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"Pengosongan lambung merupakan masalah yang sering terjadi pada bayi prematur akibat imaturitas sistem gastrointestinal. Tujuan dari studi kasus ini adalah melakukan analisis penerapan Teori Konservasi Levine pada lima bayi prematur yang mengalami masalah pemenuhan kebutuhan nutrisi melalui pemberian posisi miring kanan, pronasi dan miring kiri bergantian selama tiga hari. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil penerapan intervensi pengaturan posisi pronasi dengan pendekatan Teori Konservasi Levine dapat menurunkan kejadian muntah, distensi abdomen dan pengeluaran residu lambung. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami masalah pengosongan lambung.

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Gastric emptying is a common problem in premature infants due to immaturity of the gastrointestinal system. The objective of this case study was to analyze the application of Levine's Conservation Theory to five premature infants who had problems in fulfilllment the nutritional needs through giving alternate position in the right lateral position, pronation and left lateral position for three days. Levine's Conservation Theory was used by applying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. The results showed that the implementation of pronation positioning using Levine's Conservation Theory can reduce the frequency of vomiting, abdominal distension, and gastric residual. Nurses can apply the intervention as a standard operating procedure in premature infants who experience gastric emptying."

"Intoleransi pemberian minum enteral merupakan masalah yang sering terjadi pada bayi berat lahir rendah. Tujuan dari studi kasus ini adalah melakukan analisis optimalisasi pemenuhan kebutuhan nutrisi enteral pada bayi berat lahir rendah melalui pengaturan posisi dengan pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil penerapan intervensi pengaturan posisi dengan pendekatan Teori Konservasi Levine dapat menurunkan kejadian desaturasi, distensi abdomen, dan frekuensi muntah. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi berat lahir rendah yang mengalami intoleransi pemberian minum enteral.

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Enteral feeding intolerance is a problem that often occurs in low birth weight infants. The objective of this case study was to analyze the optimization of the fulfillment of enteral nutrition in low birth weight infants through positioning with Levine`s Conservation Theory. Five cases were selected due to nursing problems in nutrition which is less than body requirements. Levine`s Conservation Theory was used by applying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. The results showed that implementation of positioning with Levine`s Conservation Theory can reduce the incidence of desaturation, abdominal distension, and frequency of vomiting. Nurses can make the intervention as a standard operating procedure in low birth weight infants who experience enteral feeding intolerance."

"Masalah kesehatan yang paling sering dialami oleh bayi prematur adalah masalah sistem pencernaan sehingga peningkatan berat badan sesuai target tidak dapat tercapai. Tujuan dari studi kasus ini adalah melakukan analisis peranan jenis nutrisi terhadap peningkatan berat badan bayi prematur dengan masalah defisit nutrisi melalui pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan defisit nutrisi. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil pemberian asuhan keperawatan menunjukkan bahwa Teori Konservasi Levine mempengaruhi peningakatan berat bayi prematur. Bayi prematur yang diberikan ASI terjadi peningatan berat badan 10-15 gram per hari, sedangkan bayi prematur yang diberikan susu formula terjadi peningatan berat badan 5-10 gram per hari. Perawat anak dapat mengoptimalkan pemberian ASI kepada bayi prematur untuk meningkatkan berat badan.

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The most common health problems experienced by premature infants is the problem of the digestive system so that weight gain on target cannot be achieved. The purpose of this case study is to analyze the role of nutrients to premature infant weight gain with nutritional deficits through the Levine Conservation Theory approach. Five selected cases indicate a nutritional deficit nursing problem. The Levine Conservation Theory Approach is conducted using energy conservation principles, structural integrity conservation, conservation of personal integrity, and conservation of social integrity. The results of nursing care show that Levine Conservation Theory influences the weighting of premature infants. Premature infants given breastfeeding weight 10 15 grams per day, whereas premature infants given formula milk occured weight gain 5 10 grams per day. Child nurses can optimize breastfeeding for premature babies to gain weight."

"Pengontrolan suhu tubuh sangat penting pada bayi prematur karena fluktuasi suhu meningkatkan ketidakseimbangan tingkat metabolisme bayi baru lahir. Pengaturan suhu tubuh yang buruk menjadi sasaran faktor lingkungan yang dapat menyebabkan kehilangan panas yang cepat sehingga rentan terhadap peningkatan risiko morbiditas dan mortalitas akibat hipotermia. Tujuan dari penelitian ini untuk mengetahui penerapan teori Konservasi  Levine dalam mengatasi masalah risiko termoregulasi tidak efektif pada bayi baru prematur di ruang Perinatologi. Model Konservasi Levine berfokus pada peningkatan adaptasi dan mempertahankan integritas diri (wholeness) dengan menggunakan prinsip konservasi. Masalah risiko termoregulasi tidak efektif merupakan salah satu gambaran terganggunya konservasi energi mencakup ketersediaan dan pengeluaran energi bayi baru lahir dan menyebabkan terjadinya peningkatan konsumsi oksigen dengan mempertahankan fungsi normal termogenesis

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Body temperature control is very important in preterm infant because temperature fluctuations improve the balance. Poor body temperature regulation is the target of environmental factors that can cause rapid heat loss, making them susceptible to an increased risk of morbidity and mortality due to hypothermia. The purpose of this study was to determine the application of Levine's Conservation theory in overcoming the problem of ineffective thermoregulation risk in premature newborns in the Perinatology room. Levine's Conservation Model focuses on increasing adaptation and maintaining wholeness using conservation principles. The problem of the risk  ineffective thermoregulation is one of the features of the disruption energy conservation and energy expenditure of baby and causes an increase in oxygen consumption by maintaining normal thermogenesis function.

 

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"Kesulitan menyusu merupakan masalah yang sering terjadi pada bayi prematur. Tujuan dari studi kasus ini adalah melakukan analisis optimalisasi pemenuhan kebutuhan nutrisi oral pada bayi prematur melalui edukasi perencanaan pulang pada orang tua dengan pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan defisit nutrisi dan menyusui tida efektif. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil pemberian asuhan keperawatan menunjukkan bahwa pengetahuan dan keterampilan ibu menyusui bayi meningkat sehingga pemenuhan kebutuhan nutrisi bayi terpenuhi dan meningkatkan berat badan bayi melalui edukasi perencanaan pulang. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami kesulitan menyusu.

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Having difficulty in breastfeeding is a common problem on premature infants. The purpose of this study is to analyze the optimization of the oral fulfillment of nutritional needs in premature infants through discharge planning education for the parents using Levine rsquo s Conservation Theory. Five chosen cases shows the occurrences of nutritional deficit nursing problems. Levine rsquo s Conversation Theory approach is done using energy conservation principle, structural integrity conservation, personal integrity conservation, and social integrity conservation.

The research result from the intervention of discharge planning education with Levine rsquo s Conservation Theory could improve the mothers rsquo knowledge and skills so that the fulfillment of nutritional needs of the infants fulfilled and also increasing the infants rsquo weight. Nurse could make the intervention as a standard procedure for premature infants who experienced breastfeeding difficulty."

"Bayi prematur dengan alat bantu nafas ventilasi mekanik memerlukan tindakan bersihan jalan napas. Penelitian menggunakan quasy experiment pada dua kelompok A dan B untuk mengetahui perubahan saturasi sebelum, selama dan setelah tindakan bersihan jalan napas. Kelompok A open suction dan B closed suction masing-masing 30 dan 10 bayi prematur. Analisis menggunakan uji statistik repeated Anova yang dilanjutkan dengan post hoc paired wise comparison. Tindakan bersihan jalan napas menggunakan open suction nilai p kurang 0,001 secara statistik terdapat perbedaan rerata yang bermakna terhadap perubahan saturasi, sedangkan closed suction nilai p kurang 0,001 terdapat perbedaan rerata yang bermakna terhadap perubahan saturasi. Penggunaan alat pengisap lendir closed suction menunjukan keadaan saturasi oksigen lebih stabil, sehingga lebih disarankan untuk tindakan bersihan jalan napas pada bayi prematur. Penggunaan closed suction akan efektif pada keadaan sekret yang encer.

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Premature infant with a mechanical ventilation need airway clearance. The study used quasy experiment in two groups A and B to provide information before and after airway clearance. Group A open suction and B closed suction each of 30 and 10 premature infants. The analysis used the statistical repeated Anova test followed by post hoc paired wise comparison. Airway clearance using an open suction with p.value 0.001, statistically, there is a mean actually oxygen saturation, while closed suction p value of less than 0.001 is the average actually oxygen saturation. The used closed suction shows a more stable oxygen saturation state, more for airway clearance in premature infants. The use of the closed suction will be effective in the state of dilute secretions."

"Bayi prematur berisiko tinggi mengalami sepsis neonatorum awitan lambat pada minggu-minggu pertama pasca kelahiran. Tujuan dari studi ini adalah mengaplikasikan Teori Konservasi Levine dalam menurunkan kejadian sepsis neonatorum awitan lambat pada bayi baru lahir prematur dengan pemberian oral care ASI. Proses asuhan keperawatan menggunakan pendekatan Teori Konservasi Levine berdasarkan empat konservasi yaitu konservasi energi, konservasi integritas struktural, konservasi integritas personal dan konservasi integritas sosial. Lima kasus terpilih menunjukkan masalah keperawatan gangguan pertukaran gas, pola nafas tidak efektif, defisit nutrisi, termoregulasi tidak efektif, risiko infeksi dan risiko gangguan perlekatan. Hasil implementasi pemberian oral care ASI dapat menurunkan kejadian sepsis awitan lambat, mempercepat bayi minum penuh dan mempercepat proses penyapihan alat bantu pernafasan. Intervensi ini dapat menjadi standar prosedur operasional bagi perawat dalam memberikan asuhan keperawatan pada bayi baru lahir.

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Premature infants are at high risk for late onset neonatal sepsis in the first few weeks after birth. The aim of this study was to apply the Levine rsquo s Conservation Theory to decrease the incidence of late onset neonatal sepsis in preterm newborns by oral care of ASI. The nursing care process uses the Levine rsquo s Conservation Theory approach based on four conservation, such as conservation of energy, conservation of structural integrity, conservation of personal integrity and conservation of social integrity. Five selected cases indicate nursing problems of gas exchange disorders, ineffective breathing patterns, nutritional deficits, ineffective thermoregulation, infection risk and risk of attachment disturbance. The results of ASI oral care implementation may decrease the incidence of late onset sepsis, accelerate full feed and accelerate the weaning process of respiratory aids. This intervention can be standard operating procedure for nurses in providing nursing care to newborns."

"Masalah pernapasan merupakan masalah krusial pada bayi prematur dan memerlukan penanganan segera. Pemberian asuhan keperawatan pada bayi prematur dengan gangguan oksigenasi dapat dioptimalkan melalui intervensi fasilitated tucking. Efek positif dari fasilitated tucking adalah mempromosikan bayi dalam kestabilan fungsi fisiologis, sehingga membantu proses oksigenasi bayi menjadi lebih baik. Penggunaan Teori Konservasi Levine dapat diaplikasikan dalam penerapan asuhan keperawatan yang menerapkan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Lima kasus terpilih menunjukkan masalah keperawatan pemenuhan gangguan oksigenasi. Praktik keperawatan berbasis pembuktian yang dilakukan melalui fasilitated tucking terbukti efektif terhadap laju perubahan yang konstan terhadap parameter fisiologis yaitu nadi dan saturasi oksigen. Intervensi fasilitated tucking berbasis teori Konservasi Levine dapat diterapkan dalam pemberian asuhan keperawatan yang berkualitas pada bayi prematur dengan gangguan pemenuhan oksigenasi.

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Respiratory distress is the crucial problem in preterm infants and appropriate management soon. Providing nursing care for preterm infants with impaired oxygenation fulfillment can be optimalized by applying fasilitated tucking intervention. Positive effect of fasilitated tucking can promoth physiological function stability, therefore it helps oxygenation process better. Levine's Conservation Theory was used by appliying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. Five cases were selected due to nursing problems in impaired oxygenation fulfillment. Evidenced done by doing fasilitated tucking effective for changes physiologic parameters constantly namely heart rate and oxygen saturation. Fasilitated tucking intervention with Levine's Conservation Theory can be applied for quality nursing intervention in preterm infants with impaired oxygenation fulfillment."

"[ABSTRAKLatar belakang: Prematuritas merupakan salah satu kelainan yang masih menjadimasalah global. Kejadian prematuritas tidak hanya terjadi di negara berkembangtetapi juga di negara maju. Beberapa kondisi ibu hamil dapat memicu keadaanhipoksia dalam rahim sehingga menyebabkan kelahiran prematur. Keadaanplasenta menggambarkan kesejahteraan janin intra uteri. Kondisi hipoksia selulermemicu ekspresi HIF-1α yang menjadi faktor transkripsi bagi CA9 sebagaipenanda hipoksia. Penelitian ini bertujuan menganalisis pengaruh hipoksiaterhadap plasenta prematur.Metode: Sampel menggunakan plasenta prematur yang hipoksia (H) dan nonhipoksia(N) sebagai kontrol. Parameter yang dinilai adalah struktur histologisplasenta (Hematoksilin-Eosin), regulator hipoksia HIF-1α (imunohistokimia), danpenanda hipoksia CA9 (ELISA).Hasil: Penilaian struktur histologis menunjukkan adanya perbedaan jumlahpembuluh darah fetus antara kedua kelompok secara bermakna, dimana padakelompok hipoksia jumlah pembuluh darah fetus lebih banyak dibandingkankelompok non-hipoksia. Distribusi intensitas ekspresi HIF-1α kedua kelompokjuga berbeda bermakna. Rerata kadar CA9 kedua kelompok tidak berbedabermakna, namun terdapat kecenderungan rerata kadar CA9 kelompok hipoksialebih tinggi 28% dibandingkan yang non-hipoksia.Kesimpulan: Pengaruh hipoksia terhadap plasenta prematur pada tingkatmolekuler berupa stabilitas protein HIF-1α yang menyebabkan peningkatanjumlah pembuluh darah fetus dan terjadi kecenderungan peningkatan sintesisprotein CA9.

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ABSTRACTBackground: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein.;Background: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein., Background: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein.]"

"ABSTRAKBayi yang lahir prematur berisiko mengalami permasalahan kesehatan, sehingga membutuhkan perawatan yang intens dari sejak di rumah sakit sampai ketika bayi sudah boleh dipulangkan ke rumah. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh edukasi dalam perencanaan pulang terhadap pengetahuan dan keterampilan ibu merawat bayi prematur. Penelitian ini merupakan studi quasi experiment dengan rancangan pre and post-test without control design. Sampel penelitian ini adalah 35 ibu yang melahirkan bayi prematur dan bayinya di rawat di ruang Perinatologi sebuah rumah sakit di Jakarta. Sampel diambil secara consecutive sampling. Intervensi penelitian adalah pemberian edukasi menggunakan media pembelajaran booklet dan audiovisual yang berisi tentang ASI, teknik menyusui, perawatan metode kanguru, cara pencegahan infeksi, dan tanda bahaya pada bayi. Hasil penelitian menunjukkan bahwa setelah diberikan edukasi selama perencanaan pulang, pengetahuan ibu merawat bayi prematur rata-rata mengalami kenaikan skor sebesar 29,52, aspek keterampilan menyusui skornya naik sebesar 33,29 dan keterampilan perawatan metode kanguru terdapat kenaikan skor sebesar 30,25. Hasil analisis menunjukkan bahwa ada perbedaaan yang signifikan antara rata-rata skor pengetahuan ibu merawat bayi prematur, skor keterampilan menyusui, dan skor keterampilan perawatan metode kanguru (PMK) sebelum dan setelah diberikan edukasi selama perencanaan pulang (p> 0,001). Pelaksanaan program edukasi selama perencanaan pulang yang dilakukan selama tiga hari dapat meningkatkan pengetahuan dan keterampilan ibu merawat bayi prematur. Edukasi dalam perencanaan pulang sebaiknya rutin diterapkan di rumah sakit sebagai intervensi keperawatan mandiri agar makin meningkatkan kualitas pelayanan keperawatan.ABSTRACTDischarge Planning Improving Knowledge and Skill Mother Who Birth Premature to Take Care Baby. Premature babies have a greater risk for health problems. Therefore, they need an intensive care since they are in the hospital until they go home. The purpose of this research was to find out the influence of education program for the knowledge and skills of the mothers on caring for their premature babies during discharge planning. This research was a quasi-experimental study with pre and post-test design without control groups. The sample of this research was 35 mothers who gave birth to premature babies and their babies receive care at a perinatology room in a hospital in Jakarta. The sample was taken using consecutive sampling. The intervention in this research was giving an education to the mothers of premature babies using booklet and audiovisual as the learning media containing information about breast milk, breastfeeding technique, kangaroo mother care, the method for infection prevention, and warning signs in babies. The research finding showed that after giving the education during the discharge planning, the knowledge of the mothers on caring for their babies, on average, had an increased score of 29.52, the score for the skills aspect increased by 33.29, and the score for kangaroo care mother skills increased by 30.25. The result of the analysis showed that there was a significant difference between the average score of the knowledge of the mothers on caring for premature babies, the score of breastfeeding skills, and the score for kangaroo care mother skills before and after the education program during the discharge planning (p> 0.001). The implementation of the education program during discharge planning that was done for three days could increase the knowledge and skills of the mothers on caring for their premature babies. The education during discharge planning should be conducted regularly at the hospital as an independent nursing intervention to improve the quality of nursing services."