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"Penulisan karya ilmiah akhir ini bertujuan untuk mengaplikasikan teori Konservasi melalui pendekatan asuhan perkembangan dalam perawatan tiga bayi berat lahir rendah (BBLR) yang mengalami penundaan pemberian nutrisi enteral dini. Nutrisi enteral dini memfasilitasi adaptasi saluran cerna sehingga tercapai maturasi yang penting bagi penerimaan nutrisi enteral bayi selanjutnya. Penyebab penundaan pemberian nutrisi enteral dini pada BBLR ini adalah intoleransi minum dan perdarahan saluran cerna. Kebutuhan nutrisi BBLR tetap terpenuhi melalui pemberian secara parenteral. Adapun pendekatan asuhan perkembangan yang digunakan bertujuan agar energi yang dimiliki bayi dapat digunakan secara optimal untuk tumbuh dan berkembang melalui pencapaian konservasi, dalam hal ini konservasi energi. Selama menjalani perawatan, BBLR dalam uraian karya ilmiah akhir ini menunjukkan status oksigenasi yang baik, instabilitas suhu tidak terjadi, dan penurunan berat badan masih dalam kisaran rentang normal yaitu 10-15% dari berat badan lahir.

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This scientific assignment aimed to applying the Conservation theory by approach of developmental care in nursing care of three cases of low birth weight (LBW) infants who experienced the delayed early enteral nutrition. Early enteral nutrition facilitated the adaptation of gastrointestinal tract in order to reach maturation which is important for LBW infants to receive enteral nutrition later. The causes of delayed early enteral nutrition in these LBW infants were feeding intolerance and gastrointestinal bleeding. Nutritional needs of these LBW infants was fulfilled by parenteral nutrition. The using of developmental care approach aimed to strive the energy of LBW infants could be optimally utilize for growth and development through attainment of energy conservation as one of conservation principles in Conservation theory. During treatments, LBW infants in this scientific assignment showed normal oxygenation status, stability of body temperature, and weight loss was still within normal range was 10-15% of birth weight."

"Masalah nutrisi merupakan permasalahan yang sering dihadapi oleh anak kanker. Tujuan penulisan Karya Ilmiah Akhir ini adalah memberikan gambaran pelaksanaan Praktik Residensi Keperawatan Anak kanker yang mengalami masalah nutrisi dengan mengaplikasikan Model Konservasi Levine. Dalam pencapaian kompetensi sebagai Ners Spesialis Keperawatan Anak residen telah menjalankan peran sebagai pemberi asuhan keperawatan, peran koordinasi dan kolaborasi, pembuatan keputusan etik, advocator, dan innovator. Aplikasi Model Konservasi Levine tertuang dalam lima kasus terpilih, dimana trophicognosis yang umum ditemukan adalah ketidakseimbangan nutrisi kurang atau lebih dari kebutuhan tubuh. Intervensi diberikan berdasarkan empat prinsip konservasi. Hasil evaluasi terhadap trophicognosis ketidakseimbangan nutrisi menunjukkan adanya peningkatan terhadap kemampuan konservasi energi. Model Konservasi Levine dapat diterapkan pada klien anak dengan kanker yang mengalami masalah nutrisi. Pencapaian kompetensi dalam praktik residensi keperawatan anak telah memperkaya dan meningkatkan pengetahuan serta keterampilan klinis residen.

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Nutritional problem is commonly faced by children with cancer. The aim of this final assignment was to provide Nursing Practice Residency implementation of children with cancer which have nutritional problems by applying Levine Conservation Model. Competencies that had been made included providing nursing care, coordination and collaboration, ethical decision making, advocator and innovator. Levine Conservation Model was applied in five selected cases and the trophicognosis commonly found was imbalanced nutrition supply of the body needs. Interventions were given based on the four principles of conservation, that are conservation of energy, conservation of structural integrity, conservation of personal integrity, and conservation of social integrity. Evaluation of nutritional imbalance trophicognosis showed an increase in energy conservation ability. Levine Conservation Model can be applied to children with cancer who have a nutrition problem. Achievement of competence in the practice residency of nursing children have enriching and improving knowledge and clinical skills of resident."

"Karya ilmiah akhir ini membahas tentang penerapan model Konservasi Levine dalam pemberian asuhan keperawatan pada lima bayi yang mendapat fototerapi Fototerapi bertujuan menurunkan konsentrasi bilirubin serum pada bayi dengan hiperbilirubinemia akan tetapi fototerapi memiliki efek samping Efek samping fototerapi dapat diminimalkan melalui pemberian asuhan keperawatan dengan menerapkan prinsip konservasi untuk mempertahankan keseimbangan energi konservasi integritas struktural personal dan sosial Kelima bayi yang mendapat fototerapi menunjukkan keseimbangan volume cairan suhu tubuh stabil tidak terjadi iritasi mata dan kulit dan orang tua dapat berinteraksi dengan bayi selama pelaksanaan fototerapi Model Konservasi diharapkan menjadi acuan praktik keperawatan pada neonatus yang dilakukan fototerapi

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This final scientific report discusses the application of Levine 39 s Conservation model in nursing care of the five infants who do phototherapy Instead of reducing infants rsquo serum bilirubin concentrations by hyperbilirubinemia phototherapy has side effect Side effect of phototherapy can be minimized through the provision of nursing care by applying conservation principle in order to maintain energy balance structural integrity conservation personal and social integrity The infants show the balance of fluid volume normal range body temperature no eyes and skin irritation and the parents can still interact with their baby during phototherapy implementation This Conservation model is expected to be a reference of nursing practice in neonates who get phototherapy"

"ABSTRAKKanker merupakan penyakit yang dapat menyebabkan gangguan nutrisi pada anak. Tujuan dari karya ilmiah akhir adalah menggambarkan aplikasi model konservasi Levine dalam melakukan asuhan keperawatan pada anak dengan kanker yang mengalami masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh dan pencapaian kompetensi praktik spesialis keperawatan anak. Peran perawat yang dilakukan selama praktik residensi adalah sebagai pemberi asuhan, advokat, edukator, dan peneliti yang dilaksanakan dengan memperhatikan etik dan legal. Pendekatan model konservasi Levine menggunakan empat prinsip konservasi yaitu konservasi energi, integritas struktural, integritas personal, dan sosial. Empat prinsip konservasi tersebut diaplikasikan ke dalam proses keperawatan yang dimulai dengan pengkajian, trophicognosis, hipotesis, intervensi, dan evaluasi pada lima kasus kelolaan. Evaluasi yang didapat untuk masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh adalah masalah teratasi sebagian ditandai dengan mual berkurang dan asupan makan meningkat. Model konservasi Levine dapat diaplikasikan pada anak dengan kanker dalam upaya konservasi energi dan peningkatan kualitas hidup anak.

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ABSTRACT

Children with cancer were potentially experienced nutritional imbalance. The purpose of the final report was to described the application of Levine Conservation Model in performing nursing care for children with cancer whom experienced problems nutritional imbalance, and achievement of residency competency for pediatric nursing. The role of the nurse performed during residency were conducted as direct nursing care, advocate, educator, and researcher based on professional, ethical and legal. Levine's model approach using four principles were conservation of energy, structural integrity, personal integrity, and social integrity. These conservation principles were applied to the nursing care since assessment, trophicognosis, hypothesis, intervention, and evaluation phases in five selected cases of patients. Organismic evaluation obtained for all nutritional imbalance problems were solved partially that can be measured from the lower level of nausea and the higher food intake. Levine conservation model may apply to nursing care in children with cancer who experienced nutritional problems to increase quality of life."

"[ABSTRAKBayi prematur dapat mengalami hambatan kenaikan berat badan yang disebabkan oleh usia gestasi, penyakit penyerta, dan pengalaman nyeri atau stres. Hambatan kenaikan berat badan dapat diatasi dengan asuhan keperawatan yang tepat dalam pemenuhan kebutuhan nutrisi pada bayi prematur. Asuhan keperawatan dengan Model Konservasi Levine telah digunakan pada aplikasi praktik residensi di Ruang Neonatus Rumah Sakit Cipto Mangunkusumo dalam menganalisis kenaikan berat badan bayi prematur pada lima kasus terpilih mulai dari Bulan Maret-Mei tahun 2015. Analisis kasus didapatkan dari tahap pengkajian, tropikognosis, hipotesis, intervensi, dan evaluasi. Tropikognosis yang telah teridentifikasi yaitu risiko gangguan pemenuhan kebutuhan nutrisi. Intervensi telah dilakukan berdasarkan prinsip konservasi dan hasil evaluasinya yaitu bayi prematur mengalami kenaikan berat badan dengan konservasi energi. Kenaikan berat badan pada bayi prematur menunjukkan keberhasilan dari penerapan asuhan keperawatan berbasis Model Konservasi Levine.

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ABSTRACTThe preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine?s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine?s Conservation Model. ;The preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine?s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine?s Conservation Model. , The preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine’s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine’s Conservation Model. ]"

"Penulisan karya ilmiah akhir ini bertujuan untuk memberikan gambaran penerapan teori Model Konservasi pada bayi dengan kebutuhan asuhan perkembangan. Bayi berat lahir rendah (BBLR) membutuhkan adaptasi yang luar biasa agar dapat mempertahankan kelansungan hidupnya, oleh sebab itu dibutuhkan perawatan NICU. Namun ternyata dampak dari perawatan NICU yang lama mengakibatkan tingginya angka kesakitan dan disabilitas pada BBLR kedepannya. Oleh sebab itu intervensi dini harus sudah diberikan sejak awal bayi mulai dirawat melalui asuhan perkembangan. Asuhan perkembangan adalah segala upaya yang dilakukan dalam rangka memberikan dukungan fisik, psiko dan sosial kepada bayi berat lahir rendah dengan cara memodifikasi lingkungan agar dapat mempromosikan pertumbuhan dan perkembangannya. Salah satu intervensi dini yang dapat memperbaiki kekurangan stimulasi yang membangun untuk meningkatkan pertumbuhan dan perkembangan adalah stimulasi taktil kinestetik yang dilakukan oleh ibu.

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This scientific final assignment is intended to describe the application of the theory of Conservation Model in infants with developmental care needs. Low birth weight infants needs a great effort to adapt and survive, therefore need neonatal intensive care unit (NICU). But it turns out the impac to fthe old NICU care resulting in high morbidity and disability. Therefore,early intervention should have been given since the beginning of the baby was admitted through developmental care. Developmental care is all the efforts made in order to facilitate and support the physical, social and psycho of low birth weight infant through modifications to the environment to be able to promote the growth and development of low birth weight infant. One of the early intervention that can correct the lack of stimulation to promote growth and development is a tactile kinestetic stimulation by the mother."

"Karya Ilmiah Akhir ini merupakan gambaran pelaksanaan kegiatan praktik keperawatan ners spesialis anak selama satu tahun yang dimulai dari tanggal 3 Oktober 2011 sampai dengan 20 April 2012 yang menerapkan peran dan fungsi dari ners spesialis keperawatan anak. Karya Ilmiah Akhir ini memfokuskan pada aplikasi Teori Konservasi Levine dalam asuhan keperawatan klien anak yang mengalami peningkatan suhu tubuh di ruang perawatan penyakit infeksi. Pengkajian yang dilakukan meliputi konservasi energi, konservasi integritas struktur, konservasi integritas personal dan konservasi integritas sosial. Tropikognosis dan justifikasi yang dirumuskan meliputi dari keempat konservasi tersebut. Hipotesa, planning dan implementasi disesuaikan dengan konservasi energi, konservasi integritas struktur, konservasi integritas personal dan konservasi integritas sosial. Dari hasil evaluasi didapatkan bahwa kelima kasus klien terpilih yang mengalami peningkatan suhu tubuh setelah diberikan asuhan keperawatan, didapatkan hasil 5 klien semuanya terbebas dari demam dan semuanya pulang dengan kondisi bebas demam. Selanjutnya dalam memberikan asuhan keperawatan pada klien anak, residen merekomendasikan untuk menerapkan prinsip caring, atraumatic care, family centered care dan upaya pencegahan infeksi nosokomial dengan cara bekerja sesuai dengan standar operasional prosedur dan standar asuhan keperawatan serta memperhatikan prinsip sterilitas dan teknik aseptik yang dapat dilakukan dengan tindakan cuci tangan dengan handrub. Sebagai inovator residen melakukan modifikasi ruang tindakan menjadi ruangan yang bernuansa anak untuk meminimalkan atraumatic care dan residen juga melakukan discharge planning dimulai dari pasien baru sampai pasien pulang dan membuat media penkes sebagai media untuk melakukan pendidikan kesehatan pada orang tua dan keluarga pasien.

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This final scientific paper is a clinical nursing practice report of pediatrics nurse specialist practice that is conducted for one year from 3rd October 2011 until 20th April 2012 by applying the role and function of pediatrics nurse specialist. The paper is focusing on the application of Levine’s conservation theory into nursing care of children suffering from hyperthermia in infection ward. The assessment that is performed including conservation of energy, the structure of conservation integrity, personal integrity conservation, and social integrity conservation. Tropicognoses and justification, which are formulated including the fourth areas of conservation. Hipotesa, plan, and implementation are customized with conservation of energy, the structure of conservation integrity, personal integrity conservation, and social integrity conservation. Based on the conducted evaluation, it was resulted that from five chosen clients who suffering from hypothermia, after receiving nursing care they were recover from hyperthermia and discharged home with normal body temperature. Moreover, in providing nursing care to children, resident recommends to apply the principal of caring, atraumatic care, family centered care and effort preventing nosocomial infection by working based on standard operating procedure and nursing care standard, and also applying sterile principal and aseptic technique by washing hand with handrub. As an innovator, resident modified the intervention room as a child room with some decorations in order to minimize atraumatic care. The resident was also made a discharge planning with starting from obtaining new patient until discharging home, and provided health education for parents and family of clients."

"Teori Konservasi Levine merupakan model keperawatan praktis dengan menggunakan prinsip konservasi yang berfokus pada keseimbangan energi anak sakit kritis untuk kesehatan dan penyembuhan. Keseimbangan energi ini dapat diperoleh dari asupan nutrisi yang adekuat. Hal ini ditemui pada lima kasus kelolaan yang dibahas dalam karya ilmiah akhir ini, dan ditemukan masalah ketidakseimbangan nutrisi kurang dari kebutuhan. Menurut teori Konservasi, ketidakseimbangan nutrisi kurang dari kebutuhan dapat diatasi dengan menggunakan prinsip konservasi energi, integritas sruktural, personal dan sosial, yakni pemberian nutrisi secara adekuat, sehingga dapat mengimbangi kebutuhan energi yang didapat dengan yang diperlukan tubuh. Hasil evaluasi menunjukkan bahwa kemajuan kesehatan setiap kasus berbeda, tergantung pada kondisi penyakit anak, yang ditandai dengan pindah ke ruang rawat lain atau meninggal dunia.

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Levine Conservation Theory is a practice nursing model with conservation principles that focused in critical ill child energy balancing for health and healing. Energy balancing is got from the adequate intake nutrition. It was found in five cases that discused in this Final Assignment, with the problem was nutrition imbalance less than body requirement. According to Conservation theory, nutrition imbalance less than body requirement could be solved by implementing principles of energy conservation, structural conservation, personal conservation dan social conservation, that gave adequate nutrition so could make the balance of energy supply and demand. Result of the evaluation showed that the health progress in the cases was different, depend on child disease condition, that marked with moved to the other ward and death."

"Demam merupakan gejala yang sering dialami anak dengan penyakit infeksi. Kondisi demam tinggi berdampak merugikan anak. Demam tinggi membuat anak tidak nyaman dan orang tua cemas serta meningkatkan kebutuhan kalori dan cairan. Oleh karena itu dibutuhkan asuhan keperawatan model konservasi. Penulisan Karya Ilmiah Akhir ini bertujuan memberikan gambaran kegiatan pelaksanaan praktik residensi ners spesialis anak, gambaran aplikasi model konservasi dalam asuhan keperawatan demam pada anak yang mengalami penyakit infeksi. Model Konservasi Levine berfokus pada konservasi energi, integritas struktrur, personal dan sosial untuk mencapai keutuhan. Berdasarkan 5 kasus yang dibahas, intervensi yang diberikan untuk trophicognosis peningkatan suhu tubuh (demam) antara lain mengupayakan penurunan suhu tubuh, mempertahankan lingkungan sejuk dan nyaman, meningkatkan istirahat, memberikan asupan cairan dan nutrisi adekuat serta menurunkan kecemasan anak dan orang tua menggunakan konsep family centered care. Model Konservasi dapat diterapkan dalam asuhan anak demam. Disarankan untuk lebih meningkatkan upaya konservasi integritas personal dan sosial melalui pendidikan kesehatan pada keluarga.

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Fever is a symptom that is often experienced by children with infectious diseases. High fever conditions adversely affects children. High fever makes the child uncomfortable and parent’s anxiety and also increase calorie and fluid needs. Therefore, the child needs nursing care such as conservation model by Levine. This scientific final assignment to provide an overview of the implementation of the activities of child specialist nurse practice, an overview of applications of conservation models in nursing care of fever in children with infectious diseases. Levine Conservation Model focuses on energy conservation, structure integrity, personal and social to achieve wholeness. Based on 5 cases discussed, interventions given to trophicognosis increased body temperature (fever), which are to seek a decrease in body temperature, maintaining comfortable environment, improve rest, provide adequate nutrition and fluid intake as well as decrease the anxiety of children and parents using the concept of family-centered care. Conservation Model can be applied in the care of fever children. It is recommended to further enhance the conservation of personal integrity and social health through the family education."

"Karya ilmiah akhir ini membahas tentang penerapan model Konservasi Levine dalam pemberian asuhan keperawatan pada pada anak dengan gangguan pernapasan. Infeksi saluran pernapasan akut merupakan suatu gangguan pulmonal yang memiliki efek samping hipoksemia dan kegagalan pernapasan melalui pemberian asuhan keperawatan dengan menerapkan prinsip konservasi untuk mempertahankan keseimbangan energi, konservasi integritas struktural, personal dan sosial. Beberapa masalah keperawatan yang ditemukan antara lain gangguan pertukaran gas, ketidakefektifan pola napas dan ketidakefektifan bersihan jalan napas. Model Konservasi diharapkan menjadi acuan praktik keperawatan pada pada anak dengan gangguan pernapasan.

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The end scientific work is about the application of the Levine's Conservation model in the provision of nursing care to children with respiratory disorders. Respiratory infection acute is a pulmonary disorder that has a side effect of hypoxemia and respiratory failure. The side effects of hypoxemia and respiratory failure can be minimized through the provision of nursing care by applying the principle of conservation of energy to maintain balance, conservation of structural integrity, personal and social. Some nursing problems were found among other disorders of gas exchange, breathing pattern ineffective airway clearance and ineffectiveness. This Conservation model is expected to be a reference of nursing practice in children with respiratory disorders."