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"ABSTRAKFraktur femur dikenal sebagai fraktur yang umum terjadi di wilayah perkotaan dibandingkan wilayah pedesaan. Di perkotaan banyak dijumpai kasus fraktur femur, namun di pedesaan lebih banyak ditemukan yaitu fraktur pada ekstremitas atas. Hal ini karena perbedaan karakteristik wilayah dan penduduk dari keduanya, sehingga masyarakat kota memiliki faktor risiko yang khas wilayah perkotaan seperti contohnya fraktur yang terjadi karena trauma atau kecelakaan lalu lintas. Pada kasus ini, Ny H merupakan seorang wanita berusia 43 tahun dan bertempat tinggal di wilayah perkotaan. Ny H mengalami fraktur femur intertrochanter tertutup bukan disebabkan karena cedera tetapi karena proses infeksi. Berdasarkan pengkajian dan analisis data pada periode pre operasi maupun post operasi, ditemukan masalah keperawatan nyeri akut, hambatan mobilitas fisik, risiko infeksi, risiko trauma, dan risiko kerusakan integritas kulit. Intervensi keperawatan yang dibahas dalam karya tulis ini adalah mengenai latihan kekuatan otot isometrik untuk mencegah penurunan kekuatan otot dan mempersiapkan ambulasi serta mobilisasi dini secara optimal.

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ABSTRACT

Femoral fractures are known as common fractures in urban areas rather than rural areas. In urban areas there are many cases of femoral fracture, but in rural areas more commonly found is fracture in upper limb. This is due to the different characteristics of the region and the population of both, so that urban people have typical risk factors in urban areas such as fractures that occur because of injury or traffic accidents. In this case. Mrs H is a 43 year old female and lives in an urban area. Mrs H has a closed femoral fracture intertrochanter not caused by injury but because of infection process. Based on assessment and analysis of data in the preoperative and postoperative periods, acute pain nursing problems, impaired physical mobility, infection risk, risk for injury, and risk for impaired skin integrity were found. Nursing interventions discussed in this paper are about isometric excercise to prevent decreased muscle strength and prepare for early ambulation and early mobilization."

"Osteomielitis merupakan infeksi pada tulang, sumsum tulang dan jaringan sekitar yang terjadi karena masuknya mikroorganisme dengan tanda yang khas yaitu nyeri. Pembedahan merupakan salah satu pilihan penatalaksanaan pada osteomielitis dengan nyeri sebagai keluhan utama yang sering dilaporkan. Nyeri yang dialami pada klien dengan osteomielitis setelah pembedahan menjadi semakin berat ketika dilakukan perawatan luka. Asuhan keperawatan manajemen nyeri diterapkan pada Tn. MI berusia 25 tahun dengan latar belakang etnis Betawi yang menjalani debridement dan remove implant dengan riwayat operasi open reduction internal fixation ORIF femur dan tibia dekstra tujuh tahun lalu. Manajemen nyeri yang diterapkan yaitu dengan mendengarkan musik selama perawatan luka. Evaluasi dilakukan dengan menggunakan visual analogue scale VAS dan monitor tanda nonverbal nyeri. Evaluasi hasil pada hari pertama setelah debridement pada saat dilakukan perawatan luka yaitu VAS 8 dengan wajah ekspresi merintih disertai menggerakkan kaki kiri. Nyeri yang dirasakan TN. MI berkurang secara progresif selama perawatan luka dengan nilai VAS 3 dan ekspresi wajah tenang pada hari keenam setelah operasi. Penulis merekomendasikan terapi musik sebagai pilihan manajemen nyeri nonfarmakologi dengan kolaborasi pemberian analgetik sebelum perawatan luka sehingga tujuan manajemen nyeri dapat tercapai optimal.

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Osteomyelitis is an infection of bone, bone marrow and surrounding tissues that occur due to the entry of microorganisms with pain as spesific sign. Surgery is one of the management options in osteomyelitis with pain as the main complaint that often reported. Pain experienced by clients with osteomyelitis after surgery becomes more severe during wound care. Nursing care of pain management applied to Mr. MI , 25 years old with Betawi ethnic background undergoing debridement and remove implants with a history of open reduction internal internal fixation ORIF surgery of the femur and tibia dekstra seven years ago.

Pain management is applied by listening music during wound care. The evaluation was performed using visual analogue scale VAS and nonverbal pain monitor. Evaluation of the results on the first day after debridement during wound care that showed VAS value 8 with a face moaning expression and wiggle his left foot. Music therapy was effective on reducing pain especially during wound care. The pain felt by TN. MI progressively decreased during wound care with VAS value 3 and calm facial expression on the sixth day after surgery. Recommendation music therapy as nonpharmacological pain management option with collaboratve analgesic treatment before wound care will provide optimal results for pain management goal. "

"Osteoartritis adalah penyakit degenerasi pada sendi yang melibatkan kartilago, lapisan sendi, ligamen, dan tulang karena proses inflamasi kronis pada sendi dan tulang disekitar sendi, sehingga dapat menyebabkan fraktur dengan angka kejadian yang meningkat ketika disertai dengan obesitas. Obesitas terjadi karena gaya hidup yang kurang baik, seperti menurunnya minat dalam berolah raga. Individu dengan osteoartritis pada sendi panggul dan disertai obesitas mudah mengalami fraktur collum femur sehingga ketika sudah terjadi fraktur maka diperlukan tindakan operasi THR Total Hip Replacement . Pada post operasi Total Hip Replacement harus segera dilakukan mobilisasi dengan latihan kekuatan otot seperti ankle pump, pengesetan quadtriseps, gluteal, hip and knee flexion, short arc quad, bed mobility exercise dan latihan penggunaan alat walker. Hasil yang didapatkan, klien mendapatkan tingkat ambulasi yang diharapkan, tidak terjadi komplikasi pada berbagai sistem tubuh serta tidak memperpanjang masa rawat.

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Osteoarthritis is a degenerative disease of the joint involving the cartilage, lining of the joints, ligaments, and bones due to chronic inflammatory processes in the joints and bones around the joint, thus causing fractures with increased incidence rates when accompanied by obesity. Obesity occurs due to poor lifestyle, such as decreased interest in exercise. Individuals with osteoarthritis of the hip joint and with obesity are susceptible to fracture of the femur collum so that when a fracture occurs it is necessary to perform THR Total Hip Replacement surgery. In post operation Total Hip Replacement should be mobilized with muscle strength training such as ankle pump, quadtriseps setup, gluteal, hip and knee flexion, short arc quad, bed mobility exercise and walker tool usage exercise. The results obtained, the client gets the expected level of ambulation, no complications occur on various body systems and does not extend the length of stay."

"Fraktur intertrochanter femur merupakan fraktur yang terjadi di antara trochanter mayor dan minor sepanjang linea intertrochanter di luar kapsul sendi. Hambatan mobilitas fisik merupakan salah satu masalah yang ditemukan pada klien dengan Fraktur intertrochanter femur. Intervensi latihan rentang pergerakan sendi dapat dilakukan untuk mengatasi hambatan mobilitas fisik dengan tujuan untuk mengurangi keterbatsan rentang gerak sendi, disabilitas, dan kontraktur. Karya ilmiah ini bertujuan untuk memberikan gambaran asuhan keperawatan melalui pendekatan keperawatan kesehatan masyarakat perkotaan pada klien Fraktur intertrochanter femur dengan hambatan mobilitas fisik. Intervensi ini diterapkan pada klien selama 11 hari sebelum operasi dan 4 hari setelah operasi. Klien diberikan edukasi untuk melakukan latihan dua kali sehari dan disesuaikan dengan toleransi klien. Tindakan latihan rentang pergerakan sendi dilakukan selama 10 sampai 15 menit dengan posisi semi fowler atau supinasi. Hasil evaluasi didapatkan adanya peningkatan rentang gerak sendi pada hari pertama dan kedua post operasi ORIF sampai sudut elevasi kaki kiri mencapai 60 derajat area sendi hip. Intervensi Latihan rentang pergerakan sendi sangat direkomendasikan untuk diterapkan di area pelayanan keperawatan khususnya di ruang bedah sebagai tindakan mandiri yang dapat dilaksanakan perawat.

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Fracture intertrochanter femur is a fracture that occurs between the trochanter major and minor along the line intertrochanterica outside the joint capsule. Impaired physical mobility is one of the typical problems found in clients with femoral intertrochanter fractures. Intervention range of joint movement exercises can be performed to overcome the physical mobility barriers in patients with the aim of reducing the range of motion of joints such as disability and contractures. This scientific work aims to provide an image of nursing care through the approach of Urban Health Nursing Problems on clients Fracture intertrochanter femur with physical mobility barriers. This intervention is applied to the client for 11 days before surgery and 4 days after surgery. Client is given education to do the exercises twice a day and adjusted to client tolerance. The range of joint movement movements is performed for 10 to 15 minutes in a semi-fowler or supine position. The results showed an increase in range of motion of the joints on the first day and second post of ORIF surgery until the left foot elevation angle reaches 60 degrees of the hip joint area. Intervention The range of joint movement exercises is highly recommended to be applied in the nursing service area, especially in the operating room as an independent action that the nurse can perform."

"Mobilisasi dini pasca operasi merupakan salah satu intervensi yang penting pada periode pasca operasi yang dapat mempersingkat hari rawat LOS dan mencegah komplikasi post operasi. Namun demikian, mobilisasi pasca operassi merupakan elemen asuhan keperawatan yang kadang terlupakan. Tujuan penulisan adalah untuk menganalisis intervensi program mobilisasi dini pada klien Ny.S 60 tahun dengan lumbal spinal stenosis L4-L5 pasca operasi dekompresi dan pemasangan TLIF Transforaminal Lumbar Interbody Fusion dengan riwayat hipertensi, obesitas dan foot drop dextra. Intervensi dilakukan selama lima hari perawatan yang meliputi edukasi kesehatan, latihan kekuatan otot, mobilisasi di tempat tidur, hingga mobilisasi jalan dengan menggunakan walker. Hasil pelaksanaan intervensi adalah kemampuan klien dalam mobilisasi meningkat yang ditunjukan dengan pencapaian 6 dari 8 skor JH-HLM John Hopkins Highest Level of Mobilty yaitu klien mampu berjalan lebih dari 10 langkah dalam 5 hari perawatan. Selain itu, kondisi umum klien meningkat yaitu secara fisik meliputi: klien lebih aktif untuk merubah posisi dan bergerak, keluhan nyeri dan kelelahan jarang, mengatakan lebih nyaman dan tubuhnya tidak kaku ; emosional meliputi: mood tampak baik, kecemasan untuk mobilisasi minimal, kooperatif dalam program mobilisasi , dan sosial meliputi: peningkatan tingkat kemandirian klien untuk mobilisasi, keluarga berpartisipasi aktif dalam mendukung dan mendampingi klien dalam program mobilisasi. Hasil analisis menunjukan bahwa intervensi program mobilisasi dini pasca operasi berdampak positif terhadap hasil perawatan pasca operasi klien sehingga perlu menjadi prioritas dalam asuhan keperawatan pasca operasi.

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Early postoperative mobilization is one of the most important interventions in the postoperative period that can shorten length of stay LOS and prevent postoperative complications. However, postoperative mobilization is the most frequently overlooked element of nursing care. The purpose of the writing was to analyze the early mobilization program on the Ny.S 60 years old client with Lumbar L4 L5 spinal stenosis post decompression and TLIF Transforaminal Lumbar Interbody Fusion installation with history of hypertension, obesity, and foot drop dextra. Interventions were performed for five days of care that included health education, muscle strength training, bed mobilization, to out of bed mobilization using walkers.

The result of the intervention was client's ability to mobilize has increased which has been shown in the achievement of 6 of 8 JH HLM score John Hopkins Highest Level of Mobilty which client can walked more than 10 steps within 5 days of treatment. Client's general condition also improved which physical aspect including the client were more active to change position and moved, rare to complaint pain and tiredness, said more comfortable and her body more relaxed emotional aspect including good mood, minimal anxiety during mobilization, cooperative in mobilization program , social aspect including the level of client independence for mobilization increased, the family actively participated in supporting and assisting clients in the mobilization program. The results of the analysis showed that the intervention of early postoperative mobilization program had a positive impact on client's postoperative outcomes, therefore it needs to be a priority interventions in postoperative nursing care. "

"ABSTRAKCa buli merupakan salah satu masalah kesehatan masyarakat perkotaan, faktor resiko pada individu perkotaan meliputi lingkungan, gaya hidup dan asupan makanan yang mengandung amin aromatik, benzena, dan zat karsinogen lainnya. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran asuhan keperawatan pada ca buli dengan kateterisasi post TURBT. Pencegahan infeksi saluran kencing pada pasien dengan kateterisasi irigasi dilakukan dengan cara perawatan kateter perhari serta teknik aseptik dalam intervensi keperawatan. Perawatan dengan menggunakan chlorhexidin 2% mampu mencegah komplikasi infeksi akibat kateter.

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ABSTRACT

Bladder cancer is the most problem people who live in city, environment, smoke and lifestyle is risk factor who get bladder cancer. This paper aims to show how to care patient with bladder cancer on bladder irrigation with cathteter. To prevention cathteterisation associated urinary tract infection by doing care of cathteter everyday using chlorhexidin 2%. To reduce urinary tract infections."

"ABSTRAK Demam Berdarah Dengue (DBD) merupakan penyakit demam akut tanpa sebab yang jelas disertai bintik-bintik merah pada kulit. Karya ilmiah ini membahas asuhan keperawatan yang diberikan pada anak dengan kasus demam berdarah dengue di Teratai 3 Selatan RSUP Fatmawati. Karya ilmiah ini bertujuan untuk menggambarkan asuhan keperawatan anak dengan DBD. Salah satu masalah keperawatan yang terjadi adalah hipertermia. Tindakan keperawatan terkait hipertermia meliputi monitor suhu, peningkatan asupan cairan, penggunaan pakaian yang tipis dan menyerap keringat, tepid sponge dan kolaborasi pemberian antipiretik. Asuhan keperawatan yang diberikan berupa tepid sponge dan pemberian antipiretik untuk membantu menurunkan demam pada anak. Hasil yang didapat anak mengalami penurunan suhu tubuh sebesar rata-rata 1,1ºC setelah 30 menit pemberian tepid sponge yang disertai dengan pemberian antipiretik. Tepid sponge dapat menambah keterampilan perawat dalam menurunkan demam pada anak secara nonfarmakologis. Kata kunci: Demam berdarah dengue, hipertermia, tepid sponge.ABSTRACT Dengue Hemorrhagic Fever (DHF) are acute febrile illness with no obvious cause red spot on the skin. This paper discussed the nursing care given to children in Fatmawati?s Hospital with dengue hemorrhagic fever (DHF) cases. The purpose of paper is to describe the nursing care o the children with DHF. One problem that occurs is nursing a fever. Fever related to nursing actions include monitoring the temperature, increased fluid intake, use of thin clothes and absorbs perspiration, tepid sponge and collaboration antipyretic administration. Nursing care is given in the form of tepid sponge and antipyretic administration to help reduce fever in children. Having obtained a description of intervention, children decreased body temperature after 30 minutes of administration 1,1°C of tepid sponge with combined of antipyretic administration. Tepid sponge can increase the skills of nurses in reducing fever in children.;Dengue Hemorrhagic Fever (DHF) are acute febrile illness with no obvious cause red spot on the skin. This paper discussed the nursing care given to children in Fatmawati?s Hospital with dengue hemorrhagic fever (DHF) cases. The purpose of paper is to describe the nursing care o the children with DHF. One problem that occurs is nursing a fever. Fever related to nursing actions include monitoring the temperature, increased fluid intake, use of thin clothes and absorbs perspiration, tepid sponge and collaboration antipyretic administration. Nursing care is given in the form of tepid sponge and antipyretic administration to help reduce fever in children. Having obtained a description of intervention, children decreased body temperature after 30 minutes of administration 1,1°C of tepid sponge with combined of antipyretic administration. Tepid sponge can increase the skills of nurses in reducing fever in children.;Dengue Hemorrhagic Fever (DHF) are acute febrile illness with no obvious cause red spot on the skin. This paper discussed the nursing care given to children in Fatmawati?s Hospital with dengue hemorrhagic fever (DHF) cases. The purpose of paper is to describe the nursing care o the children with DHF. One problem that occurs is nursing a fever. Fever related to nursing actions include monitoring the temperature, increased fluid intake, use of thin clothes and absorbs perspiration, tepid sponge and collaboration antipyretic administration. Nursing care is given in the form of tepid sponge and antipyretic administration to help reduce fever in children. Having obtained a description of intervention, children decreased body temperature after 30 minutes of administration 1,1°C of tepid sponge with combined of antipyretic administration. Tepid sponge can increase the skills of nurses in reducing fever in children.;Dengue Hemorrhagic Fever (DHF) are acute febrile illness with no obvious cause red spot on the skin. This paper discussed the nursing care given to children in Fatmawati?s Hospital with dengue hemorrhagic fever (DHF) cases. The purpose of paper is to describe the nursing care o the children with DHF. One problem that occurs is nursing a fever. Fever related to nursing actions include monitoring the temperature, increased fluid intake, use of thin clothes and absorbs perspiration, tepid sponge and collaboration antipyretic administration. Nursing care is given in the form of tepid sponge and antipyretic administration to help reduce fever in children. Having obtained a description of intervention, children decreased body temperature after 30 minutes of administration 1,1°C of tepid sponge with combined of antipyretic administration. Tepid sponge can increase the skills of nurses in reducing fever in children."