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"[ABSTRAKKarsinoma buli merupakan kasus keganasan terbanyak pada sistem perkemihan. Lebih dari 50 persen kasus keganasan pada sistem perkemihan merupakan kasus karsinoma buli. Karsinoma buli pada tahap awal biasanya ditangani dengan tindakan operasi Transurethral Resection Bladder (TURB). Intervensi edukasi merupakan hal yang penting dilakukan sebelum dan sesudah operasi pembedahan dilakukan. Edukasi pada klien bertujuan untuk mengurangi ansietas klien, sebagai promosi kesehatan, peningkatan pemberdayaan klien dan keluarga dalam asuhan keperawatan. Intervensi edukasi pada klien meningkatkan kesuksesan dalam mencapat tujuan-tujuan dalam asuhan keperawatan, maka dari itu edukasi perlu dipersiapkan perawat karena merupakan intervensi vital dalam setiap asuhan keperawatan.

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ABSTRACTBladder carcinoma is the most prevalent malignancies cases of urinary system. More than 50 percent cases of malignancies of the urinary system are bladder carcinoma cases. Bladder carcinoma at an early stage is usually treated with TURB surgery. Education is an important thing to do to Client. Education on the client aims to reduce client anxiety, as health promotion, and increase clients and families empowerment in nursing care. Educational intervention on clients will improve the success rate of nursing care, and because of that, before doing education to client, nurses must be prepare everything.;Bladder carcinoma is the most prevalent malignancies cases of urinary system More than 50 percent cases of malignancies of the urinary system are bladder carcinoma cases Bladder carcinoma at an early stage is usually treated with TURB surgery Education is an important thing to do to Client Education on the client aims to reduce client anxiety as health promotion and increase clients and families empowerment in nursing care Educational intervention on clients will improve the success rate of nursing care and because of that before doing education to client nurses must be prepare everything , Bladder carcinoma is the most prevalent malignancies cases of urinary system More than 50 percent cases of malignancies of the urinary system are bladder carcinoma cases Bladder carcinoma at an early stage is usually treated with TURB surgery Education is an important thing to do to Client Education on the client aims to reduce client anxiety as health promotion and increase clients and families empowerment in nursing care Educational intervention on clients will improve the success rate of nursing care and because of that before doing education to client nurses must be prepare everything ]"

"ABSTRAKLatar belakang: Sistektomi radikal dengan ileal conduit yang merupakan tata laksana utama karsinoma buli adalah prosedur pembedahan kompleks yang seringkali membutuhkan rawat inap yang lama dan menyebabkan berbagai komplikasi. Malnutrisi praoperatif merupakan kontributor penting terhadap tingginya morbiditas dan mortalitas pada sistektomi radikal. Dukungan nutrisi perioperatif yang adekuat bertujuan untuk menurunkan stres akibat pembedahan sehingga dapat mencegah komplikasi, menunjang outcome yang baik, dan memperpendek masa rawat inap pascaoperasi.Metode: Laporan serial kasus ini menyajikan empat kasus karsinoma buli, dengandua kasus termasuk kaheksia kanker dan dua kasus termasuk pra-kaheksia. Keempat pasien dilakukan sistektomi radikal dengan ileal conduit dan diberikan dukungan nutrisi perioperatif yang mencakup carbohydrate loading dan nutrisi enteral dini pascaoperasi serta pemberian nutrisi secara bertahap. Dilakukan pemantauan yang meliputi keluhan klinis, pemeriksaan fisik, antropometri, hasil laboratorium, dan analisis asupan.Hasil: Tiga pasien mengalami hiperglikemia yang berlangsung singkat tanpa membutuhkan terapi insulin. Dua pasien mengalami ileus paralitik pascaoperasi, namun dapat teratasi secara konservatif dalam waktu cepat. Dua pasien mencapai 70-80 target kalori dalam 5 hari pascaoperasi, sedangkan pasien yang mengalami ileus paralitik mencapai target kalori 60-70 dalam waktu 9 hari pascaoperasi. Masa rawat inap pascaoperasi bervariasi mulai dari 7 hingga 10 hari.Kesimpulan: Dukungan nutrisi perioperatif pada keempat pasien menunjang dalam mengontrol stres pembedahan yang terlihat dari hiperglikemia yang hanya berlangsung singkat, mencegah komplikasi, serta memperpendek masa rawat inap.

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ABSTRACT

Background Radical cystectomy and ileal conduit, a mainstay treatment of bladder carcinoma, is a complex surgery which not rarely requires a long hospital stay and has many complications. Preoperative malnutrition is on of important contributor to high morbidity and mortality in radical cystectomy. Adequate perioperative nutritional support aims to alleviate surgical stress, thus prevent complications, support good outcome, and shorten length of hospital stay after surgery.

Method This case series presenting 4 cases of bladder carcinoma, consists of 2 cases of cancer cachexia and 2 cases of pre cachexia. All of the patients had undergone radical cystectomy and ileal conduit, and was supported by perioperative nutrition including carbohydrate loading and postoperative early enteral nutrition. The monitoring included clinical complaints, physical examination, anthropometry, laboratory results, and intake analysis.

Result Three patients had hyperglycemia lasted only in short period and no insulin treatment needed. Two patients experienced postoperative paralytic ileus and was resolved only with conservative treatment. Two patients achieved 70 ndash 80 calorie target on 5 days after surgery, while the others who experienced paralytic ileus achieved 60 ndash 70 calorie target in 9 days postoperative. Length of stay in the hospital after surgery was varied between 7 to 10 days.

Conclusion Perioperative nutritional support on the above patients had contribution in controlling surgical stress, seen on the short period hyperglycemia, preventing complications, and shortening the hospital stays."