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"Praktik residensi keperawatan maternitas bertujuan untuk meningkatkan pengetahuan ketrampilan dan sikap dalam memberikan asuhan keperawatan pada masalah kesehatan perempuan sepanjang periode kehidupannya baik di rumah sakit maupun komunitas Residensi keperawatan maternitas mencapai tujuan tersebut melalui pengembangan fungsi dan peran perawat Tujuan penulisan laporan ini untuk memberikan gambaran peran spesialis keperawatan maternitas sebagai pemberi asuhan keperawatan konselor advokat edukator koordinator kolaborator komunikator agen pembaharu dan peneliti Spesialis keperawatan maternitas memberikan asuhan keperawatan dengan menggunakan model konsep dan teori keperawatan yang sesuai dengan kondisi klien Penerapan teori self care Orem sesuai untuk memandirikan ibu hamil dengan gestational diabetes mellitus dalam merawat kehamilannya Kata kunci Gestational diabetes mellitus Spesialis keperawatan maternitas Teori keperawatan Daftar Pustaka 37 1995 ndash 2011.

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Maternity nursing residency practice aims to improve knowledge skills and attitudes in providing nursing care to women 39 s health problems during the period of their life either in the hospital or community Maternity nursing residency achieves these goals through the development of nurse rsquo s function and role The purpose of this report is to provide an overview of maternity nursing specialist rsquo s role as a care provider a counselor an advocate an educator a coordinator a collaborator a communicator an innovator and a researcher Maternity nursing specialists provide nursing care with the application of nursing conceptual models and theories suitable to the client 39 s condition The application of Orem rsquo s self care nursing theory is appropriate for pregnant women with gestational diabetes mellitus to meet theirself care needs during pregnancy Keywords Gestational diabetes mellitus Maternity nursing specialist nursing theory Bibliography 37 1995 ndash 2011 "

"Anemia pada kehamilan masih menjadi perhatian selama periode reproduksi, karena berhubungan dengan peningkatan mortalitas dan morbiditas ibu dan bayi. Ibu hamil multipara memiliki resiko lebih besar mengalami anemia dalam kehamilannya. Peran perawat spesialis maternitas sangat penting untuk membantu ibu hamil multipara dengan anemia dalam memenuhi kebutuhan dasarnya karena berbagai masalah keperawatan yang muncul. Metodologi dalam penulisan menggunakan studi kasus pada lima orang ibu hamil multipara dengan anemia. Masalah keperawatan yang muncul diantaranya resiko cedera pada ibu, resiko cedera pada janin, gangguan rasa nyaman: pusing, keterbatasan aktivitas dan potensial peningkatan pengetahuan tentang anemia. Penerapan teori self care berfokus pada kemampuan individu untuk memenuhi kebutuhan dirinya secara mendiri dengan memperhatikan tingkat ketergantungan perawatan. Penerapan teori self care cocok digunakan pada ibu hamil multipara dengan anemia dalam membantu memandirikan pasien. Perawat dapat menggunakan kerangka kerja Orem sebagai panduan dalam melakukan proses keperawatan.

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Anemia in pregnancy is still being a major concern on health problem during reproductive period, as it is associated with increased maternal and infant morbidity and mortality. Multiparous pregnant women have a higher risk to be anemic during their pregnancies. Nurse specialist maternity play the crucial roles to help multiparous pregnant women with anemia in filling their basic needs due to various nursing problems. Methodology in writing uses case studies on five multiparous pregnant women with anemia. Several nursing issues commonly emerged are the risk of injury both to the mother and to the fetus, common sense problem: dizziness, limited activity and the knowledge of anemia that is potentially improved. The self-care theory focuses on an individual's ability to fill his or her self-needs by paying attention to the level of dependent care. The application of self-care theory is suitable for multiparous pregnant women with anemia as it helps them to be independent patients. Nurses may use the Orem framework as a guide in conducting the nursing process."

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Retensi urin postpartum merupakan ketidakmampuan mengosongkan kandung kemih secara spontan setelah melahirkan dengan residu urin lebih dari 200 ml. Komplikasi yang dapat terjadi yaitu distensi kandung kemih, kontraksi uterus terhambat, perdarahan, otot detrusor melemah, kateterisasi intermiten dan disfungsi berkemih permanen. Penatalaksanaan keperawatan pada retensi urin postpartum dengan memberikan asuhan keperawatan secara holistik menggunakan studi kasus dan penerapan teori keperawatan. Penerapan teori self care Orem dan comfort Kolcaba pada lima kasus retensi urin postpartum dengan membahas permasalahan yang dialami dan menguraikan peran perawat pada kasus tersebut, dengan tujuan kebutuhan kenyamanan dan kemandirian pasien dapat terpenuhi. Kejadian retensi urin dapat diatasi dengan menerapkan evidence based nursing practice kegel excercise dan bladder training. Studi kasus yang dilakukan pada lima ibu postpartum yang mengalami retensi urin didapatkan bahwa kegel exercise dan bladder training mampu mengatasi retensi urin secara signifikan, menurunkan tingkat nyeri, dan meningkatkan self care.

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Postpartum urinary retention is the inability to empty the bladder spontaneously after giving birth with more than 200 ml urine residue. Complications that can occur are distention of the bladder, obstructed uterine contractions, bleeding, weak detrusor muscles, intermittent catheterization and permanent voiding dysfunction. Nursing management in postpartum urinary retention by providing nursing care holistically uses case studies and the application of nursing theory. Application of self care Orem and Comfort Kolcaba theory in five cases of postpartum urine retention by discussing the problems experienced and outlining the role of nurses in the case, with the aim of comfort and independence of patients can be fulfilled. Urinary retention can be overcome by applying evidence based nursing practice kegel excercise and bladder training. Case studies conducted on five postpartum mothers who experienced urinary retention found that kegel exercise and bladder training were able to overcome urinary retention significantly, reduce pain levels, and improve self care.

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"Praktik residensi keperawatan maternitas diselenggarakan untuk menghasilkan perawat maternitas yang menguasai aplikasi teori keperawatan maternitas dan memiliki keterampilan khusus untuk melakukan perawatan maternitas baik di rumah sakit maupun di komunitas. Laporan residensi ini menjelaskan tentang pelaksanaan praktik residensi maternitas, peran dan fungsi perawat maternitas, pencapaian kompetensi praktik dan upaya untuk memodifikasi hambatan yang dihadapi. Laporan residensi ini fokus pada penerapan teori need for help Wiedenbach dan self care Orem pada ibu hamil dengan tuberculosis multi drug resistance. Perawat maternitas perlu meningkatkan pengetahuan dan keterampilan klinik secara berkelanjutan sehingga mampu meningkatkan kualitas asuhan keperawatan maternitas.

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Maternity nursing practice residency organized to produce nurse of maternity who master the application of nursing theory and have special skills to do a good maternity care in hospitals and in the community. This residency final report describes the implementation of the practice residency maternity, roles and functions of nurses maternity, the attainment of practice and attempts to modify the barriers. Focus of this final report is application of theory need for help Wiedenbach and self care Orem in pregnant women with tuberculosis multi drug resistance. Nurse maternity needs to improve knowledge and clinical skills on an ongoing basis to improve the quality of maternity nursing care. "

"Kesehatan reproduksi merupakan masalah penting untuk diperhatikan dalam rangka meningkatkan derajat kesehatan perempuan. Sebagai salah satu usaha untuk mencapai tujuan tersebut, dilaksanakanlah program ners spesialis keperawatan maternitas. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran pelaksanaan praktek residensi ners spesialis keperawatan maternitas dengan fokus penerapan model konsep need for help Wiedenbach pada fase akut dan self care Orem pada fase pemeliharaan pada asuhan keperawatan klien dengan retensio plasenta. Masalah keperawatan pada tahap akut yaitu kekurangan volume cairan, gangguan integritas jaringan, dan kecemasan, sementara pada tahap pemeliharaan adalah gangguan pemenuhan kebutuhan sehari-hari, ketidakefektifan proses menyusui, dan risiko infeksi. Tindakan yang dilakukan meliputi resusitasi cairan, pengeluaran plasenta, perbaikan kontraksi uterus, dan pendidikan kesehatan tentang perawatan pada ibu dan bayi. Evaluasi pada fase akut yaitu perdarahan berkurang, kontraksi uterus kuat, dan pada fase pemeliharaan yaitu peningkatan kemandirian klien.

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Reproductive health is a critical problem that needs attentions in order to increase the female health level. As an attempt to reach this goal, a maternity nursing specialist program is performed. This final scientific work aimed to describe the residential practice of maternity nursing specialist which focused on the application of Wiedenbach's concept of need for help during the acute phase and Orem's self care model during the maintenance phase in the nursing care to a client with placenta retention.

Nursing problems in the acute stage were fluid volume deficit, impaired tissue integrity, and anxiety, while in the maintenance stage were daily needs fulfillment, ineffective breastfeeding, and risk of infection. The nursing intervention included fluid resuscitation, placenta delivery, uterine contraction improvement, and health education related to mother and baby care. The evaluation in the acute phase included reduced bleeding and good uterine contraction, while in the maintenance phase included the enhancement of client's independency."

"[ABSTRAKPermasalahan kesehatan selama masa kehamilan membutuhkan perhatian dari petugas kesehatan sehingga proses kehamilan dan persalinan dapat berjalan selamat. Peran Ners spesialis keperawatan maternitas sangat diperlukan dalam upaya pencegahan dan penanggulangan masalah tersebut. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran pelaksanaan praktik residensi ners spesialis keperawatan maternitas dan memberikan gambaran fokus penerapan model konsep need for help Wiedenbach pada fase akut dan self care Orem pada fase pemeliharaan. Evaluasi yang diharapkan pada fase akut adalah kontraksi berhenti, dan tidak adanya tanda-tanda kegawatan maternal dan janin. Evaluasi pada fase pemeliharaan yaitu peningkatan kemandirian klien. Penerapan model dan konsep keperawatan need for help dan self care terbukti bermanfaat mengatasi kontraksi dalam kehamilan sehingga bisa di aplikasikan dalam proses asuhan keperawatan kontraksi dalam kehamilan.

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ABSTRACTHealth problems during pregnancy require the attention of health professionals so that the process of pregnancy and childbirth can be safe. The role of maternity nursing specialist is indispensable in the prevention and control of the problem. This final scientific work aimed to provide an overview of the implementation of maternity nursing specialist residency practice and describe the application of Wiedenbach Need for Help Conceptual Model in the acute phase and Orem Self Care Conceptual Model in the maintenance phase. The expected evaluation in the acute phase was the contraction stopped, and there were no signs of maternal and fetal distress. The evaluation in the maintenance phase was the increase of the client independency. The application of Need for Help and Self Care Nursing Model and Concept has been proved beneficial to overcome the preterm contraction, so that these models can be applied in the nursing care process of preterm contraction., Health problems during pregnancy require the attention of health professionals so that the process of pregnancy and childbirth can be safe. The role of maternity nursing specialist is indispensable in the prevention and control of the problem. This final scientific work aimed to provide an overview of the implementation of maternity nursing specialist residency practice and describe the application of Wiedenbach Need for Help Conceptual Model in the acute phase and Orem Self Care Conceptual Model in the maintenance phase. The expected evaluation in the acute phase was the contraction stopped, and there were no signs of maternal and fetal distress. The evaluation in the maintenance phase was the increase of the client independency. The application of Need for Help and Self Care Nursing Model and Concept has been proved beneficial to overcome the preterm contraction, so that these models can be applied in the nursing care process of preterm contraction.]"

"Laporan ini merupakan rangkuman kegiatan praktek residensi ners spesialis keperawatan maternitas selama satu tahun untuk menerapkan peran dan fungsi perawat maternitas dengan mengambil contoh penerapan teori model keperawatan Self Care Orem dan Transkultural Nursing Leininger pada pasien dengan anemia selama hamil. Penerapan teori Self care Orem pada kelima kasus yang sudah dilakukan residen mencakup universal self care, developmental self care, health deviation dan conditioning factor. Kekuatan teori Self Care Orem pada klien dengan anemia selama hamil dapat membantu mengatasi klien untuk mencapai kemandirian baik dalam kondisi anemia ringan, sedang dan berat. Kelemahan teori Orem pada klien dengan anemia kurang dapat mendapatkan hasil pengkajian nutrisi. Disamping itu dilaporkan tentang kegiatan pencapaian kompetensi perawat spesialis keperawatan maternitas sebagai pemberi asuhan, konselor, pendidik, advokad, kolaborator, peneliti dan change agent serta proyek inovasi yang dilakukan di lahan praktek.

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This report is a summary of the activities of specialist nursing practice residency maternity nurses for a year to implement the roles and functions of maternity care by taking the example of the application of theoretical models of nursing Orem Self Care and Leininger Transcultural Nursing in patients with anemia during pregnancy. Application of Orem's theory of self-care in the five cases that have been made resident includes universal self care, developmental self care, health deviation and conditioning factor. Strength theory of Orem Self Care on the client with anemia during pregnancy can help to overcome the client to achieve independence either in a mild anemia, moderate and severe. Weaknesses of the theory of Orem on the client with anemia are less able to get the nutrition assessment. Besides, it was reported on activities of achievement of competencies as a maternity nurse specialist nursing care providers, counselors, educators, Advocates, collaborator, researcher and change agent and innovation projects undertaken in the field of practice."

"Perawat sebagai bagian dari tenaga kesehatan memiliki peran untuk memberikan asuhan keperawatan yang komprehensif untuk memantau dan memonitor kondisi ibu. Salah satu peran perawat maternitas adalah memberikan asuhan keperawatan pada pasien dengan penyakit trofoblas dengan menerapkan teori keperawatan. Dari lima kasus kelolaan, dua kasus berumur 40 tahun. Semua kasus mengalami peradarahan. Dua kasus mengalami penyakit trofoblas ganas low risk. Dua kasus dikuretase, satu kasus histerektomi dan dua kasus kemoterapi. Semua kasus mengalami anemia baik anemia ringan sampai berat. Pasien mengalami masalah kekurangan volume cairan, kecemasan, defisit perawatan diri dan kesiapan peningkatan pengetahuan. Teori ini sesuai diterapkan pada pasien dengan penyakit trofoblas untuk memperoleh rasa nyaman selama proses tindakan dan dapat melewati proses kuretase dan kemoterapi dengan risiko minimal. Penanganan sedini mungkin akan meningkatkan peluang hidup ibu cukup besar dan peluang memiliki anak kembali cukup besar.

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Nurse as a part from health worker has role for giving comprhensive nursing care to see and observe the mother condition. One of the maternity nurse role is to give a nursing care to the patient with mola hidatidosa and applied the nursing concept. Five case management, the age of two cases are under 20 years old, one case is 27 years old, and two cases over the 40 years old. All of the cases have the bleeding. Two cases is low risk trofoblast gestational disease. Curettage is done for the two cases, hysterectomy is done for one case, and chemotherapy is done for the two cases. All of the cases get anemia, start from high until low anemia. Patients experience problems of fluid volume deficit, anxiety, self care deficit, and readness to increase knowledge. Both theory are able to be applied for the patient with Mola Hidatidosa to get the comfort feeling along the surgical prosess and can pass the curettage and chemotherapy process with the minimal risk. By early managing will increase the probability of the life and have the next child again."

"Salah satu tujuan dari MDGs adalah menurunkan angka kematian ibu dan bayi. Upaya penurunan angka kematian ibu dan bayi di Indonesia belum memuaskan, target Indonesia menurunkan angka kematian ibu 102 per 100.000 kelahiran hidup pada tahun 2015. Peran ners spesialis keperawatan maternitas sebagai praktisi keperawatan, pendidik, konselor, advokat, pengelola, koordinator, kolaborator, peneliti dan agen pembaharu sangat diperlukan untuk menurunkan angka kematian ibu dan bayi. Tujuan umum pembuatan laporan akhir praktik residensi adalah untuk memberikan gambaran pelaksanaan kegiatan praktik residensi dengan fokus penerapan model keperawatan Need for Help Wiedenbach dan Self Care Orem pada asuhan keperawatan ibu hamil dengan kontraksi dini. Aplikasi teori keperawatan Need for Help Wiedenbach dan Self Care Orem efektif dilakukan pada lima ibu hamil dengan kontraksi dini. Integrasi model keperawatan Need for Help Wiedenbach diterapkan pada fase akut. Sedangkan pada fase pemeliharaan dilakukan asuhan keperawatan dengan Self Care Orem. Aplikasi teori tersebut berhasil membantu menyelesaikan masalah keperawatan dan menghentikan kontraksi uterus sampai usia kehamilan aterm. Setelah melaksanakan praktik residensi spesialis keperawatan maternitas, penulis mampu mencapai target kompetensi dengan baik.

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One of the MDGs goals is to lower maternal and infant mortality rate. Efforts to lessen maternal and infant mortality rate in Indonesia are unsatisfactory. Indonesia's target is to reduce maternal mortality to 102 per 100,000 live births in 2015. Roles of maternity nursing specialist nurses as care givers, educators, counselors, advocates, coordinators, managers, collaborators, researchers and change agents are needed to lower maternal and infant mortality rate.

The goal of the residency practice final report is to provide an overview of the implementation of residency practice focused on Wiedenbach Need for Help and Orem Self Care Nursing Model on nursing care of pregnant women with early contractions.

The application of Wiedenbach Need for Help and Orem Self Care nursing theory was effectively done to five pregnant women with early contractions. The integration of Wiedenbach Need for Help nursing model was applied in the acute phase. While in the maintenance phase, Orem Self Care nursing care was performed. The application of the theory was successfully help to solve nursing problems and to stop the uterine contractions until term gestation. After performing the maternity nursing specialist residency practice, the author was able to achieve the competency targets well."

"Perawat spesialis maternitas berperan dalam menurunkan Angka Kematian Ibu AKI akibat komplikasi kehamilan dan persalinan. Salah satu peran perawat adalah memberikan asuhan keperawatan yang komprehensif dengan mengidentifikasi dan mengatasi masalah pasien perdarahan post partum dengan pedekatan teori keperawatan. Penerapan model need for help Wiedenbach diterapkan pada fase akut untuk mefasilitasi ibu mengatasi masalah perdarahan yang dialami dan teori self care Orem diterapkan pada fase pemulihan untuk memfasilitasi pasien meningkatkan kemampuan dalam merawat dirinya. Lima kasus kelolaan pasien memiliki masalah yang berbeda beda sesuai hasil pengkajian model need for help Wiedenbach dan self care Orem. Kasus yang dilaporkan adalah pasien perdarahan post partum akibat retensio plasenta dengan keluhan perdarahan aktif, lemas, pusing. Masalah keperawatan yang ditemukan pada fase akut adalah perdarahan, kurang volume cairan, resiko gangguan perfusi jaringan, kecemasan, sedangkan masalah keperawatan pada fase pemeliharaan adalah defisit perawatan diri, risiko cidera, nyeri, kecemasan, dan berduka. Intervensi keperawatan yang dilakukan pada fase akut adalah untuk mengatasi masalah kegawatan dengan menghentikan perdarahan dan resusitasi cairan. Sedangkan intervensi keperawatan pada fase pemulihan adalah untuk meningkatkan kemandirian pasien dalam melakukan perawatan dirinya. Evaluasi yang didapatkan adalah perdarahan teratasi dan pasien mandiri dalam melakukan perawatan dirinya

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The Final Report of residential of Maternity Nursing Specialist which focus on application Theori of need for Help Wiedenbach and Self Care orem of Women with Post Partum Haemorhagae AbstrackMaternity nursing specialists have role in reducing maternal mortality due to complication of pregnancy and childbirth. One of the nurses 39 roles is to provide comprehensive nursing care by identifying and resolving patient problems with postpartum hemorrhage using nursing theories. The application of "the need for help" Wiedenbach theory in the acute phase is to facilitate mother in overcoming the bleeding problem and "the self care" Orem theory is applied in the recovery phase to facilitate patient having self care. Five cases of postpartum hemorrhage patients have different problems according to the results of "the need for help" theory of Wiedenbach and "self care" theory of Orem.

Reported cases were postpartum hemorrhage patients due to placental retention with active bleeding, weakness and dizziness complaints. Nursing problems found in the acute phase are bleeding, lack of fluid volume and risk of tissue perfusion disorders, while the problems in the recovery phase are self care deficits, risk of injury, pain, anxiety and grief. In the acute phase, nursing interventions is conducted to overcome emergency problem by stopping bleeding and fluid resusitation. While in the recovery phase, the nursing interventions is conducted to facilitate patients in doing self care. Evaluation obtained is bleeding resolved and having self care patients. "