba-tiba.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l3 level1 lfo8; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ajarkan klien cara mengunakan alat bantu berjalan bila dibutuhkan. Anjurkan klien agar berjalan secara perlahan-lahan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DIAGNOSA KEPERAWATAN<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan eliminasi urine yang berhubungan dengan keterlibatan ginjal sekunder terhadap hiperkalsemia dan hiperfosfatemia.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">TUJUAN:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien akan kembali pada haluaran urine normal ,seperti yang ditunjukkan oleh tidak terbentuknya batu atau haluaran urine 30-60 ml/jam.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi keperawatan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">INTERVENSI KEPERAWATAN:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l19 level1 lfo9; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perbanyak asupan klien sampai 2500 ml- cairan per hari. Dehidrasi merupakan hal yang berbahaya bagi klien dengan hiperparatiroidisme karena akan menigkatkan kadar kalsium serum dan memudahkan terbentuknya batu ginjal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l19 level1 lfo9; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan sari buah canbery atau prune untuk membantu agar urine lebih bersifat asam. Keasaman urine yang tinggi membantu mencegah pembentukan batu ginjal ,karena kalsium lebih mudah larut dalam urine yang asam ketimbang urine yang basa.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DIAKNOSA KEPERAWATAN:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan nutrisi yang berhubungan dengan anoreksia dan mual<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien akan mendapatkan masukan makanan yang mencukupi , seperti yang di buktikan oleh tidak adanya mual dan kembali pada atau dapat mempertahankan berat badan ideal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Itervensi keperawatan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 142.9pt; mso-add-space: auto; mso-list: l30 level1 lfo10; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan dorongan pada klien untuk mengkonsumsi diet rendah kalsium untuk memperbaiki hiperkelsemia .<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 142.9pt; mso-add-space: auto; mso-list: l30 level1 lfo10; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jelaskan pada klien bahwa tidak mengkonsumsi susu dan produk susu dapat menghilangkan sebagian manovestasi gasrtointestinal yang tidak menyanagkan .<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 142.9pt; mso-add-space: auto; mso-list: l30 level1 lfo10; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bantu klien untuk mengembangkan diet yang mencakup tinggi kalori tanpa produk yang mengandung susu.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 142.9pt; mso-add-space: auto; mso-list: l30 level1 lfo10; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rujuk klien ke ahli gizi untuk membantu perencanaan diet klien.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 106.35pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify; text-indent: 36.55pt;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l5 level1 lfo1; tab-stops: 46.5pt; text-align: justify; text-indent: 42.0pt;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">C.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penatalaksanaan Bedah Hiperparatiroidisme<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengobatan definitif hiperparatiroidisme primer adalah bedah pengangkatan kelenjar atau pengangkatn kelenjar yang menyebabkan hipersekresi PTH. Biasanya hanya kelenjar paratiroid yang sakit saja yang diangkat. Namun bila keempat kelenjar mengalami hiperplasia, maka akan diangkat tiga dari keempat kelenjar tersebut.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Komplikasi hiperparatiroidektomi serupa dengan yang terdapat pada tiroidektomi dan jarang terjadi. Hipokalsemia merupakan komplikasi yang secara potensial mengancam hidup mesti masih tersisa kelenjar paratiroid yang lain karena edema dapat mengurangi fungsinya. Klien juga dapat mengalami distres pernafasan yang berhubungan baik dengan hemoragi atau kekambuhan kerusakan saraf laringeal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Angka kesembuhan untuk hiperparatiroidisme primer setelah operasi pengangkatan adalah 95%. Angka keberhasilan yang tinggi ini secara langsung berkaitan dengan pengalaman ahli bedah dan eksplorasi menyeluruh leher (Black-Matassarin, 1997)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l5 level1 lfo1; tab-stops: 46.5pt; text-align: justify; text-indent: 42.0pt;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">D.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hipoparatiroidisme<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hipoparatiroidisme terjadi akibat hipofungsi paratiroid atau kehilangan fungsi kelenjar paratiroid. Namun begitu, kondisi ini merupakan kondisi yang langka yang umumnya terjadi setelah pengangkatan keempat kelenjar secara tidak sengaja pada operasi tumor leher. Penyebab kongenital, genetik atau autoimun dari hipoparatiroidisme sangat jarang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 78.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> Gejala klinis hipoparatiroidisme mencerminkan gangguan metabolik yang disebabkan oleh defisiensi PTH. Defisiensi yang terpenting diantaranya adalah hipokalsemia, yang mengakibatkan perubahan eksitabilitas neuromuskular dan kontraksi muskular. Otot skeletal cenderung untuk menjadi spastis (tetani hipokalsemil). Kerja jantung menjadi tidal teratur, dan pada kasus-kasus yang berat, dapat terjadi henti jnatung. Aktifitas saraf juga mengalami perubahan, terjadi fluktuasi antara hipereksitabilitas dan depresi. Semua gejala dapat dihilangkan denagn pemberian terapi hormon substitusional manggunakan PTH sintesis.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l5 level1 lfo1; tab-stops: 46.5pt; text-align: justify; text-indent: 42.0pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">E.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penatalaksanaan Klien dengan Hipoparatiroidisme</span></b><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; mso-list: l17 level1 lfo33; tab-stops: 46.5pt; text-align: justify; text-indent: -.5in;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">I.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pengkajian<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 81.0pt; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji dengan cermat klien yang berisiko untuk mengalami hipoparatiroidisme akut, seperti pada klien pascatiroidektomi, terhadap terjadinya hipokalsemia. Tanyakan klien tentang adanya manifestasi bekas atau semutan disekitar mulut atau ujung jari kaki. </span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Periksa juga terhadap temuan tanda Chvosteks atau Trousseaus positif. Yang penting adalah mengkaji manifestasi disters pernafasan sekunder terhadap laringopasme. Pada klien dengan hipoparatiroidisme akut, perlu dikaji terhadap adanya tanda perubahan fisik nyata seperti kulit dan rambut kering. Juga kaji terhadap sindrom seperti-Parkinson atau adanya katarak. Pengkajian keperawatan lainnya mencakup:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 81.0pt; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: 81.0pt; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; mso-list: l2 level1 lfo34; tab-stops: 46.5pt; text-align: justify; text-indent: -31.95pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Riwayat penyakit<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l12 level1 lfo35; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sejak kapan klien menderita penyakit<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l12 level1 lfo35; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Apakah ada anggota keluarga yang berpenyakit sama<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l12 level1 lfo35; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Apakah klien pernah mengalami tindakan operasi khususnya pengangkatan kelenjar paratiroid atau klenjar tiroid<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l12 level1 lfo35; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Apakah ada riwayat penyinaran daerah leher<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; mso-list: l2 level1 lfo34; tab-stops: 46.5pt; text-align: justify; text-indent: -31.95pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Keluhan utama meliputi:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l36 level1 lfo36; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kelainan bentuk tulang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l36 level1 lfo36; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perdarahan yang sulit berhenti<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l36 level1 lfo36; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kejang-kajang, kesemutan dan lemah<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; mso-list: l2 level1 lfo34; tab-stops: 46.5pt; text-align: justify; text-indent: -31.95pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan fisik mencakup:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l10 level1 lfo37; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kelainan bentuk tulang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l10 level1 lfo37; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tetani<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l10 level1 lfo37; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tanda Trousseaus dan Chovsteks<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l10 level1 lfo37; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pernafasan berbunyi ( tridor )<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l10 level1 lfo37; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span lang="DE" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rambut jarang dan tipis; pertumbuhan kuku buruk, deformitas dan mudah patah; kulit kering dan kasar<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; mso-list: l2 level1 lfo34; tab-stops: 46.5pt; text-align: justify; text-indent: -31.95pt;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan penunjang<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l25 level1 lfo38; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span lang="DE" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan kadar kalsium serum<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 153.0pt; mso-add-space: auto; mso-list: l25 level1 lfo38; tab-stops: 46.5pt; text-align: justify; text-indent: -32.5pt;"><span lang="DE" style="font-family: Symbol; font-size: 12pt; line-height: 150%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan radiologi<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; mso-list: l17 level1 lfo33; tab-stops: 46.5pt; text-align: justify; text-indent: -.5in;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">II.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dengan hipoparatiroidisme rentan terhadap hipokalsemia, yang dapat mengarah pada masalah kolaboratif Tetani otot yang berhubungan dengan penurunan kadar kalsium serum. Dan karena kondisi hipoparatiroidisme dapat menjadi kondisi yang kronis, klien harus dapat melakukan perawatan diri, sehingga membuat diagnosa keperawatn risiko terhadap infektif penatalaksanaan regimen terapeutik (individual) yang berhubungan dengan regimen diet dan medikasi menjadi penting untuk klien ini. Secara umum diagnosa keperawatan utama pada klien ini adalah:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; mso-list: l22 level1 lfo39; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Masalah kolaboratif: tetani otot yang berhubungan dengan penurunan kadar kalsium serum<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; mso-list: l22 level1 lfo39; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Risiki terhadap infektif penatalaksanaan regimen terapeutik (individual) yang berhubungan dengan kurang pengetahuan tentang regimen dien dan medikasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; mso-list: l17 level1 lfo33; tab-stops: 46.5pt; text-align: justify; text-indent: -.5in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">III.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rencana Tindakan Keperawatan</span></b><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Masalah kolaboratif:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tetani otot yang berhubungan dengan penurunan kadar kalsium serum<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien tidak akan menderita cedera, seperti yang dibuktikan oleh kadar kalsium kembali ke batas normal, frekuensi pernafasan normal, dan gas-gas darah dalam batas normal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 117.0pt; mso-add-space: auto; tab-stops: 46.5pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi keperawatan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; mso-list: l1 level1 lfo40; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Saat merawat klien dengan hipoparatiroidisme hebat, selalu waspadalah terhadap spasme laring dan obstruksi pernafasan. Siapkan selalu set selang endotrakeal, laringoskop, dan trakeostomisaan merawat klien dengan tetani akut.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; mso-list: l1 level1 lfo40; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jika klien berisiko terhadap hipokalsemia mendadak, seperti setelah tiroidektomi, selalu disiapkan cairan infus kalsium karbonat di dekat tempat tidur klien untuk segera digunakan jika diperlukan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; mso-list: l1 level1 lfo40; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jika selang infus harus dilepas, biasanya hanya diklem dulu untuk beberapa waktu sehingga selalu tersedia akses vena yang cepat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; mso-list: l1 level1 lfo40; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jika tersedia biasanya klien diberikan sumber siap pakai kalsium karbonat seperti Tums<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 46.5pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa keperawatan:<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Risiko terhadap infektif penatalaksanaan regimen terapeutik (individual) yang berhubungan dengan kurang pengetahuan regimen diet dan medikasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 46.5pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 46.5pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan:<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 46.5pt; text-align: justify;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien akan mengerti tentang diet dan medikasinya, seperti yang dibuktikan oleh pernyataan klien dan kemampuan klien untuk mengikuti regimen diet dan terapi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 117.0pt; tab-stops: 46.5pt; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi keperawatan :<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; mso-list: l14 level1 lfo41; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penyuluhan kesehatan untuk klien dengan hipoparatiroidisme kronis sangat penting karena klien akan membutuhkan medikasi dan modifikasi diet sepanjang hidupnya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; mso-list: l14 level1 lfo41; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Saat memberikan penyuluhan kesehatan tentang semua obat-obat yang harus digunakan di rumah, pastikan klien mengetahui bahwa semua bentuk vitamin D, kecuali dihidroksikolekalsiferol, diasimilasi dengan lambat dalam tubuh. Oleh karenanya akan membutuhkan waktu satu minggu atau lebih untuk melihat hasilnya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; mso-list: l14 level1 lfo41; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ajarkan klien tentang diet tinggi kalsium namun rendah fosfor. Ingatkan klien untuk menyingkirkan keju dan produk susu dari dietnya, karena makanan ini mengandung banyak fosfor.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 135.0pt; mso-add-space: auto; mso-list: l14 level1 lfo41; tab-stops: 46.5pt; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tekankan pentingnya perawatan medis sepanjang hidup bagi klien hipoparatiroidisme kronis. Intruksikan klien untuk memeriksakan kadar kalsium serum sedikitnya tiga kali setahun. Kadar kalsium serum harus dipertahankan normal untuk mencegah komplikasi. Jika terjadi hiperkalsemia atau hipokalsemia, dokter harus menyesuaikanregimen terapeutik untuk memperbaiki ketidakseimbangan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.Kebiasan hidup sehari-hari<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-indent: .25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a. pola makan <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-indent: .25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.pola tidur( KLian menghabiskan banyak waktu untuk tidur)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-indent: .25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c. pla aktivitas<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.tempat tinggal klien sekarang dan pada waktu balita<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4keluhan utama kjlien,mencakup gangguan pada berbagi system tubuh :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l9 level1 lfo11; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">System pulmonary<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l9 level1 lfo11; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">System pencernaan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l9 level1 lfo11; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">System krdiovarkular<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l9 level1 lfo11; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">System muskulosketal<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l9 level1 lfo11; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">System neurologic <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l9 level1 lfo11; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">f.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> System rproduksi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l9 level1 lfo11; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">g.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Metebolik emosi /psikologis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 4.5pt; mso-add-space: auto;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5. pemeriksaan fisik mencakup:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 40.5pt; mso-add-space: auto; mso-list: l16 level1 lfo12; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penampilan secara umum; amati wajah klien terhadap adanya dema sekitar mata,wajah bulan dan ekspresi wajah kosong serta roman wajah kasar.lidah tampak menebal dan gerak- gerik klien sangant lamban. Postur tubuh kecil dan pendek .kulit kasar,tebal, dan bersisik,dingin dan pucat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 40.5pt; mso-add-space: auto; mso-list: l16 level1 lfo12; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Nadi lambatr dan suhu tubuh menurun.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 40.5pt; mso-add-space: auto; mso-list: l16 level1 lfo12; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pembasaran jantung.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 40.5pt; mso-add-space: auto; mso-list: l16 level1 lfo12; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Disritmia dan hipotensi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 40.5pt; mso-add-space: auto; mso-list: l16 level1 lfo12; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Parastesia dan reflek tendon menurun<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 4.5pt; mso-add-space: auto;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6. pengkjian pisikososial:klien sangat sulit membina hubungan sosial sdengan lingkungannya , mengurng diri/bahkan mania.kluarga mengeluh klien sangat malas beraktivitas,dan ingin tidur sepanjang hari.kajilah bagaimana konsep diri klien mencakup kellima komponen konsep diri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 4.5pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 4.5pt; mso-add-space: auto;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.pemeriksaan penunjang mencakup: pemeriksaan kadar T3 dan T4 serum; pemeriksaan TSH (pada klien dengan hipotiroidisme primer akan terjadi peningkatan TSH serum,sedangkan pada sekunder kadar TSH dapat menur atau normal.)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 4.5pt; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 4.5pt; mso-add-space: auto;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">II. DIAGNOSA KEPERAWATAN<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diaknosa keperawatan utama yang dapat di jumpai pada klien dengan hipotiroidisme antara lain: <o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l4 level1 lfo13; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penurunan curah jantung yang berhubungan dengan penurunan volume sekuncup sebagai akibat dari bradikardi; arteriossklerosis arteri koronaria.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l4 level1 lfo13; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pola nafas yang tidak efektif yang berhubungan dengan penurunan tenaga/kelelahan;espansi paru yang menurun, obesitasn dan inaktivitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l4 level1 lfo13; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangauan proses piker yang berhubungan dengan edema jaringan serebral dan retensi air.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">III. <b style="mso-bidi-font-weight: normal;">RENCANA TINDAKAN KEPERAWTAN<o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa Keperawatan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penurunan curah jantung yang berhubungan dengan volume sekuncup akibat bradikardi dan ateriosklerosis arterti koronaria<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Fungsi kardiovaskular tetap optimal yang ditandai dengan tekanan darah, irama jantng dalam batas normal.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi Keperawatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l35 level1 lfo14; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pantau tekanan darah, denyut dan irama jantung setiap 2 jam untuk mengidentivikasi kemungkinan terjadinya gangguan hemodinamik jantung seperti hipotensi, penurunan haluaran urine dan perubahan status mental.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l35 level1 lfo14; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Anjurkan klien untuk memberitahukan perawat segera bila klien mengalami nyeri dada, karena pada klien dengan hipotiroidisme kronik dapat berkembang arterosklerosis arteri koronaria.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l35 level1 lfo14; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kolaborasi pemberian obat-obatan untuk mengurangi gejala-gejala. Obat yang sering digunakan adalah levotyroxine sodium (Synthroid, T4, dan Eltroxin). Observasi dengan ketat adanya nyeri dada dan dispnoe. Pada dosis awal pemberian obat biasanya dokter memberikan dosis minimal yang ditingkatkan secara bertahap setiap 2-3 minggu sampai ditemukan dosis yang tepat untuk pemeliharaan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l35 level1 lfo14; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ajarkan kepada klien dan keluarga cara penggunaan obat serta tanda-tanda yang harus diwaspadai bila terjadi hipertiroidismr akibat penggunaan obat yang berlebihan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoNormal" style="line-height: 150%;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa Keperawatan:<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pola nafas tidak efektif yang berhubungan dengan kelelahan, obesitas dan inaktivitas<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dapat mempertahankan pola nafas yang efektif.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi keperawatan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l40 level1 lfo15; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Amati dan catat irama serta kedalaman pernafasan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l40 level1 lfo15; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Auskultasi bunyi pernafasan dan catat dengan seksama.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l40 level1 lfo15; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bila klien mengalami kesulitan pernafasan yang berat, kolaborasikan dengan dokter kemungkinan penggunaan alat bantu untuk bernafas seperti ventilator.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l40 level1 lfo15; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hindarkan penggunaan obat sedatif karena dapat menekan pusat pernafasan. Bila klien menggunakan obat transqualizer dosis biasanya diturunkan karena klien sangat peka.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l40 level1 lfo15; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bantu klien beraktivitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l40 level1 lfo15; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penuhi kebutuhan sehari-hari klien sesuai kebutuhan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa Keperawatan:<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan proses berfikir yang berhubungan dengan edema jaringan otak dan retensi air<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Proses berfikir klien kembali ketingkat yang optimal.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi Keperawatan:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l23 level1 lfo16; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Observasi dan catat tanda gangguan proses berfikir yang berat seperti:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l23 level2 lfo16; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">a.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Letargi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l23 level2 lfo16; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">b.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan Memori<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l23 level2 lfo16; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">c.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tidak ada perhatian<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l23 level2 lfo16; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">d.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kesulitan berkomunikasi]<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l23 level2 lfo16; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">e.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Mengantuk.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l23 level1 lfo16; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Orientasikan klien kembali dengan lingkungannya baik terhadap orang, tempat, waktu. Biasanya gejala-gejala berkurang dalam waktu 2-3 minggu pengobatan sehingga mengorientasikan kembali klien terhadap lingkungan nyata yang sangat diperlukan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l23 level1 lfo16; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Beri dorongan pada keluarga agar dapat menerima perubahan perilaku klien dan mengadaptasinya. Jelaskan pula bahwa dengan pengobatan yang teratur gejala-gejala akan berkurang.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penyuluhan Kesehatan:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penyuluhan kesehatan sangat penting bagi klien dan keluarga. Berikanlah kepada mereka hal-hal yang harus diperhatikan dalam penggunaan obat di rumah dan perawatan klien pada umumnya. Berikan penjelasan tentang:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l38 level1 lfo17; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Cara penggunaan obat, dosis dan waktunya. Tidak meminum obat bersama dengan obat lain.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l38 level1 lfo17; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tanda dan gejala bila kelebihan obat atau sebaliknya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l38 level1 lfo17; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Menggunakan selimut tambahan pada waktu tidur, penggunaan baju hangat dan pakaian yang tebal bila suhu udara dingin.s<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 85.65pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hal 68-71<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">D. Penatalaksanaan Klien Dengan Hipertropi Kelenjar Tiroid<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 22.5pt; mso-add-space: auto; mso-list: l8 level1 lfo25; mso-text-indent-alt: -.25in; text-indent: -22.5pt;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">I.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penatalaksaan Klien dengan Hipertropi Kelenjar Tiroid<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l0 level1 lfo18; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji riwayat penyakit :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l33 level1 lfo19; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sudah sejak kapan keluhan dirasakan klien<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l33 level1 lfo19; text-indent: -.25in;"><span style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Apakah ada anggota keluarga yang berpenyakit sama<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l0 level1 lfo18; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tempat tinggal sekarang dan masa pada balita<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l0 level1 lfo18; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Usia dan jenis kelamin<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l0 level1 lfo18; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kebiasaan makan; bertujuan untuk mengidentifikasi kemungkinan adanya faktor goitrogenik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l0 level1 lfo18; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Penggunaan obat-obatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l28 level1 lfo20; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kaji jenis obat-obatan yang sedang digunakan dalam tiga bulan terakhir<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l28 level1 lfo20; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sudah berapa lama digunakan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l28 level1 lfo20; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan pemberian obat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l0 level1 lfo18; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Keluhan klien<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l37 level1 lfo21; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sesak nafas, a[akah bertambah sesak bila beraktifitas<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l37 level1 lfo21; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Sulit menelan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l37 level1 lfo21; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Leher bertambah besar<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l37 level1 lfo21; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Suara serak/ parau<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l37 level1 lfo21; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Merasa malu dengan bentuk leher yang besar dan tidak simetris<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l0 level1 lfo18; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l29 level1 lfo22; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Palpasi kelenjar tiroid, nodul tunggal atau ganda, konsistensi dan simetris tidaknya, apakah terasa nyeri pada saat dipalpasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l29 level1 lfo22; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Insoeksi bentuk leher, simetris tidaknya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l29 level1 lfo22; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Auskultasi bruit pada arteri tyroidea<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l29 level1 lfo22; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Nilai kualitas suara<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l29 level1 lfo22; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Palpasi apakah terjadi devisiasi trachea<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l0 level1 lfo18; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">8.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan diagnostic<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l21 level1 lfo23; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan kadar T3 dan T4 serum<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l21 level1 lfo23; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pemeriksaan RAI <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l21 level1 lfo23; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Test TSH serum<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l0 level1 lfo18; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">9.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Lakukan pengkajian lengkap dampak perubahan patologis diatas terhadap kemungkinan adanya gangguan pemenuhan oksigen, nutrisi, cairan dan elektrolitseta gangguan rasa aman dan perubahan konsep diri seperti :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Status pernafasan: grekuensi, pola dan teratur tidaknya, dan apakah klien menggunakan otot pernafasan tambahan seperti retraksi sternal dan cuping hidung<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Warna kulit, apakah tampak pucat atau sianosis<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Suhu kulit khususnya daerah akral<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Keadaan umum/ kesadaran, apakah klien tampak gelisah ata tidak berdaya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berat badan dan tinggi badan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kadar hemoglobin<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kelembaban kulit dan teksturnya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Porsi makan yang dihabiskan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Turgor<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jumlah dan jenis cairan peroral yang dikonsumsi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kondisi mukosa mulut<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kualitas suara<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bagaimana ekspresi wajah, cara berkomunikasi dan gaya interaksi klien dengan orang disekitarnya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l6 level1 lfo24; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bagaimana klien memandang dirinya sebagai seorang pribadi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 22.5pt; mso-add-space: auto; mso-list: l8 level1 lfo25; mso-text-indent-alt: -.25in; text-indent: -22.5pt;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">II.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa Keperawatan</span></b><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa keperawatn utama yang dijumpai pada klien dengan goiter non toksik antara lain :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l20 level1 lfo26; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pola nafas yang tidak efektif yang berhubungan dengan penekanan kelenjar tiroid terhadap trachea<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l20 level1 lfo26; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan nutrisi: kurang dari kebutuhan tubuh yang berhubungan dengan asupan yang kurang akibat disfagia<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l20 level1 lfo26; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan citra diri yang berhubungan dengan perubahan bentuk leher<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l20 level1 lfo26; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Gangguan rasa aman: ansietas yang berhubungan dengan kurang informasi tentang penyakit dan pengobatannya, atau persepsi yang salah tentang penyakit yang diderita<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-left: 22.5pt; mso-add-space: auto; mso-list: l8 level1 lfo25; mso-text-indent-alt: -.25in; text-indent: -22.5pt;"><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">III.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Rencana Tindakan Keperawatan</span></b><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 4.5pt;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa keperawatan</span></i><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Pola nafas yang tidak efektif yang berhubungan dengan penekanan kelenjar tiroid terhadap trachea.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan:<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Selama dalam perawatan, pola nafas klien efektif kembali (sambil menunggu tindakan pembedahan bila diperlukan ) dengan kriteria sebagai berikut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l31 level1 lfo27; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Frekuensi pernafasan 16-20 x/menit dan pola teratur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l31 level1 lfo27; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Akral hangat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l31 level1 lfo27; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kulit tidak pucat atau sianosis<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l31 level1 lfo27; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Keadaan klien tenang/ tidak gelisah<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoNormal" style="line-height: 150%;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi Keperawatan<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Batasi aktivitas, hindarkan aktivitas yang melelahkan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Posisi tidur setengah duduk dengan kepala ekstensi bila diperlukan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-indent: -.25in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kolaborasi pemberian obat-obatan seperti dexamethason (untuk mengurangi edema)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bila dengan koservatif gejala tidak hilang, kolaborasi tindakan operatif<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Bantu aktivitas klien ditempat tidur<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Observasi keadaan klien secara teratur<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l27 level1 lfo28; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">7.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hindarkan klien dari kondisi-kondisi yang menuntut penggunaan oksigen lebih banyak seperti ketegangan, lingkungan yang panas atau yang yerlalu dingin<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosa Keperawatan:<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan nutrisi: kurang dari kebutuhan tubuh yang berhubungan dengan asupan nutrien kurang akibat disfagia<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan:<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Nutrisi klien dapat terpenuhi kembali dalam waktu 1-2 minggu dengan kriteria sebagai berikut:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l26 level1 lfo29; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berat badan bertambah<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l26 level1 lfo29; text-indent: -.25in;"><span style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Hemoglobin: 12-14 gr% (wanita) dan 14-16 gr% (pria)<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l26 level1 lfo29; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tekstur kulit baik<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi keperawatan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l11 level1 lfo30; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Berikan makanan lunak atau cair sesuai kondisi klien<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l11 level1 lfo30; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Porsi makanan kecil tetapi sering<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l11 level1 lfo30; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Beri makanan tambahan diantara jam makan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l11 level1 lfo30; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Timbang berat badan dua hari sekali<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l11 level1 lfo30; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Kolaborasi pemberian ruborantia bila diperlukan<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l11 level1 lfo30; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">6.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Ciptakan lingkungan yang menyenangkan menjelag jam makan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dioagnosa keperawatan:<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Perubahan citra diri yang berhubungan dengan bentuk leher<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Tujuan:<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 150%;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Setelah menjalani perawatan, klien memiliki gambaran diri yang positif kembali dengan criteria:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l15 level1 lfo31; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien menyenangi kembali tubuhnya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l15 level1 lfo31; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dapat melakukan upaya-upaya untuk mengurangi dampak negative penbesaran pada leher<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l15 level1 lfo31; text-indent: -.25in;"><span lang="DE" style="font-family: SimSun; font-size: 12pt; line-height: 150%;">-<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Klien dapat melakukan aktivitas fisik dan sosial sehari-hari<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%;"><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Intervensi keperawatan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l13 level1 lfo32; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Dorong klien mengungkapkan perasaan dan pikirannya tentang bentuk leher yang berubah <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l13 level1 lfo32; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diskusikan upaya-upaya yang dapat dilakukan klien untuk mengurangi perasaan malu seperti menggunakan baju yang berkerah tertutup<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l13 level1 lfo32; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">3.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Beri pujian bila klien dapat melakukan upaya-upaya positif untuk meningkatkan penampilan diri<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l13 level1 lfo32; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">4.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jelaskan penyebab terjadinya perubahan bentuk leher dan jalan keluar yang dapat dilakukan seperti tindakan operasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l13 level1 lfo32; text-indent: -.25in;"><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">5.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="DE" style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Jalaskan pula setiap resiko yang perlu diantisipasi dari setiap tindakan yang dapat dilakukan<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 78.0pt; text-align: justify; text-indent: -28.35pt;"><div style="text-align: auto; text-indent: 0px;"><br />
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</div>Ian zkate pakpahanhttp://www.blogger.com/profile/10259135788220046244noreply@blogger.com1tag:blogger.com,1999:blog-2556652656898751244.post-28980986885286203712010-10-17T11:52:00.002+07:002010-10-17T11:52:48.567+07:00ASKEP GANGGUAN KELENJAR HIPOFISE<span class="Apple-style-span"><span class="Apple-style-span" style="font-size: 35px; line-height: 40px;"></span></span><br />
<span class="Apple-style-span"><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-size: 26.0pt; line-height: 115%; mso-ansi-language: EN-US;">ASKEP </span><span lang="IN" style="font-size: 26.0pt; line-height: 115%;">GANGGUAN KELENJAR HIPOFISE</span><span style="font-size: 26.0pt; line-height: 115%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
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</div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-size: 14.0pt; line-height: 115%;">oleh<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span style="font-size: 14.0pt; line-height: 115%; mso-ansi-language: EN-US;">STIKES BORROMEUS</span><span style="font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><br />
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</div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-size: 18.0pt; line-height: 115%;">PROGRAM STUDI DIII KEPERAWATAN<o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-size: 18.0pt; line-height: 115%;">SEKOLAH TINGGI ILMU KESEHATAN SANTO BORROMEUS <o:p></o:p></span></div><div align="center" class="MsoNormal" style="text-align: center;"><span lang="IN" style="font-size: 18.0pt; line-height: 115%;">2010<o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">BAB I<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">PENDAHULUAN<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">I.1 Latar belakang<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: .5in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kelenjar pituitari (hipofisis) berukuran kurang lebih 1 cm dengan berat 500 mg. Terletak di sella tursica dari tulang sphenoid. Sella tursica dekat dengan chiasma opticum. Kelenjar hipofise sebenarnya terdiri dari dua kelenjar, pituitari anterior yang berukuran lebih besar terletak di anterior atau disebut adenohipofise dan pituitari posterior atau neurohipofise. Pituitari anterior biasa juga disebut sebagai <i style="mso-bidi-font-style: normal;">Master gland</i>, karena pengaruhnya pada kelenjar lain dan pada seluruh tubuh. Pengaruh ini dilaksanakan oleh 6 hormon yang diproduksi oleh sel yang berbeda- beda yang terdapat di lobus anterior hipofise, dan oleh dua hormon yang diproduksi oleh lobus posterior hipofise.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">I.2 Tujuan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l35 level1 lfo36; text-align: justify; text-indent: -1.1pt;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">Tujuan umum<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; text-align: justify; text-indent: -.55pt;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";"><span style="mso-spacerun: yes;"> </span>Diharapkan dengan adanya makalah ini mahasiswa mahasiswi dapat memahami serta menerapkan dalam kehidupan sehari – hari.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 35.45pt; mso-add-space: auto; mso-list: l35 level1 lfo36; text-align: justify; text-indent: 0in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">Tujuan khusus<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">Mahasiswa progam study D3 keperawatan STIkes St. Borromeus mampu memahami apa yang dimaksud dengan definisi, anatomi fisiologi, patofisiologi, asuhan keperawatan, diagnosa keperawatan, rencana tindakan keperawatan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">I.3 Metode Penulisan<o:p></o:p></span></b></div><div class="MsoListParagraph" style="line-height: 150%; text-align: justify; text-indent: .5in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">Metode yang kita gunakan dalam menyusunan makalah ini adalah dengan study pustaka dan konsultasi pada dosen pembimbing. Kita juga mencari informasi melalui<span style="mso-spacerun: yes;"> </span>media webside untuk mendukung sumber makalah yang kita susun<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: .25in; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">I.4 Sistematika penuliasan.<o:p></o:p></span></b></div><div class="MsoListParagraph" style="line-height: 150%; text-align: justify; text-indent: .5in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">Makalah ini terdiri dari 3 bab: Bab<span style="mso-spacerun: yes;"> </span>I Pendahuluan antara lain: latar belakang, </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Arial Unicode MS";">t</span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">ujuan, </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Arial Unicode MS";">m</span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Arial Unicode MS";">etode, dan sistematika penulisan ; Bab II Tinjauan teoretis yang berisikan anatomi fisiologi, disfungsi kelenjar hipofise, asuhan keperawatan yang terdiri dari : Pengkajian, Diagnosa Keperawatan, Rencana tindakan keperawatan, Tindakan keperawatan, dan Evaluasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: center;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">BAB II<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: center;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tinjauan Teoretis<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 25.1pt; mso-add-space: auto; mso-list: l23 level1 lfo28; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Anatomi dan Fisiologi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-add-space: auto; mso-list: l10 level1 lfo29; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kelenjar Hipofise<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Times New Roman"; mso-no-proof: yes;"><!--[if gte vml 1]><v:shape id="Picture_x0020_17" o:spid="_x0000_i1026"
type="#_x0000_t75" style='width:388.5pt;height:374.25pt;visibility:visible;
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o:title=""/> </v:shape><![endif]--><img height="499" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image004.jpg" v:shapes="Picture_x0020_17" width="518" /></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Kelenjar pituitari(hipofisis) berukuran kurang lebih 1 cm dengan berat 500 mg. Terletak di sella tursica dari tulang sphenoid. Sella tursica dekat dengan chiasma opticum. Kelenjar hipofise sebenarnya terdiri dari dua kelenjar, pituitari anterior yang berukuran lebih besar terletak di anterior atau disebut adenohipofise dan pituitari posterior atau neurohipofise. Pituitari anterior biasa juga disebut sebagai Master gland, karena pengaruhnya pada kelenjar lain dan pada seluruh tubuh. Pengaruh ini dilaksanakan oleh 6 hormon yang diproduksi oleh sel yang berbeda- beda yang terdapat di lobus anterior hipofise, dan oleh dua hormon yang diproduksi oleh lobus posterior hipofise.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bagian anterior kelenjar hipofisis mempunyai banyak fungsi dan karena memiliki kemampuan dalam mengatur fungsi-fungsi dari kelenjar-kelenjar endokrin lain, maka bagian anterior kelenjar hipofisis ini dikenal juga dengan nama kelenjar utama (<i style="mso-bidi-font-style: normal;">master of gland)</i>. Sel-sel hipofisis anterior merupakan sel-sel yang khusus menyekresikan hormon-hormon tertentu. Tujuh macam hormon dan peranan metabolik<span style="mso-spacerun: yes;"> </span>fisiologinya telah diketahui dengan baik. Hormon- hormon terssebut adalah <i style="mso-bidi-font-style: normal;">adrenocortocotropic hormone</i> (ACTH), <i style="mso-bidi-font-style: normal;">melanocyte-stimulating hormone</i> (MSH), <i style="mso-bidi-font-style: normal;">thyroid-stimulating hormone</i> (thyrotropin, TSH<i style="mso-bidi-font-style: normal;">), follicle-stimulating hormone </i>(FSH), <i style="mso-bidi-font-style: normal;">luteinizing hormone</i>(LH<i style="mso-bidi-font-style: normal;">), growth hormone</i> (GH), dan <i style="mso-bidi-font-style: normal;">prolactin</i> (PRL). Beberapa hormon ini (ACTH, MSH, GH, dan prolaktin) merupakan <i style="mso-bidi-font-style: normal;">polipeptida,</i> sedangkan hormon yang lainnya (TSH, FSH, dan LH) merupakan <i style="mso-bidi-font-style: normal;">glikoprotein</i>. Penelitian morfologis menemukan bahwa setiap hormon disintesis oleh satu jenis sel tertentu. Dapat dikatakan bahwa bagian anterior kelenjar hipofisis sesungguhnya merupakan gabungan dari beberapa kelenjar yang berdiri sendiri-sendiri, yang semuanya berada di bawah pengawasan hipotalamus. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Lobus posterior kelenjar hipofisis atau neurohipofisis terutama berfungsi untuk mengatur keseimabangan cairan. Vasopresin atau hormon antidiuretik (ADH) terutama disintesis dalam nukleus supraoptik dan pareventrikular hipotalamus dan disimpan dalam neurohipofisis.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Thyroid stimulating hormon (TSH), adrenocorticotropic hormon (ACTH), dan gonadotropic hormon disebut tropic hormon karena hormon- hormon ini menstimulasi hormon lain untuk mensekresi hormon yang aktif yang mempengaruhi perubahan sel- sel tubuh tertentu. Hormon hipofise lain melaksanakan penggaruhnya pada sel tubuh secara langsung ( non tropik ). <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-fareast-font-family: "Times New Roman"; mso-no-proof: yes;"><!--[if gte vml 1]><v:shape id="Picture_x0020_2"
o:spid="_x0000_i1025" type="#_x0000_t75" style='width:449.25pt;height:469.5pt;
visibility:visible;mso-wrap-style:square'> <v:imagedata src="file:///C:\Users\ZON4_14N\AppData\Local\Temp\msohtmlclip1\01\clip_image005.png"
o:title=""/> </v:shape><![endif]--><img height="626" src="file:///C:/Users/ZON4_14N/AppData/Local/Temp/msohtmlclip1/01/clip_image006.jpg" v:shapes="Picture_x0020_2" width="599" /></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b. Hubungan antar hipotalamus dan kelenjar hipofise</span></b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Hipotalamus terdiri dari sebuah nuklei dan berperan sebagai suatu penghubung yang penting antara mekanisme pengaturan neurologis dan hormonal. Hipotalamus melaksanakan pengontrolan pada kelenjar hipofise anterior dan terhadap kelenjar lain dan sel-sel tubuh. Hipotalamus (terletak pada jaringan sekitar ventrikel ketiga) dan lobus hipofise anterior dihubungkan oleh sistem perdarahan portal hipotalamus-hipofise (hipotalamus-hipofise portal blood system) dengan demikian neurosekresi releasing factor (RF) dan inhibiting factor (IF) dilakukan dari hipotalamus ke hipofise. Diduga bahwa masing-masing hormon hipofise memiliki RF dan IF yang menstimulir atau menghambat pelepasan hormon-hormon tersebut. Dengan diketahuinya struktur kimia dari suatu inhibitory dan releasing factor , istilah faktor diubah menjadi hormon. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Hipotalamus juga mengendalikan kelenjar hipofise posterior yang berhubungan dengannya secara struktural. ADH dan oksitosin sebenarnya diproduksi di hipotalamus dalam nuklei paraventrikular dan supraoptik dan dibawa oleh neuron melalui transport aksonal melalui cabang-cabang terminal yang terletak di lobus posterior hipofise. Disana mereka disimpan dan kemudian dilepaskan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-collapse: collapse; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; width: 631px;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: center;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hormon<o:p></o:p></span></b></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: center;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Fungsi<o:p></o:p></span></b></div></td> </tr>
<tr style="mso-yfti-irow: 1;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="bottom" width="281"> <div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hipofise anterior<o:p></o:p></span></b></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 2;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281"> <div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Growth hormon (GH)<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Target organ : seluruh tubuh, kemungkinan bekerja pada kebanyakan jaringan melalui somatomedin. Berhubungan dengan pertumbuhan sel, tulang, dan jaringan lunak.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Meningkatkan mitosis<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Mempengaruhi metabolisme karbohidrat, protein, dan lemak.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Meningkatkan glukosa darah dengan menurunkan penggunaan glukosa, antagonis insulin.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Meningkatkan sintesa protein.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Meningkatkan kadar asam lemak bebas, lipolisis, dan pembentukan keton.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Meningkatkan retensi elektrolit dan cairan ekstraseluler.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 3;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281"> <div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Prolaktin (PRL)<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Target organ : payudara dan gonad.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perlu bagi perkembangan payudara dan laktasi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pengatur fungsi reproduksi pada pria dan wanita.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 4;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281"> <div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Thyroid Stimulating Hormon (TSH)<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Target organ : tiroid<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perlu untuk pertumbuhan dan fungsi tiroid.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 5;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281"> <div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Adrenokorticoid-stimulating hormon (ACTH; Corticotropin)<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Organ target: korteks <span style="mso-spacerun: yes;"> </span>adrenal<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perlu untuk pertumbuhan dan mempertahankan ukuran kortek adrenal. Sedikit berperan dalam pelepasan mineralokortikoid (aldosteron).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Mengontrol pelepeasan glukokorticoid (kortisel) dan androgen adrenal.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 6;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281"> <div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gonadotropin <o:p></o:p></span></b></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 7;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Folikel stimulating hormon (FSH)<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Luteinizing hormon (LH)<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Target organ : gonad<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Menstimulasi gametogenesis dan produksi seks steroid pada pria dan wanita.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 8;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hipofise Posterior<o:p></o:p></span></b></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><br />
</div></td> </tr>
<tr style="mso-yfti-irow: 9;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Antidiuretic hormone (ADH)<o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Merubah membran tubulus ginjal untuk meningkatkan absorpsi air; merangsang otot polos usus, dan pembuluh darah.<o:p></o:p></span></div></td> </tr>
<tr style="mso-yfti-irow: 10; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 210.95pt;" valign="top" width="281"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Oxitocin <o:p></o:p></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 262.25pt;" valign="top" width="350"> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Merangsang kontraksi uterus dan pengeluaran air susu.<o:p></o:p></span></div></td> </tr>
</tbody></table><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; mso-add-space: auto; mso-list: l29 level1 lfo31; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Peran Fisiologis Dan Metabolik Hormon-Hormon Hipofisis Anterior<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">GH, prolaktin, dan MSH mempunyai pengaruh metabolik langsung pada jaringan sasaran sebaliknya ACTH, TSH, FSH, dan LH fungsi utamanya adalah mengatur sekresi kelenjar-kelanjar endokrin lainnya, karena itu dikenal sebagai hormon-hormon tropik. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">GH atau somatotropin mempunyai pengaruh metabolik utama,baik pada anak-anak maupun orang dewasa. Pada anak-anak, hormon ini diperlukan untuk pertumbuhan somatik. Pada orang dewasa, hormon ini berfungsi mempertahankan ukuran orang dewasa normal dan juga berperan dalam pengaturan sintesis protein dan pembuangan zat makanan. GH memproduksi faktor pertumbuhan-1 mirip insulin (IGF-1) yang merantarai efek perangsang-pertumbuhan. Tanpa IGF-1, GH tidak dapat merangsang pertumbuhan. Sekresi GH diatur oleh growth hormone-releasing hormone (GHRH) dari hipotalamus dan oleh somatostatin, suatu hormon penghambat. Pelepasan GH dirangsang oleh hipoglikemia dan oleh asam amino seperti arginin, ditambah juga dengan stress dan latihan berat. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">MSH merupakan suatu unsur pokok dari proopiomelanokortin. Hormon ini meningkatkan pigmentasi kulit dengan merangsang dispersi granula-granula melanin dalam melanosit. Sekresi MSH diatur oleh corticotropin-releasing hormone (CRH) dan dihambat oleh peningkatan kadar kortisol. Defisiensi sekresi kortisol dapat merangsang pelepasan MSH, sedangkan kadar kortisol yang tinggi menekan sekresi hormon ini. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Prolaktin merupakan salah satu kelompok hormon yang dibutuhkan untuk perkembangan payudara dan sekresi susu. Pelepasan prolaktin berada di bawah pengaruh penghambatan tonik oleh hipotalamus melalui dopamin yang disekresi oleh sistem neuron dopaminergik tuberohipofisel. Jika <b>faktor-faktor penghambat</b> ini tidak ada maka sekresi prolaktin akan meningkat dan dapat terjadi laktasi. Thyrotropin-releasing hormone (TRH) merangsang sekresi prolaktin. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">ACTH merangsang pertumbuhan dan fungsi korteks adrenal dan merupakan suatu faktor yang sangat penting pada pengaturan produksi dan pelepasan kortisol. Secara tunggal, ACTH tampaknya tidak mempunyai efek ekstraadrenal yang berarti CRH dan arginine vasopressin (AVP) bekerja secara sinergis untuk merangsang sekresi ACTH. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">TSH merangsang pertumbuhan dan fungsi kelenjar tiroid. TSH ini menyebabkan pelepasan tiroksin (T<sub>4</sub>) dan tryodo tironin (T<sub>3</sub>), selanjutnya hormon-hormon ini akan mengatur sekresi TSH. TRH merangsang sekresi TSH.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">FSH dan LH dikenal juga sebagai gonadotropin. Pada laki-laki, FSH mempertahankan dan merangsang spermatogenesis, sedangakan LH merangsang sekresi testoteron oleh sel-sel Leydig atau sel-sel interstisial testis. FSH dan LH ini akan disekresi secara kontinu atau secara tonik pada laki-laki. Sebaliknya, pada perempuan FSH merangsang perkembangan folikel dan sekresi estrogen oleh sel-sel folikel. LH menyebabkan ovulasi dan mempertahankan serta merangsang sekresi progesteron oleh korpus luteum yang berkembang dari folikel sesudah ovulasi. Pelepasan FSH dan LH pada perempuan bersifat siklik, sedemikian pula sehingga kadar kedua hormon tersebut akan melonjak pada pertengahan siklus dan kemudian sedikit demi sedikit menurun pada akhir siklus, dan diikuti oleh menstruasi. Sekresi FSH dan LH diatur oleh sekresi (amplitudo dan frekuensi) gonadotropin-releasing hormone (GnRH) yang bersifat pulsatil.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Konsekuensi klinis defisiensi pelepasan ACTH dan TSH masing-masing berupa insufisiensi adrenal dan hipotiroidisme. Tidak adanya pelepasan gonadotropin mengakibatkan hipotiroidisme. Sebaliknya, sekresi ACTH yang berlebihan akan mengakibatkan hiperfungsi korteks adrenal atau sindrom Cushing. Sindrom kelebihan TSH atau pelepasan gonadotropin jarang ditemukan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diagnosis klinis gangguan hipofisis membutuhkan penegasan biokimia melalui uji khusus yang memperlihatkan fungsi hipofisis abnormal yang merupakan karakteristik keadaan yang dicurigai. Hormon hipofisis yang sudah diterangkan yaitu, ACTH, MSH, TSH, FSH, LH, GH, dan prolaktin semuanya dapat dihitung dalam serum atau plasma.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; mso-add-space: auto; mso-list: l29 level1 lfo31; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Disfungsi kelenjar hipofise<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Penyakit hipofise adalah penyakit yang tidak umum terjadi, namun dapat timbul sebagai kondisi hiperfungsi hipofise, hipofungsi hipofise, dan lesi/ massa setempat yang menyebabkan tekanan pada khiasma optikus atau bagian basal otak.<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-list: l16 level1 lfo32; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -13.65pt;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hiperfungsi kelenjar hipofise<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Sering disebut juga hiperpituitarisme yaitu suatu kondisi patologis yang terjadi akibat tumor atau hiperplasi hipofise sehingga menyebabkan peningkatan sekresi salah satu hormon hipofise atau lebih.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">PATOFISIOLOGI<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: .5in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hiperfungsi hipofise dapat terjadi dalam beberapa bentuk bergantung pada sel mana dari kelima sel-sel hipofise yang mengalami hiperfungsi. Kelenjar biasanya mengalami pembesaran, disebut adenoma makroskopik bila diameternya lebih dari 10 mm, yang terdiri atas satu jenis sel atau beberapa jenis sel. Kebanyakan adalah tumor yang terdiri atas sel-sel laktotropik (juga dikenal sebagai prolaktinomas). Tumor yang kurang umum terjadi adalah adenoma somatotropik. Tumor yang terdiri atas sel- sel pensekresi TSH-, LH-, atau FSH- sangat jarang terjadi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Prolaktinoma (adenoma laktotropin) biasanya adalah tumor kecil, jinak, yang terdiri atas sel-sel pensekresi prolaktin. Gejala yang khas pada kondisi ini sangat jelas pada wanita usia reproduktif dan dimana terjadi (tidak menstruasi, yang bersifat primer dan sekunder), galaktorea (sekresi ASI spontan yang tidak ada hubungannya dengan kehamilan), dan infertilitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Adenoma somatotropik terdiri atas sel-sel yang mensekresi hormon pertumbuhan. Gejala klinik hipersekresi hormon pertumbuhan bergantung pada usia klien saat terjadi kondisi ini. Misalnya saja pada klien pre pubertas, dimana lempeng epifise tulang panjang belum menutup, mengakibatkan pertumbuhan tulang-tulang memanjanng sehingga mengakibatkan gigantisme. Pada klien post pubertas, adenoma somatotropik mengakibatkan akromegali, yang ditandai dengan pembesaran ekstermitas (jari, tangan, kaki), lidah, rahang, dan hidung. Organ-organ dalam juga turut membesar (mis : kardiomegali).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Kelebihan hormon pertumbuhan menyebabkan gangguan metabolik, seperti hiperglikemia dan hiperkalsemia. Pengangkatan tumor dengan pembedahan merupakan pengobatan pilihan. Gejala metabolik dengan tindakan ini dapat mengalami perbaikan, namun perubahan tulang tidak mengalami regresi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Adenoma kortikotropik terdiri atas sel-sel pensekresi ACTH. Kebanyakan tumor ini adalah mikroadenoma dan secara klinis dikenal dengan tanda khas penyakit cushing’s.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-add-space: auto; mso-list: l6 level1 lfo33; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gigantisme dan Akromegali<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gigantisme dan akromegali disebabkan oleh sekresi GH yang berlebihan. Keadaan ini dapat diakibatkan tumor hipofisis yang menyekresi GH atau karena kelainan hipotalamus yang mengarah pada pelepasan GH secara berlebihan. Pada beberapa pasien dapat timbul akromegali sebagai respons terhadap neoplasia yang menyekresi GHRA ektopik. Pada pasien ini terdapat hiperplasia hipofisis somatotrop dan hipersekresi GH.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bila kelebihan GH terjadi selama masa anak-anak dan remaja, maka pertumbuhan longitudinal pasien sangat cepat, dan pasien akan menjadi seorang raksasa. Setelah <b>pertumbuhan somatis selesai, hipersekresi GH tidak akan menimbulkan GIGANTISME, tetapi menyebabkan penebalan tulang-tulang dan jaringan lunak.</b> Keadaan ini disebut akromegali, dan penderita akromegali memperlihatkan pembesaran tangan dan kaki.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Penderita mungkin membutuhkan ukuran sarung tangan yang lebih besar. Kaki juga menjadi lebih besar dan lebar, dan penderita menceritakan mereka harus mengubah ukuran sepatunya. Pembesaran ini biasanya disebabkan oleh pertumbuhan dan penebalan tulang dan peningkatan pertumbuhan jaringan lunak.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Selain itu, perubahan bentuk raut wajah dapat membantu diagnosis pada insepeksi. Raut wajah menjadi semakin kasar, sinus paranasalis dan sinus frontalis membesar. Bagian frontal menonjol, tonjolan supraorbital menjadi semakin nyata, dan terjadi deformitas mandibula disertai timbulnya prognatisme (rahang yang menjorok ke depan) dan gigi geligi tidak dapat menggigit. Pembesaran<span style="mso-spacerun: yes;"> </span>mandibula menyebabkan gigi-gigi renggang. Lidah juga membesar, sehingga penderita sulit berbicara. Suara menjadi lebih dalam akibat penebalan pita suara.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Deformitas tulang belakang karena pertumbuhan tulang yang berlebihan, mengakibatkan timbulnya nyeri dipunggung dan perubahan fisiologik lengkung tulang belakang. Pemeriksaan radiografik tengkorak pasien akromegali menunjukkan perubahan khas disertai pembesaran sinus paranasalis, penebalan kalvarium, deformitas mandibula ( yang menyerupai bumerang ), dan yang paling penting ialah penebalan dan destruksi sela tursika yang menimbulkan dugaan adanya tumor hipofisis.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bila akromegali berkaitan dengan tumor hipofisis, maka pasien mungkin mengalami nyeri kepala bitemporal dan gangguan penglihatan disertai hemianopsia bitemporal akibat penyebaran supraselar tumor tersebut, dan penekanan kiasma optikum. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pasien dengan akromegali memiliki kadar basal GH dan IGF-1yang tinggi dan juga dapat diuji dengan pemberian glukosa oral. Pada subjek yang normal, induksi hiperglikemia dengan glukosa akan menekan kadar GH. Sebaliknya, pada pasien akromegali atau gigantisme kadar GH gagal ditekan.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">CT-scan dan MRI pada sela tursika memperlihatkan mikroadenoma hipofisis, serta makroadenoma yang meluas ke luar sela mencakup juga sisterna diatas<span style="mso-spacerun: yes;"> </span>sela, dan daerah sekitar sela, atau sinus sfenoid.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 35.45pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pengobatan akromegali atau gigantisme lebih kompleks. Iridiasi hipofisis, pembadahan mengakibatkan penurunan atau perbaikan penyakit. Pengobatan medis dengan menggunakan octreotide, suatu analog somatostatin, juga tersedia. Octreoide dapat menurunkan supresi kadar GH dan IGF-1, mengecilkan ukuran tumor, dan memperbaiki gambaran klinis.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraph" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-list: l16 level1 lfo32; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -14.2pt;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hipofungsi kelenjar hipofise<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Insufisiensi hipofisis pada umumnya mempengaruhi semua hormon yang secara normal disekresi oleh kelenjar hipofisis anterior. Oleh karena itu, manifestasi klinis dari panhipopituitarisme merupakan gabungan pengaruh metabolik akibat berkurangnya sekresi masing-masing hormon hipofisis. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Beberapa proses patologik dapat mengakibatkan insufisiensi hipofisis dengan cara merusak sel-sel hipofisis normal: (1) <b>tumor hipofisis</b>, (2<b>) trombosis vaskular</b> yang mengakibatkan nekrosis kelenjar hipofisis normal, (3) <b>penyakit granulomatosa infiltratif</b>, dan (4) <b>idiopatik </b>atau mungkin penyakit yang<span style="mso-spacerun: yes;"> </span>bersifat autoimun.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Sindrom klinis yang diakibatkan oleh panhipopituitarisme pada anak-anak dan orang dewasa berbeda-beda. Pada anak-anak, terjadi gangguan pertumbuhan somatis akibat defisiensi pelepasan GH. <b>Dwarfisme hipofisis (kerdil)</b> merupakan konsekuensi dari defisiensi terssebut. Ketika anak-anak tersebut mencapai pubertas, maka tanda-tanda seksual sekunder dan genitalia eksterna gagal berkembang. Selain itu, sering pula ditemukan berbagai derajat insufisiensi adrenal dan <b>hipotiroidisme</b>; mereka mungkin akan mengalami kesulitan di sekolah dan memperlihatkan perkembangan intelektual yang lamban; kulit biasanya pucat karena tidak adanya MSH.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kalau hipopituitarisme terjadi pada orang dewasa, kehilangan fungsi hipofisis sering mengikuti kronologis sebagai berikut : <b>defisiensi GH, hipogonadisme, hipotiroidisme dan insufisiensi adrenal</b>. Karena orang dewasa telah menyelesaikan pertumbuhan somatisnya, maka tinggi tubuh pasien dewasa dengan hipopituitarisme adalah normal. Manifestasi defisiensi GH mungkin dinyatakan dengan timbulnya kepekaan yang luar biasa terhadap insulin dan terhadap hipoglikemia puasa. Bersamaan dengan terjadinya <b>hipogonadisme,</b> pria menunjukan penurunan libido, impotensi dan pengurangan<span style="mso-spacerun: yes;"> </span>progresif pertumbuhan rambut dan bulu di tubuh, jenggot, dan berkurangnya perkembangan otot. Pada wanita, berhentinya siklus menstruasi atau ammanorea, merupakan tanda awal dari kegagalan hipofisis. Kemudian diikuti oleh atrofi payudara dan genitalia eksterna. Baik laki-laki maupun perempuan menunjukkan berbagai tingkatan hipotiroidisme dan insufisiensi adrenal. <b>Kurangnya MSH</b> akan mengakibatkan kulit pasien ini kelihatan pucat. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kadang kala, pasien memperlihatkan kegagalan hormon hipofisis saja. Dalam keadaan ini, penyebab defisiensi agaknya terletak pada hipotalmus dan mengenai hormon pelepasan yang bersangkutan. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pada pasien dengan panhipopituitarisme, tingkat dasar hormon tropik ini rendah, sama dengan tingkat produksi hormon kelenjar target yang dikontrol oleh hormon-hormon tropik ini. <o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pasien dengan hipopituitarisme, selain memiliki tingkat hormon basal yang rendah, juga tidak merespons terhadap pemberian hormon perangsang sekresi. Uji fungsi hipofisis kombinasi dapat dilakukan pada pasien ini dengan menyuntikkan (1) insulin untuk menghasilkan hipoglikemia, (2) CRH, (3) TRH, dan (4) GnRH. Hipoglikemia dengan kadar serum glukosa yang kurang dari 40mg/dl, normalnya menyebabkan pelepasan GH, ACTH, dan kortisol; TRH merangsang pelepasan TSH dan prolaktin; sedangkan GnRH merangsang pelepasan FSH dan LH. Pasien dengan panhipopituitarisme gagal untuk merespons empat perangsang sekresi tersebut. Selain studi biokimia, juga disarankan pemeriksaan radiografi kelenjar hipofisis pada pasien yang diperkirakan menderita penyakit hipofisis, karena tumor-tumor hipofisis seringkali menyebabkan gangguan-gangguan ini.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pengobatan hipopituitarisme mencakup penggantian hormon-hormon yang kurang. GH manusia, hormon yang hanya efektif pada manusia, dihasilkan dari teknik rekombinasi asam deoksiribonukleat (DNA), dapat diguanakan untuk mengobati pasien dengan defisiensi GH dan hanya dapat dikerjakan oleh dokter spesialis. GH manusia jika diberikan pada anak-anak yang menderita dwarfisme hipofisis, dapat menyebabkan peningkatan tinggi badan yang berlebihan. GH manusia rekombinan juga dapat digunakan sebagai hormon pengganti pada pasien dewasa dengan panhipopituitarisme. Hormon hipofisis hanya dapat diberikan dengan cara disuntikan. Sehingga, terapi harian pengganti hormon kelenjar target akibat defisiensi hipofisis untuk jangka waktu yang lama, hanya diberikan sebagai alternatif. Sebagai contoh, insufisiensi adrenal yang disebabkan karena defisiensi sekresi ACTH diobati dengan memberikan hidrokortison oral. Pemberian<span style="mso-spacerun: yes;"> </span>tiroksin oral dapat mengobati hipotitoidisme yang diakibatkan defisiensi TSH. Pemberian androgen dan estrogen dapat mengobati defisiensi gonadotropin ,namun pemberian gonadotropin tersebut dapat menginduksi ovulasi. Defisiensi GH membutuhkan injeksi GH setiap hari.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Insufisiensi hipofise menyebabkan hipofungsi organ sekunder. Hipofungsi hipofise jarang terjadi, namun dapat saja terjadi dalam setiap kelompok usia. Kondisi ini dapat mengenai semua sel hipofise (panhipopituitarisme) atau hanya sel-sel tertentu, terbatas pada satu subset sel-sel hipofise anterior (mis: hipogonadisme sekunder terhadap defisiensi sel-sel gonadotropik) atau sel-sel hipofise posterior (mis: diabetes insipidus).<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">PATOFISIOLOGI<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 49.65pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Penyebab hipofungsi hipofise dapat bersifat primer dan sekunder. Primer bila gangguannya terdapat pada kelenjar hipofise itu sendiri, dan sekunder bila gangguan terdapat pada hipotalamus. Penyebab tersebut termasuk diantaranya :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l33 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Defek perkembangan kongenital, seperti pada dwarfisme pituitari atau hipogonadisme.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l33 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tumor yang merusak hipofise (mis: adenoma hipofise nonfungsional) atau merusak hipotalamus (mis: kraniofaringioma atau glioma).<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l33 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Iskemia, seperti pada nekrosis postpartum (sindrom sheehan’s).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diagnosis insufisiensi hipofise dapat diduga secara klinik namun harus ditegakan melaui uji biokimia yang sesuai, yang akan menunjukan defisiensi hormon. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 49.65pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Panhipopitutarisme. <span style="mso-spacerun: yes;"> </span>Pada orang dewasa dikenal sebagai (Penyakit simmonds) yang ditandai dengan kelemahan umum, intoleransi terhadap dingin, napsu makan buruk, penurunan berat badan, dan hipotensi. Wanita yang terserang penyakit ini tidak akan mengalami menstruasi dan pada pria akan menderita impotensi dan kehilanngan libido. Insufisiensi hipofise pada masa kanak-kanak akan mengakibatkan dwarfisme.<o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-list: l6 level1 lfo33; text-align: justify; text-indent: -21.25pt;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Gangguan sekresi Vasopresin<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Vasopresin arginin ( AVP ) merupakan suatu hormon antideuretik (ADH ) yang dibuat dinukleus supraoptik dan paraventrikuler hipotalamus bersama dengan protein pengikatnya, yaitu neurofisin II. Vasopresin kemudian diangkut dari badan – badan sel neuron tempat pembuatannya, melalui akson menuju keujung – ujung saraf yang berada dikelenjar hipofisis posterior tempat penyimpanannya. AVP dan neurofisinnya yang tidak aktif kemudian disekresi bila ada rangsang tertentu. Sekresi AVP diatur<span style="mso-spacerun: yes;"> </span>oleh rangsangan yang meningkat pada reseptor volume dan osmotik. Suatu peningkatan osmolalitas cairan esktraseluler atau penurunan volume intravaskuler akan merangsang sekresi AVP ,AVP kemudian terikat pada sebuah reseptor yaitu AVPR2, ditubulus ginjal melalui pengaktifan <i style="mso-bidi-font-style: normal;">adenilat siklase </i><span style="mso-spacerun: yes;"> </span>dan peningkatan turunan siklis adenosin monofosfat (cAMP). Akhirnya meningkatkan permeabilitas epitel duktus koligentes ginjal terhadap air. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; text-align: justify; text-indent: .5in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Gangguan sekresi AVP termasuk <i style="mso-bidi-font-style: normal;">diabetes insipidus </i>(DI) dan <i style="mso-bidi-font-style: normal;">sindrom ketidakpadanan sekresi </i><span style="mso-spacerun: yes;"> </span>ADH (SIADH). Gangguan ini dapat terjadi akibat dekstrusi nukleus hipotalamik yaitu tempat vasopresin<span style="mso-spacerun: yes;"> </span>disintesis (DI sentral) atau sebagai akibat tidak responsifnya tubulus ginjal terhadap vasipresin (DI nefrogenik) walaupun kadar hormon ini sangat tinggi.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; text-align: justify; text-indent: .5in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Ada beberapa keadaan yang dapat mengakibatkan diabetes insipidus, termasuk tumor – tumor dihipotalamus, tumor – tumor besar hipofisis yang meluas ke luar sela tursika dan menghancurkan nukleus hipotalamik, trauma kepala, cedera hipotalamus pada saat operasi, oklusi pembuluh darah intraserebral dan penyakit – penyakit granulomatosa. DI nefrogenik dapat diturunkan melalui mutasi dalam reseptor vasopresin.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; text-align: justify; text-indent: .5in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Pasien dengan DI mangalami polidipsi dan poliuria dengan volume urine antara 5 – 10 L/ hari kehilangan cairan yang banyak melalui ginjal ini dapat dikompensasi dengan minum banyak cairan. Bila pasien tidak mampu mempertahankan masukan air minum, berat badannya menurun, kulit dan membran mukosa menjadi kering. Karena minum banyak air<span style="mso-spacerun: yes;"> </span>untuk mempertahankan hidrasi tubuh, pasien – pasien ini akan mengeluh penuh pada perut dan anoreksia. Rasa haus dan buang air kecil berlangsung terus pada malam hari sehingga pasien akan merasa terganggu tidurnya karena harus sering buang air kecil pada malam hari. Volume urine menurun dan berat jenis uerine meningkat segera setelah pemberian vasopresin. Pasien – pasien ini mengalami defisiensi vasopresin, namun memiliki respon ginjal yang normal terhadap hormon. Sebaliknya pasien dengan DI nefrogenik gagal untuk merespon AVP.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">DI sentral diobati dngan AVP. Preparat yang paling sering dipakai 1-deamino-8 D-arginin vasopresin (DDAVP), diberikan intranasal atau oral dan memiliki jangka waktu kerja dari 12 jam sampai 24 jam. DI nefrogenik ditangani dengan penggantian cairan, pengobatan penyakit ginjal yang mendasarinya, dan penghentian terapi lithium bila memungkinkan. Pengobatan dengan kombinasi hidroklorotiazid dan amilorid dapat menurunkan beratnya poliuria. Pada anak – anak dengan DI nefrogenik, keadaan tersebut akan membaik sesuai dengan keadaan umur.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">SIADH biasanya ditemukan menyertai penyakit – penyakit hipotalamus atau paru atau terjadi setelah pemberian obat. Pasien akan mengalami sindrom hipoosmolar dengan kelebihan dan gangguan retensi air. Gejala –gejalanya merupakan akibat adanya hiponatremia berat dan menyerang sistem saraf pusat sehingga pasien mudah marah, kekacauan mental, kejang, dan koma, terutama bila natrium dan serum menurun dibawah 120 mEq/L osmolalitas<span style="mso-spacerun: yes;"> </span>serum rendah, dan osmolalitas urine tinggi dan meningkat diatas osmolalitas serum. Pada pasien – pasien ini, BUN dan serun keratinin kadarnya rendah dan natrium urine lebih tinggi dari 20 mEq/L.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Pengobatan SIADH didasarkan pada pembatasan pemberian air, yaitu kurang dari 1000 ml/hari dan pemberian 3% - 5% larutan NaCL yang dicampur dengan furosemid. Diureti ini akan menginduksi pengeluaran cairan dan NaCl, yang disimpan dalam bentuk hipertonik. Demeklosiklin, suatu obat yang secara langsung menghambat efek vasopresin pada tingkat tubulus ginjal, dapat dipakai dengan efektif untuk memperbaiki hipoosmolalitas yang terjadi akibat adanya SIADH. <o:p></o:p></span></div><div class="MsoListParagraph" style="line-height: 150%; mso-add-space: auto; mso-list: l6 level1 lfo33; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: 13.65pt;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diabetes Insipidus (DI)<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Diabetes Insipidus (DI) ditandai dengan kurangnya ADH sekunder terhadap lesi yang menghancurkan hipotalamus, stalk hipofise, atau hipofise posterior. Kondisi ini dapat disebabkan oleh tumor, infeksi otak atau meningen, hemoragi intrakranial, atau trauma yang mengenai tulanga bagian dasar tengkorak. Klien dengan diabetes insipidus mengeluarkan urine hipotonik dalam jumlah yang besar (5 sampai 6 liter per hari).<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Diabetes insipidus dikelompokan menjadi nefrogenik (adalah diabetes insipidus yang terjadi secara herediter dimana tubulus ginjal tidak berespons secara tepat terhadap ADH, sementara kadar hormon dalam serum normal). Primer (DI yang disebabkan oleh gangguan pada hipofise), sekunder (DI yang disebabkan oleh tumor pada daerah hipofise-hipotalamus, dan tumor sekunder metatasis dari paru-paru dan payudara, dan DI yang berkaitan dengan obat-obatan diakibatkan oleh pemberian litium karbonat [Eskalith, Lihthobid, Carbolith] dan Demeclocyline [Declomycin] ). Obat-obatan ini dapat mempengaruhi respons tubulus ginjal terhadap air. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Insufisiensi hipotalamus membutuhkan terapi penggantian hormon yang sesuai. Terapi penggantian dengan ADH menunjukkan hasil yang efektif dalam mengobati DI.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 25.1pt; mso-add-space: auto; mso-list: l23 level1 lfo28; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">B.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Asuhan Keperawatan Klien dengan Hiperfungsi dan Hipofungsi Hipofise<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l12 level1 lfo30; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hiperfungsi Hipofise<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l9 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.5in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pengkajian<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l36 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Riwayat penyakit ; manifestasi klinis tumor hipofise bervariasi tergantung pada hormon mana yang disekresi berlebihan. Tanyakan manifestasi klinis dari peningkatan prolaktin, GH dan ACTH mulai dirasakan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l36 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kaji usia, jenis kelamin dan riwayat penyakit yang sama dalam keluarga.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l36 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Keluhan utama, mencakup :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l15 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perubahan ukuran dan bentuk tubuh serta organ-organ tubuh<span style="mso-spacerun: yes;"> </span>seperti jari-jari, tangan, dsb.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l15 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perubahan tingkat energi, kelelahan dan letargi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l15 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Nyeri pada punggung dan perasaan tidak nyaman.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l15 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Dispaneuria dan pada pria disertai dengan impotensia.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l15 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Nyeri kepala, kaji P, Q, R, S, T.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l15 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gangguan penglihatan seperti menurunnya ketajaman penglihatan, penglihatan ganda, dsb.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l15 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kesulitan dalam berhubungan seksual.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l15 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perubahan siklus menstruasi (pada klien wanita) mencakup keteraturan, kesulitan hamil.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l15 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Libido seksual menurun<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l15 level1 lfo4; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Impotensia.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l36 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemeriksaan fisik mencakup:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Amati bentuk wajah, khas pada hipersekresi GH seperti bibir dan hidung besar, tulang supraorbita menjolok.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kepala, tangan/lengan dan kaki juga bertambah besar, dagu menjorok kedepan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Amati adanya kesulitan mengunyah dan geligi yang tidak tumbuh dengan baik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemeriksaan ketajaman penglihatan akibat kompresi saraf optikus, akan dijumpai penurunan visus.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Amati perubahan pada persendian di mana klien mengeluh nyeri dan sulit bergerak. Pada pemeriksaan ditemukan mobilitas terbatas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Peningkatan perspirasi pada kulit menyebabkan kulit basah karena berkeringat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Suara membesar karena hipertropi laring.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pada palpasi abdomen, didapat hepatomegali dan splenomegali.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hipertensi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Disfagia akibat lidah membesar.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 128.4pt; mso-add-space: auto; mso-list: l5 level1 lfo5; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pada perkusi dada dijumpai jantung membesar<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l36 level1 lfo3; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemeriksaan diagnostik mencakup :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l21 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kadar prolaktin serum : ACTH, GH<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l21 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Foto tengkorak<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l21 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">CT Scan otak<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l21 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Angiografi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l21 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tes supresi dengan Dexamethason<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-list: l21 level1 lfo6; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tes toleransi glukosa.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l9 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.5in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diagnosa Keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diagnosa keperawatan utama yang dapat dijumpai pada klien dengan hiperpituitarisme.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l20 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perubahan citra tubuh b.d perubahan penampilan fisik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l20 level1 lfo7; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Disfungsi seksual b.d penurunan libido; infertilitas.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 1.0in; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diagnosa keperawatan tambahan yang juga dijumpai adalah:<o:p></o:p></span></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l22 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Nyeri (kepala, punggung) b.d penekanan jaringan oleh tumor; hormon pertumbuhan yang berlebihan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l22 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Takut b.d ancaman kematian akibat tumor otak.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l22 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ansietas b.d ancaman terhadap perubahan status kesehatan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l22 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Koping individu tak efektif b.d hilangnya kontrol terhadap tubuh.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l22 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Keterbatasan aktivitas b.d kelemahan, letargi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l22 level1 lfo8; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perubahan sensori-perseptual (penglihatan) b.d gangguan transmisi impuls akibat kompresi tumor pada nervus optikus.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l9 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.5in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">III.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rencana Tindakan Keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Berikut ini akan diuraikan dua diagnosa keperawatan pertama.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diagnosa Keperawatan</span></i><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perubahan citra tubuh b.d perubahan penampilan fisik.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tujuan :<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Dalam waktu 2-3 minggu klien akan memiliki kembali citra tubuh yang positif.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Intervensi keperawatan :<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l27 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Nonpembedahan <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l26 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien dengan kelebihan GH<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 2.0in; mso-add-space: auto; mso-list: l30 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Dorong klien agar mau mengungkapkan pikiran dan perasaannya terhadap perubahan penampilan tubuhnya,<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 2.0in; mso-add-space: auto; mso-list: l30 level1 lfo11; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bantu klien mengidentifikasi kekuatanya serta segi-segi positif yang dapat dikembangkan oleh klien.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l26 level1 lfo10; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien dengan kelebihan prolaktin<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 2.0in; mso-add-space: auto; mso-list: l2 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Yakinkan klien bahwa sebagian gejala dapat berkurang dengan pengobatan (ginekomastia, galaktorea).<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 2.0in; mso-add-space: auto; mso-list: l2 level1 lfo12; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Dorong klien untuk mengungkapkan perasaannya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l27 level1 lfo9; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemberian obat-obatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l0 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kolaborasi pemberian obat-obatan seperti: Bromokriptin (Parlodel), merupakan obat pilihan pada kelebihan prolaktin. Pada mikro adenoma, prolaktin adapat normal kembali. Juga diberikan pada klien dengan akromegali, untuk mengurangi ukuran tumor.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l0 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Observasi efek samping pemberian bromokriptin seperti:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hipotensi ortostatik, iritasi lambung, mual, kram abdomen, dan konstipasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l0 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kolaborasi pemberian terapi radiasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l0 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Awasi efek samping terapi radiasi seperti: hipopituitarisme, kerusakan nervus optikus, disfungsi hipotalamus, dan perubahan lapang pandang.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-list: l0 level1 lfo13; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kolaborasi tindakan pembedahan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.5in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diagnosa keperawatan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Disfungsi seksual b.d hilangnya libido, infertilitas dan impotensi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tujuan :<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien akan mencapai tingkat kepuasan pribadi dari fungsi seksual<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 70.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Intervensi keperawatan:<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l11 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Identifikasi masalah spesifik yang berhubungan dengan pengalaman klien terhadap fungsi seksualnya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l11 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Dorong agar klien mau mendiskusikan masalah tersebut dengan pasangannya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l11 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kolaborasi pemberian obat-obatan bromokriptin.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l11 level1 lfo14; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bila masalah ini timbul setelah hipofisektomi, kolaborasi pemberian gonadotropin.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l9 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.5in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">IV.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tindakan Keperawatan dan Pembedahan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hipofisektomi adalah tindakan pengangkatan adenoma hipofise melalui pembedahan. Prosedur operasi tersebut mencakup tindakan transpenoidal hipofisektomi dengan narkose. Insisi pada lapisan dalam bibir atas dan masuk ke sella tursika melalui sinus spenoidalis. Yang kedua adalah transfrontal kraniotomi yaitu dengan membuka rongga kranium melalui tulang frontal.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span>Secara umum prinsip perawatan kllien dengan hipofisektomi adalah sebagai berikut :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 110.05pt; mso-add-space: auto; mso-list: l18 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pantau status neurologi klien<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 110.05pt; mso-add-space: auto; mso-list: l18 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pantau keseimbangan cairan khususnya terhadap haluaran yang berlebihan dari masukan karena dapat terjadi diabetes insipidus transien.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 110.05pt; mso-add-space: auto; mso-list: l18 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Dorong klien untuk mempertahankan ventilasi paru dengan latihan nafas dalam.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 110.05pt; mso-add-space: auto; mso-list: l18 level1 lfo15; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol; mso-fareast-language: IN;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Anjurkan klien untuk tidak batuk, menggosok hidung atau bersin.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 110.05pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 110.05pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 110.05pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l19 level1 lfo35; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.55pt;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perawatan preoperasi<o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l28 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Menjelaskan maksud dan tujuan tindakan dilakukan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l28 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Menjelaskan penggunaan tampon hidung selama 2-3hari pascaoperasi. Anjurkan klien bernafas melalui mulut selama pemasangan tampon<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l28 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Menjelaskan penggunaan balut tekan yang ditempatkan dari bawah hidung, menggosok gigi, batuk, bersin, karena hal ini dapat menghambat penyembuhan luka<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l28 level1 lfo16; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Menjelaskan berbagai prosedur diagnostik yang diperlukan sebagai persiapan operasi seperti pemeriksaan neurologik, hormonal, lapang pandang, swab tenggorok untuk pemeriksaan kultur dan sensitivitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l4 level1 lfo34; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: 0in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pendidikan kesehatan<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pendidikan kesehatan dilakukan sebelum tindakan pembedahan dilaksanakan. Setelah tindakan transpenoidal hipofisektomi, perawat menjelaskan agar klien<span style="mso-spacerun: yes;"> </span>menghindari aktivitas yang dapat menghambat penyembuhan seperti mengejan, batuk, dll. Juga jelaskan agar klien mengindahkan faktor-faktor yang dapat mencegah obstipasi. <i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien tidak menyikat gigi satu sampai dua minggu sampai penyembuhan sempurna, cukup berkumur setiap kali setelah makan. Jelaskan bahwa sensasi hilang rasa pada daerah insisi adalah biasa, dapat berlangsung 3-4 bulan. Oleh karena itu anjurkan klien memeriksa gusinya untuk mengetahui adanya lesi dan perdarahan dengan menggunakan cermin setiap hari.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Setelah operasi , pemberian hormon diperlukan untuk mempertahankan keseimbangan cairan. Jelaskan penggunaan obat-obatan dan jelaskan<span style="mso-spacerun: yes;"> </span>pula perlunya tindak lanjut secara teratur.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin-left: 70.9pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l4 level1 lfo34; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.55pt;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Perawatan pascaoperasi <o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l25 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Amati respons neurologik klien dan catat adalah perubahan penglihatan, disorientasi, dan perubahan kesadaran serta penurunan kekuatan motorik ekstremitas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l25 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Amati pula komplikasi pasca operasi yang lazim terjadi seperti transient insipidus (diabetes insipidus sesaat) : bila terjadi hal tersebut lakukan intervensi sebagai berikut:<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l1 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Catat cairan yang masuk baik peroral maupun parenteral<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l1 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tingkatkan masukan cairan bila ada rasa haus<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l1 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kolaborasi dengan dokter untuk pemberian vasopresin<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l1 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bila<span style="mso-spacerun: yes;"> </span>diperlukan lakukan pemasangan indwelling kateter untuk memudahkan pemantauan haluan cairan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 106.9pt; mso-add-space: auto; mso-list: l1 level1 lfo18; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ukur BB setiap hari<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l25 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Anjurkan klien untuk melaporkan pada perawat bila terjadi pengeluaran sekret dari hidung ke faring ( post nasal drip) yang kemungkinan mengandung CSF <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l25 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tinggikan posisi kepala 30-45<sup>o</sup>.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l25 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kaji drainase nasal terhadap kualitas dan kuantitas terhadap kemungkinan mengandung glukosa.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l25 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hindari batuk, ajarkan klien bernafas dalam, lakukan higyene oral secara teratur karena pernafasan mulut dan penggunaan tampon.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l25 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kaji tanda-tanda infeksi (meningitis ) dengan cermat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-list: l25 level1 lfo17; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kolaborasi pemberian gonadotropin, kortisol sebagai dampak hipofisektomi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l9 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.5in;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">V.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Evaluasi<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l13 level1 lfo37; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien dapat menerima kekurangan (perubahan fisik) dalam dirinya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l13 level1 lfo37; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien mampu bersosialisi dan berinteraksi dengan lingkungan sekitarnya, tanpa merasa malu akan perbedaan dalam dirinya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l13 level1 lfo37; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Klien mampu beraktivitas secara mandiri<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 88.9pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b.</span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> </span></b><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Hipofungsi Hipofis</span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">e</span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l3 level1 lfo19; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.5in;"><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pengkajian<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pengkajian keperawatan pada klien dengan kelainan ini antara lain mencakup :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l14 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Riwayat penyakit masa lalu. Adakah penyakit atau trauma pada kepala yang pernah diderita klien, serta riwayat radiasi pada kepala.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l14 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Sejak kapan keluhan dirasakan. Dampak defisiensi GH mulai tampak pada masa balita sedang defisiasi gonadotropin nyata pada masa pra remaja.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l14 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Apakah keluhan terjadi sejak lahir. Tubuh kecil dan kerdil sejak lahir terdapat pada klien kretinisme.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l14 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Berat dan tinggi badan saat lahir.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l14 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Keluhan utama klien :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l8 level1 lfo21; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pertumbuhan lambat<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l8 level1 lfo21; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ukuran otot dan tulang kecil<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l8 level1 lfo21; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tanda-tanda seks sekunder tidak berkembang : tidak ada rambut pubis dan aksila, payudara tidak tumbuh, penis tidak tumbuh, tidak mendapat haid, dan lain-lain.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l14 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemeriksaan Fisik<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l7 level1 lfo22; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Amati bentuk dan ukuran tubuh, ukuran BB dan TB, amati bentuk dan ukuran buah dada, pertumbuhan rambut aksila dan pubis, dan pada klien pria, amati pula pertumbuhan rambut di wajah (jenggot dan kumis )<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l7 level1 lfo22; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Palpasi kulit, pada wanita biasanya menjadi kering dan kasar <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l14 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kaji pula dampak perubahan fisik terhadap kemampuan klien dalam memenuhi kebutuhan dasarnya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l14 level1 lfo20; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Data penunjang dari hsil pemeriksaan diagnostik eperti : <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l34 level1 lfo23; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Foto kranium untuk melihat pelebaran dan atau erosi sella tursika<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 1.25in; mso-add-space: auto; mso-list: l34 level1 lfo23; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemeriksaan serum darah : LH dan FSH , GH, prolaktin, kortisol, aldosteron, testosteron, androgen, tes stimulasi yang mencakup uji toleransi insulin dan stimulasi tiroid realising hormon.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 150%; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l3 level1 lfo19; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.5in;"><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diagnosa </span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">K</span></b><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">eperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Diagnosa keperawatan yang dapat dijumpai pada klien hipopituitarisme adalah : <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l38 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gangguan citra tubuh b.d perubahan struktur dan fungsi tubuh akibat defisiensi gonadotropin dan defisiensi hormon pertumbuhan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l38 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Disfungsi seksual<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l38 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Koping individu tak efektif<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l38 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kurang pengetahuan tentang proses penyakit, pengobatan, dan perawatan di rumah.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l38 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Harga diri rendah b.d perubahan penampilan tubuh.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l38 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gangguan persepsi sensorik (penglihatan) b.d gangguan transmisi implus sebagai akibat penekanan tumor pada nervus optikus .<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l38 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ansietas b.d ancaman atau perubahan status kesehatan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l38 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Defisit perawatan diri b.d menurunnya kekuatan otot.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l38 level1 lfo24; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Gangguan integritas kulit (kekeringan ) b.d menurunnya kadar hormonal<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l3 level1 lfo19; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.5in;"><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">III.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Rencana Tindakan Keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Secara umum tujuan yang diharapkan dari perawatan klien dengan hipofungsi hipofisis adalah :<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l32 level1 lfo25; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien memiliki kembali citra tubuh yang positif dan harga diri yang tinggi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l32 level1 lfo25; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien dapat berpartisipasi aktif dalam program pengobatan<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l32 level1 lfo25; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien dapat memenuhi kebutuhan hidup sehari -hari<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l32 level1 lfo25; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien bebas dari rasa cemas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l32 level1 lfo25; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien terhindar dari komplikasi<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l3 level1 lfo19; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.5in;"><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">IV.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Tindakan Keperawatan<o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l31 level1 lfo26; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Kolaborasi dengan dokter dalam pemberian obat-obatan (hormonal)<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l4 level1 lfo34; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.55pt;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Defisiensi Gonadotropin</span></i><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: .5in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pria post pubertas diberikan androgen (testosteron). Lebih efektif dengan pemberian intramuskular. Jelaskan maksud pemberian obat dan cara penggunaan. Obat dan dosis biasanya bertahap dengan diawali dosis minimal dan setiap bulannya dinaikan sampai ditemukan dosis yang tepat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Observasi efek samping penggunaan testosteron seperti ginekomastia dan hipertropi inprostat. Efek maksimal obat ini akan meningkatkan ukuran penis, meningkatkan libido, ma</span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">s</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">sa otot dan tulang bertambah, kekuatan otot meningkat dan juga pertumbuhan rambut dada, aksila, </span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">serta</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"> pubis, sehingga dapat mengembalikan citra diri dan harga diri.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Wanita yang telah mencapai pubertas, mendapat therapy estrogen dan progesteron. Jelaskan hal-hal yang perlu diwaspadai klien seperti hipertensi dan tromboplebitis. Anjurkan agar melakukan follow up secara teratur. Bila menginginkan kehamilan, klien diberi chlomiphene citrat (clonid) untuk merangsang ovulasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: .5in;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-list: l4 level1 lfo34; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.55pt;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings; mso-fareast-language: IN;"><span style="mso-list: Ignore;">ü<span style="font: 7.0pt "Times New Roman";"> </span></span></span><i style="mso-bidi-font-style: normal;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Defisiensi hormon pertumbuhan (GH)</span></i><i style="mso-bidi-font-style: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><o:p></o:p></span></i></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 56.7pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 89.3pt; mso-add-space: auto; mso-list: l24 level1 lfo27; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Pemberian hormon pertumbuhan sintetis (eksogen). Somatotropin (Humatrop) harus diberikan sebelum epifise tulang menutup yaitu sebelum masa pubertas.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 89.3pt; mso-add-space: auto; mso-list: l24 level1 lfo27; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ciptakan kondisi agar klien dapat dengan bebas mengungkapkan perasaan dan pikirannya tentang perubahan tubuh yang dialaminya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 89.3pt; mso-add-space: auto; mso-list: l24 level1 lfo27; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bangkitkan motivasi agar klien mau melaksanakan program pengobatan yang sudah ditentukan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 89.3pt; mso-add-space: auto; mso-list: l24 level1 lfo27; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Anjurkan klien memeriksakan diri secara teratur ke tempat pelayanan terdekat.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 89.3pt; mso-add-space: auto; mso-list: l24 level1 lfo27; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Anjurkan pada keluarga untuk dapat membantu klien memenuhi kebutuhan sehari-harinya bila diperlukan serta dapat menciptakan lingkungan yang kondusif dalam keluarga seperti menghindarkan persaingan yang tidak sehat antar anggota keluarga.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 89.3pt; mso-add-space: auto; mso-list: l24 level1 lfo27; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bantu klien untuk mengembangkan sisi positif yang dimiliki serta membantu untuk beradaptasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 89.3pt; mso-add-space: auto; mso-list: l24 level1 lfo27; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Ajarkan klien cara melakukan perawatan kulit secara teratur setiap hari. Mengguanakan lotion pelembab sangat dianjurkan, tidak menggaruk kulit karena kulit sangat mudah mengalami iritasi.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 89.3pt; mso-add-space: auto; mso-list: l24 level1 lfo27; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Berikan pendidikan kesehatan tentang penyakitnya, pengobatan dan kunci keberhasilan pengobatan.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 89.3pt; mso-add-space: auto; mso-list: l24 level1 lfo27; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Bagi pasangan yang menginginkan keturunan bangkitkan motivasi mereka untuk dapat mengikuti program pengobatan secara teratur dan berkesinambungan karena untuk upaya ini memerlukan waktu yang lama sehingga butuh kesabaran. Bila dengan pengobatan tidak berhasil maka bantu pasangan untuk mencari jalan keluar seperti mengadopsi anak atau hal-hal lain yang mereka sepakati.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 89.3pt; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l3 level1 lfo19; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.5in;"><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">V.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><b><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Evaluasi</span></b><b><span lang="DE" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-ansi-language: DE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><o:p></o:p></span></b></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l17 level1 lfo38; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien dapat menerima kekurangan (perubahan fisik) dalam dirinya.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l17 level1 lfo38; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Klien mampu bersosialisi dan berinteraksi dengan lingkungan sekitarnya,tanpa merasa malu akan perbedaan dalam dirinya<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-list: l17 level1 lfo38; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify; text-indent: -.25in;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>Klien mampu beraktivitas secara mandiri<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 1.0in; mso-add-space: auto; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 3; text-align: justify;"><br />
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</div><div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 14.0pt; line-height: 150%;">Daftar Pustaka<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 150%;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l37 level1 lfo39; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Rumahorbo, Hotma. 1999. Asuhan Keperawatan Klien Dengan Gangguan Sistem Endokrin. Jakarta: EGC.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l37 level1 lfo39; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Price, A Sylvia dan Lorraine M Wilson. 2006. Patofisiologi vol 2 edisi 6. Jakarta: EGC.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l37 level1 lfo39; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Bagian Patologi Anatomik FKUI. 1996. Patologi. Jakarta: FKUI.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l37 level1 lfo39; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Guyton. 1996. Fisiologi Manusia dan Mekanisme Penyakit. Jakarta: EGC.<o:p></o:p></span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l37 level1 lfo39; text-indent: -.25in;"><span lang="IN" style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="IN" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Syaiffudin. 2006. Anatomi dan Fisiologi untuk Mahasiswa Keperawatan. Jakarta: EGC.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 150%; text-align: justify;"><br />
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</div></span>Ian zkate pakpahanhttp://www.blogger.com/profile/10259135788220046244noreply@blogger.com1