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"Masalah Terkait Obat (MTO) sangat umum terjadi pada pasien yang mendapatkan terapi obat. MTO dapat meningkat dengan adanya kompleksitas penyakit dan penggunaan obat, serta respons individual pasien. Pemantauan terapi obat pasien perlu dilakukan untuk memastikan terapi obat yang diterima pasien aman, efektif, rasional, dapat meningkatkan efektivitas terapi, dan meminimalkan risiko Reaksi Obat yang Tidak Dikehendaki (ROTD). Irawati (2008) menyebutkan bahwa ditemukan 452 masalah terkait obat dari 84 pasien Chronic Kidney Disease (CKD) stage 3, 4, dan 5, berupa pemilihan obat (54,2%), tidak ada indikasi yang jelas terhadap obat yang diresepkan (26,1%), dan faktor risiko lain seperti polifarmasi, penggunaan obat indeks terapi sempit, dan penggunaan nasogastric tube (NGT). Pada tugas khusus ini, dilakukan pemantauan terapi obat terhadap pasien di Ruang Perawatan Anggrek RSUD Tarakan, dengan diagnosis CKD stage 5, diabetes melitus, dan hipertensi, serta menerima terapi polifarmasi. Data diperoleh dari status pasien di ruang perawatan dan EMR meliputi identitas pasien, diagnosis, hasil pemeriksaan tanda-tanda vital, hasil pemeriksaan laboratorium, dan pengobatan yang diterima. Hasil analisis MTO menunjukkan bahwa pengobatan sesuai indikasi, tidak ada pemberian terapi tanpa indikasi, dosis obat sesuai dengan literatur, tidak ada potensi ROTD yang terjadi, dan terdapat beberapa potensi interaksi obat dalam pemberian terapi. Rekomendasi tindak lanjut MTO adalah melakukan penjedaan pada pemberian obat yang berpotensi terjadi interaksi obat, monitoring kadar gula darah, tekanan darah, dan kadar kalium pasien.

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Drug-Related Problems (DRP) are very common in patients receiving drug therapy. DRP may increase with the complexity of disease and drug use, as well as individual patient response. Monitoring patient drug therapy needs to be carried out to ensure that the drug therapy the patient receives is safe, effective, rational, can increase the effectiveness of therapy, and minimize the risk of Adverse Drug Reactions (ADR). Irawati (2008) stated that 452 drug-related problems were found from 84 patients with chronic kidney disease (CKD) stage 3, 4 and 5, in the form of drug selection (54.2%), there was no clear indication of the drug prescribed (26, 1%), and other risk factors such as polypharmacy, use of narrow therapeutic index drugs, and use of nasogastric tube (NGT). In this report, monitoring drug therapy was carried out on patients in the Orchid Treatment Room at RSUD Tarakan, with a diagnosis of CKD stage 5, diabetes mellitus and hypertension, and receiving polypharmacy therapy. Data obtained from patient status in the treatment room and EMR includes patient identity, diagnosis, vital signs examination results, laboratory examination results, and treatment received. The results of the DRP analysis showed that treatment was according to indications, there was no therapy given without indications, the drug dose was in accordance with the literature, there was no potential for ADR to occur, and there were several potential drug interactions in the administration of therapy. DRP follow-up recommendations are to pause the administration of drugs that have the potential for drug interactions, monitor the patient's blood sugar levels, blood pressure and potassium levels."

"Perawat Spesialis Medikal Bedah berperan penting dalam praktik keperawatan sebagai pemberi asuhan keperawatan kompleks, melakukan analisa ilmiah dan pembuktian ilmiah serta sebagai agen pembaharu. Melalui tulisan ini digambarkan pemberian asuhan keperawatan kepada pasien dengan diagnosis Chronic Limb Threatening Ischemia. Tujuan dari penulisan ini adalah memberikan gambaran praktek keperawatan spesialis medikal bedah menggunakan pendekatan Model Adaptasi Roy. Dari hasil pengumpulan data dan pemeriksaan fisik didapatkan 10 diagnosis keperawatan. Pemberian asuhan keperawatanpun dilakukan kepada 30 pasien sebagai kasus resume, diperoleh perilaku maladaptif pada mode fisiologis dengan diagnose terbanyak yaitu resiko infeksi dan nyeri kronik. Evidence Based Nursing dengan melakukan foot exercises kepada 8 pasien yang mengalami ulkus kaki diabetik dengan hasil yang signifikan terhadap perubahan ukuran luka. Program inovasi menerapkan Hypoglycemia-Nursing Early Warning Score System pada pasien diabetes melitus tipe 2 yang terbukti memudahkan perawat menilai resiko kejadian hipoglikemi berat selama 1 tahun. Pendekatan Model Adaptasi Roy berpengaruh besar terhadap profesi keperawatan. Model ini menjadi salah satu yang banyak digunakan dalam penelitian, pendidikan dan pelayanan keperawatan.

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Surgical Medical Specialist Nurses play an important role in nursing practice as a provider of advanced nursing care, conduct scientific analysis and scientific evidence and as a reforming agent. Through of this paper we describe the provision of nursing care to patients with a diagnosis of Chronic Limb Threatening Ischemia. The purpose of this paper is to provide an overview of the nursing practice of Surgical Medical Specialists using Roy's Adaptation Model approach. From the results of data collection and physical examination obtained 10 nursing diagnoses. In nursing care was provided to 30 patients as a case of resume, obtained maladaptive behavior in physiological mode with the most diagnoses, the risk of infection and chronic pain. Evidence Based Nursing by performing foot exercises on 8 patients who suffered diabetic foot ulcers with significant results on changes in wound size. The innovative program implementated the Hypoglycemia-Nursing Early Warning Score System in patients with type 2 diabetes mellitus which was proven to make it easier for nurses to assess the risk of severe hypoglycemic events for 1 year. Roy's Adaptation Model approach greatly influencing the nursing profession. This model is one that was widely used in research, education and nursing services"