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"ABSTRAKNama : Seno Dwi AribowoProgram Studi : Profesi Ilmu KeperawatanJudul Karya Ilmiah Akhir : Analisis Praktik Klinik Keperawatan Kesehatan Masalah Perkotaan Pada Anak Dengan Tumor Mediastinum Di Ruang Perawatan Anak Gedung A Lantai 1 Rsupn Dr. Cipto Mangunkusumo Pasien dengan penyakit tumor mediastinum ,memungkinkan terjadi peningkatan produksi sputum yang menyumbat saluran pernapasan. Salah satu tindakan yang aman dan direkomendasikan untuk mengeluarkan sputum yang menyumbat saluran napas pada pasien dengan tumor paru adalah menggunakan teknik Active Cycle of Breathing Technique ACBT . Teknik ini dilakukan terhadap salah satu pasien anak berusia 12 tahun yang mengalami tumor mediastinum dengan masalah ketidakefektifan bersihan jalan napas akibat penumpukan sputum di ruang rawat anak lantai 1 gedung A RSUPN Cipto Mangunkusumo Jakarta. Setelah dilakukan tindakan selama 11 hari didapatkan hasil, pasien dapat mengeluarkan sputum yang menyumbat sehingga produksi sputum berkurang. Berdasarkan hasil tersebut, teknik ACBT terbukti efektif membantu pasien untuk mengeluarkan sputum yang menyumbat pada pasien dengan tumor paru.Kata kunci: ACBT, Penumpukan Sputum, Tumor Mediastinum.

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ABSTRACTName Seno Dwi AribowoStudy Program Faculty of NursingTittle Analysis of Urban Nursing Practice in Patient With Mediastinal Tumor at Pediatric Ward 1st floor gedung A RSUPN Dr. Cipto Mangunkusumo Patients with a mediastinal tumor may have an increased sputum production that clogs the respiratory tract. One of the safest and recommended actions to remove sputum that obstructs the airway in patients with lung tumors is using Active Cycle of Breathing Technique ACBT technique. This technique was performed on the 12 year old pediatric patients who had a mediastinal tumor with inefective airway clearence problems due to sputum accumulation in first floor child unit Gedung A of Cipto Mangunkusumo Jakarta Hospital. After an 8 day action, the result showed patient can remove the clogged sputum so that sputum production is reduced. Based on these results, the ACBT technique proved to be effective in helping patients to remove clogged sputum in patients with lung tumors.Keywords ACBT, Sputum Accumulation, Mediastinal Tumor."

"Penyakit gagal ginjal kronis pada anak merupakan salah satu masalah kesehatan masyarakat perkotaan yang terus meningkat dari tahun ke-tahun di Indonesia dan merupakan salah satu masalah kesehatan utama di dunia. Salah satu masalah keperawatan dari penyakit gagal ginjal kronis adalah kelebihan volume cairan yang disebabkan penumpukan cairan berlebih didalam tubuh. Peran perawat pada anak dengan gagal ginjal kronis antara lain sebagai pemberi pelayanan asuhan keperawatan, sebagai advokator anak dan keluarga, sebagai edukator untuk meningkatkan pengetahuan anak dan keluarga, serta sebagai kolaborator dalam memberikan pelayanan kesehatan bersama dengan tim kesehatan lain. Peran perawat ini sangat diperlukan dalam memberikan pelayanan kesehatan baik kepada anak maupun kepada orangtua untuk meningkatkan status kesehatan pada anak dengan gagal ginjal kronis.

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Chronic kidney disease is one of the increasing urban health problems in Indonesia and one of the major health problems in the world. One of the nursing problems of chronic kidney disease is the excess volume of fluid caused by excessive of fluid in the body. The nurse roles in children with chronic kidney disease as nursing care providers, as advocate for children and families, as educators to improve the knowledge of children and families, and as collaborators in providing health services along with other health teams. The role of nurses is very necessary in providing health services to both children and parents in improving health status in children with chronic kidney disease."

"Gagal ginjal kronik pada anak merupakan salah satu penyakit yang khas pada masyarakat perkotaan. Salah satu komplikasi yang terjadi pada gagal gagal ginjal kronik adalah edema yaitu kondisi kelebihan cairan di dalam tubuh. Karya ilmiah ini bertujuan memberikan gambaran asuhan keperawatan melalui pendekatan KKMP pada pasien anak dengan gagal ginjal kronik yang mendapat tindakan hemodialisa dengan gejala edema anasarka dan edema paru. Intervensi yang diberikan adalah manajemen pembatasan cairan, intervensi ini diterapkan selama 7 hari. Hasil evaluasi didapatkan, kelebihan volume cairan teratasi ditandai dengan edema sudah tidak ada dan keadaan umum pasien baik. Intervensi ini dilakukan sejalan dengan intervensi kolaborasi dengan dokter, ahli gizi, farmasi dan bagian hemodialisa. Oleh karena itu intervensi manajemen pembatasan cairan perlu diterapkan secara disiplin di pelayanan keperawatan sebagai intervensi mandiri.

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Chronic Kidney Disease in children is one of the speciality problem in urban community. One of the most serious complication this disease is oedema which means excess fluid volume in the body. The purpose of this case study to describe about nursing care with urban health nursing practice approach in child with anasarka and lung oedema caused by CKD during hemodylisis therapy. The intervension given was fluid restiction management in 7 days of care. The result was excess fluid volume could be resolved with there was no oedema and general physically was good. These interventions are conducted in line with collaborative interventions with doctorss, nutritionists, pharmacists and hemodialysis departments. So that, this intervention has to be applied consistenly in nursing care as independent intevension for nurse."

"Gizi buruk masih menjadi masalah kesehatan utama dunia dan masih menjadi prioritas Suistanable Development Goals SDGs yang berada pada goals kedua yaitu zero hunger pada tahun 2030 untuk mengakhiri segala bentuk malnutrisi. Penulisan karya ilmiah ini bertujuan untuk mengetahui adanya perbaikan status nutrisi pada anak yang mengalami gizi buruk yang disertai penyakit infeksi fistel enterokutan. Penatalaksaan fistel enterokutan mayoritas dilakukan secara konservatif dengan memperbaiki status gizi klien. Sehingga dilakukan intervensi keperawatan dengan fokus evaluasi perbaikan status nutrisi melalui monitoring berat badan untuk mengetahui sejauh mana keberhasilan asuhan keperawatan. Hasil penerapan pemantauan status nutrisi ini didapatkan gambaran secara grafik adanya peningkatan berat badan dan perbaikan status nutrisi. Hasil penerapan aplikasi ini diharapkan adanya pertimbangan dari institusi pelayanan kesehatan untuk mengaplikasikan pemantauan berat badan sebagai bagian dari dokumentasi asuhan keperawatan.

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Malnutrition is the world 39 s major health problem and it is a priority of Suistanable Development Goals SDGs, which is in the second goal of zero hunger in 2030 to end all forms of malnutrition. This scientific paper aims to determine the improvement of nutritional status in children with malnutrition accompanied by infectious disease Enterocutanous Fistula ECFs. The majority of enterocutaneous fistula management is conservative therapy by improving the nutritional status of the client. Nursing intervention is done with focus evaluation to improve nutritional status through weight monitoring to know how successful nursing care. The results of monitoring nutritional status is obtained graphically, illustrated the increase of body weight and improvement nutritional status. The results of implementation is expected the consideration of health care institutions to apply weight monitoring as part of nursing care documentation."

"Kanker masih menjadi penyakit yang menakutkan bagi masyarakat. Kanker merupakan penyebab ke dua kematian utama setelah penyakit jantung di dunia. Salah satu kanker ganas karsinoma nasofaring KNF merupakan jenis kanker ke empat terbanyak di Indonesia. Massa yang mendesak jaringan sekitar akan menyebabkan rasa nyeri bagi pasien yang mengalami penyakit kanker. Karya ilmiah akhir ini bertujuan menganalisis praktik asuhan keperawatan pada anak dengan KNF yang mengalami nyeri kronik. Evaluasi hasil intervensi yang dilakukan didapatkan data bahwa masalah nyeri kronik, kekurangan nutrisi kurang dari kebutuhan tubuh, resiko perdarahan teratasi sebagian. Tindakan teknik distraksi berupa permainan games dan penatalaksaan nyeri menggunakan farmakologi mampu mengurangi skala Children rsquo;s Hospital of Eastern Ontario Pain Scale CHEOPS dengan KNF.

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Cancer is still a frightening disease for people. Cancer is the second leading cause of death after heart disease in the world. One of the most severe cancers of nasopharyngeal carcinoma KNF is the fourth most common cancer in Indonesia. The urgent mass of surrounding tissue will cause pain for patients with cancer. This final paper aims to analyze the practice of nursing care in children with KNF who experience chronic pain. Evaluation of intervention result done got data that problem of chronic pain, lack of nutrition less than requirement of body, risk of bleeding partially resolved. The technique of distraction such as playing games and pain management using pharmacology can reduce the scale Children rsquo s Hospital of Eastern Ontario Pain Scale CHEOPS with KNF. "

"Banyak pasien dengan Penyakit Ginjal Kronik PGK mengalami masalah overload cairan akibat dari ketidakmampuan ginjal membuang hasil metabolime melalui eliminasi urin. Overload cairan salah satu penyebab terjadinya penyakit kardiovaskuler yang merupakan penyebab kematian tersering pada anak dengan PGK. Upaya untuk mengatasi overload cairan adalah dengan melakukan pembatasan cairan. Pemantauan keseimbangan cairan menggunakan format pencatatan yang melibatkan keluarga penting dilakukan untuk mengetahui keefektifan pembatasan cairan pasien. Tujuan penulisan ini adalah mengidentifikasi keoptimalan pemantauan cairan penggunaan fluid intake output chart khusus pasien PGK. Karya tulis ilmiah ini menggunakan metode studi kasus berupa penerapan intervensi pemantauan cairan menggunakan chart yang melibatkan keluarga. Hasil intervensi menunjukan penggunaan fluid intake output chart khusus pasien PGK efektif dalam menangani overload cairan dibuktikan dengan berkurangnya manifestasi overload cairan pasien. Penulis merekomendasikan penggunaan chart khusus tersebut untuk mengatasi kelebihan volume cairan pada pasien.

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Some of patient with chronic kidney disease CKD experience fluid overload problems resulting from the inability of the kidneys to throw away metabolic outcomes through urinary elimination. Fluid overload is one of the causes of cardiovascular disease which is the most common cause of death in children with CKD. The attempt to overcome the fluid overload is by limiting the fluid. To determine the effectiveness of patient fluid restriction, it is necessary to monitor fluid balance using a recording format involving the family. The purpose of this paper is to identify the optimum use of fluid intake output chart special patient CKD for fluid monitoring. The method used in the writing of this scientific paper is a case study of the application of fluid monitoring interventions using a chart involving the family. The results of these interventions show that the use of a fluid intake output chart specifically for CKD patients is effective in dealing with fluid overload as evidenced by the reduced patient fluid overload manifestation. Therefore, this intervention is well used to develop nursing interventions so as to improve the quality of life of patients"

"ABSTRAK Kasus HIV/AIDS dan tuberkulosis banyak diderita masyarakat perkotaan.Penyakit pada masyarakat perkotaan berkaitan dengan karakteristik lingkungandan gaya hidup masyarakat perkotaan. Kasus HIV biasanya disertai denganberbagai infeksi oportunistik. Infeksi opportunistik yang paling banyak ditemukanadalah tuberkulosis, diikuti dengan kandidiasis oral, dan diare. Masalahkeperawatan utama pada pasien dengan tuberkulosis adalah ketidakefektifanbersihan jalan napas berhubungan dengan retensi sputum. Penulisan karya ilmiahakhir ini bertujuan untuk menganalisis intervensi mandiri keperawatan berupakombinasi antara anjuran minum air putih hangat, postural drainase, dan batukefektif untuk mengatasi masalah bersihan jalan napas tidak efektif. Intervensidilakukan pada pasien HIV/AIDS dengan tuberculosis di ruang rawat penyakitdalam RSCM. Hasil dan evaluasi dari intervensi yang dilakukan yaituberkurangnya penumpukan sputum pada jalan napas pasien, sehingga pasien tidakmerasakan sesak seperti sebelumnya dan bisa bernapas lebih lega. Perawatdiharapkan dapat melakukan intervensi mandiri keperawatan berupa kombinasiantara anjuran minum air putih hangat, postural drainase, dan batuk efektiftersebut untuk membantu memperbaiki status pernapasan pasien.ABSTRACT Cases of HIV / AIDS and tuberculosis affects many urban communities. Diseases

in urban communities are related to environment and lifestyle characteristics of

urban communities. HIV cases are usually accompanied by a variety of

opportunistic infections. The most common opportunistic infections is

tuberculosis, followed by oral candidiasis and diarrhea. The main nursing

problems in patients with tuberculosis is the ineffectiveness of airway clearance

related to the retention of sputum. This final scientific thesis aims to analyze the

independent nursing intervention in the form of a combination of the

recommendation to drink warm water, postural drainage, and cough effectively to

address the problem of ineffective airway clearance. The intervention was

conducted in HIV/AIDS patient with tuberculosis in medical ward RSCM. The

result of interventions was reduced sputum buildup in the airway of the patient, so

the patient did not feel crowded as before and could breathe more easily. Nurses

are expected to conduct independent nursing interventions in the form of a

combination of the recommendation to drink warm water, postural drainage and

effective coughing to help improve patient's respiratory status. ;Cases of HIV / AIDS and tuberculosis affects many urban communities. Diseases

in urban communities are related to environment and lifestyle characteristics of

urban communities. HIV cases are usually accompanied by a variety of

opportunistic infections. The most common opportunistic infections is

tuberculosis, followed by oral candidiasis and diarrhea. The main nursing

problems in patients with tuberculosis is the ineffectiveness of airway clearance

related to the retention of sputum. This final scientific thesis aims to analyze the

independent nursing intervention in the form of a combination of the

recommendation to drink warm water, postural drainage, and cough effectively to

address the problem of ineffective airway clearance. The intervention was

conducted in HIV/AIDS patient with tuberculosis in medical ward RSCM. The

result of interventions was reduced sputum buildup in the airway of the patient, so

the patient did not feel crowded as before and could breathe more easily. Nurses

are expected to conduct independent nursing interventions in the form of a

combination of the recommendation to drink warm water, postural drainage and

effective coughing to help improve patient's respiratory status. ;Cases of HIV / AIDS and tuberculosis affects many urban communities. Diseases

in urban communities are related to environment and lifestyle characteristics of

urban communities. HIV cases are usually accompanied by a variety of

opportunistic infections. The most common opportunistic infections is

tuberculosis, followed by oral candidiasis and diarrhea. The main nursing

problems in patients with tuberculosis is the ineffectiveness of airway clearance

related to the retention of sputum. This final scientific thesis aims to analyze the

independent nursing intervention in the form of a combination of the

recommendation to drink warm water, postural drainage, and cough effectively to

address the problem of ineffective airway clearance. The intervention was

conducted in HIV/AIDS patient with tuberculosis in medical ward RSCM. The

result of interventions was reduced sputum buildup in the airway of the patient, so

the patient did not feel crowded as before and could breathe more easily. Nurses

are expected to conduct independent nursing interventions in the form of a

combination of the recommendation to drink warm water, postural drainage and

effective coughing to help improve patient's respiratory status. "