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"Tujuan penelitian ini adalah mengetahui faktor-faktor yang berhubungan dengan pelaksanaan mobilisasi dini pasca bedah digestif. Jenis penelitian ini adalah kuantitatif, menggunakan metode deskriktif korelasi non eksperimental serta menggunakan desain cross sectional. Sampel berjumlah 59 responden pasca bedah digestif dengan pendekatan purposive sampling. Data dianalisis dengan Uji Chi-Square dan regresi logistik.Hasil penelitian menunjukan faktor yang berhubungan signifikan adalah stres pasca bedah digestif, nyeri, tingkat pendidikan, tingkat keparahan dan dukungan keluarga (p < 0,05). Faktor yang paling berhubungan adalah stres (OR 5,526). Disimpulkan bahwa stres merupakan variabel yang paling berhubungan dengan pelaksanaan mobilisasi pasca bedah digestif di RSUD Ulin Banjarmasin.

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The goal from this research is to know factors relating with and factors most relating with implementation of early mobilization after digestive surgery. Type of research is quantitative, using descriptive correlation method and is a non experimental research using cross sectional design. There are 59 samples of respondents. To know the most relating factor, data is being analyzed with Chi-square test method with purposive sampling.Result of this research is that factor that significantly relating is stress after digestive surgery, pain education level, degree of serious condition and family support (P < 0,05). the most relating factor is stress (OR 5.526). Summary of this research stress is the most relating variable, relating with implementation of mobilization after digestive surgery at RSUD Ulin, Banjarmasin."

"Dewasa mi gentamisin masih inerupakan obat yang pentinguntuk mengatasi infeksi berat kuman gram negatif; Karena batas keamanan gentamisin sempit maka hal ml merupkrn masalah dalam penggunaannya. Telah dilakukan pengukuran kadar gentamisin dalam serum dari 16 orang penderita pasca bedah di Bagian Kebidanan 115CM. Setiap penderita disuntikkan 80 mg gen,tamisin secara intramuskuler setiap 12 jam,selama 5 hari.pengambilam--.saxpel'.'dila kukan pada saat sebeluzn d.isuntikkan,3- jam,1 jam, 13- jam,3jam.,8 jam, 12 jam seteiah pemberian dan sesaat sebelum diberikan dosisPenentuan kadar gentamisin dalam serum dilakukan dengan cara difusi agar menurut Sabath 1930 (26) ,yang telahfikasi. Basil pengukuran yang diperoleb kemudian dicari kadar puncak dan dihiung waktu paruh gentamisin dalam serum, Dari penelitian ini didapatkan kadar puncak yang bervariasiantara 2,6 santpai 9,3 mcg/ml, ditemukan kadar subtera-peutik pada 2 penderita, waktu paruh rata-rata 2,4 jam dengan variasi antara 1 1,6 sampai Li.,6 jam. Dengan cara dan dosis yang lazim digunakan saat mi di. Bagian Kebidanan RSCM tidak ada kecenderungan terjadi toksisitas a k i b a t kumulasi, tetapi pada sebagian penderita tampaknya kadar terapeutik tidak tercapai.

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Gentaniicin is still an important drug to overcome serious

infections due to gram-negative pathogens.The narrow mar

gin of safety of this drug raises proble!n in its therapeutic

uses.

Serum levels of gentanilcin were determined from 16 post

operativepatients in the Gynaecological Department of RSCM

Each patient was given intramuscular injection of 80 mg of

gentainicin every 12 hours for five days.Blood sampling was

done at the moment before injection and half, one, one and a

half, three, eight, twelve hours after administration and at

the moment before the last dose was given.

Gentaniicin level in the serum was determined using modi

fied agar diffusion assay according to Sabath 1980 (26).

From the result of the measurement the peak level was detected

and calculation of half-life inerum was done. Peak level between 2,6 and 9,3 mc/m1 were obtained from this studies in which two-patients.--showed subtherapeutic

levels.The mean of half-life was 2,4 hours ; range between

1,6 and 4,6 hours. It is concluded that this dose regimen does not likely to cause accumulation of drug. It may otherwise gives subtherapeut.ic levels."

"ABSTRAKBladder training merupakan suatu tindakan melatih kandung kemih untuk dapat bekerjadengan normal. Penelitian ini bertujuan untuk mengetahui dampak bladder trainingmenggunakan metode konvensional dan menggunakan modifikasi cara Kozier, dilihatdari pola berkemih, keluhan berkemih dan lama waktu berkemih kembali sepertiSebelum Operasi. Penelitian menggunakan desain quasi-experimental dengan post-testonly with control group. Populasi pada penelitian ini adalah semua pasien pasca bedahortopedi yang terpasang kateter urin dan dirawat di ruang rawat bedah ortopedi Laki-laki dan perempuan Ima A RSCM Jakarta. Pengambilan sampel pada penelitian inimenggunakan metode probability sampling dengan Cara simple random sampling. Ujistatistik yang digunakan dalam penelitian ini menggunakan chi square untuk mengujiperbedaan pola berkemih dan keluhan berkemih antara kelompok treatment dan kontrol, Serta independent t test untuk mengetahui perbedaan lama waktu pada kelompok treatment dan kontrol. Hasil penelitian menunjukkan tidak ada perbedaan pola berkemih (p=1,00) dan keluhan berkemih (p=1,00) antara kelompok treatment dan kelompok kontrol, dan ada perbedaan yang signifikan antara Iama waktu kelompok treatment dan kelompok kontrol (p=0,05). Berdasarkan hal tersebut maka institusi pelayanan perlu membuat prosedur tetap untuk tindakan bladder training dan perawat perlu melakukan bladder training sebelum kateter urin pasien dilepaskan."

"[ABSTRAKLatar belakang: Luaran pasca-bedah jantung penting diketahui untuk menilai kinerja pelayanan bedah jantung anak, sehingga kualitas pelayanan dapat ditingkatkan.Tujuan: Mengetahui luaran jangka pendek (mortalitas, komplikasi pasca-bedah berat lain, dan komplikasi pasca-bedah yang berat) pada anak yang dilakukan bedah jantung. Selain itu, ingin mengetahui faktor risiko terjadinya komplikasi berat pasca-bedah jantung dan membuat sistem skor dari faktor-faktor risiko tersebut.Metode: Setiap anak dengan penyakit jantung yang dilakukan operasi jantung di RSUPN Dr Cipto Mangunkusumo Jakarta sejak April 2014 sampai Maret 2015 diikuti setiap hari sampai pasien pulang atau meninggal. Data demografis, mortalitas, morbiditas atau komplikasi pasca-bedah jantung, dan faktor risiko terjadinya morbiditas pasca-operasi yang berat diambil dari rekam medis. Pasien yang sudah pulang dari rumah sakit, dalam waktu 30 hari pasca-operasi dihubungi untuk mendapatkan data kondisi pasien dalam waktu tersebut (hidup atau meninggal).Hasil: Selama penelitian didapatkan 258 anak dilakukan bedah jantung. PJB terbanyak yang dilakukan bedah jantung adalah ventricle septal defect (28,7%) dan tetralogy of Fallot (24,4%). Komplikasi pasca-bedah jantung terjadi pada 217 (84,1%) anak dan komplikasi berat terjadi pada 49 anak (19%). Komplikasi pasca-bedah jantung terbanyak adalah hipokalsemia pada 163 (63,2%) anak, hiperglikemia 159 (61,6%), low cardiac output syndrome 52 (20,2%), aritmia 48 (18,6%), sepsis 45 (17,4%), dan efusi pleura 39 (15,1%). Komplikasi berat meliputi in-hospital mortality terjadi pada 33 (12,7%) anak dan mortalitas dalam waktu 30 hari pasca-bedah jantung terjadi pada 35 (13,6%) anak, henti jantung 13 (5%), operasi jantung ulang 10 (3,9%), dan gagal organ multipel 19 (7,4%). Faktor risiko yang berhubungan dengan meningkatnya komplikasi pasca-bedah jantung yang berat adalah peningkatan kadar laktat darah [OR 30,7 (IK 95% 8,1-117,6)], PJB sianotik [OR 4,4 (IK 95% 1,2-15,8), dan pemakaian inotropik yang tinggi [OR 7,8 (IK 95% 1,6-38,9)]. Skor faktor risiko ≥ 3 mampu memprediksi anak yang mengalami komplikasi berat pasca-bedah jantung dengan sensitivitas skor 93,9% dan spesifisitas skor 84,2%, dan area di bawah kurva receiver operating characteristic (ROC) adalah 0,94.Simpulan: Mortalitas di rumah sakit pasca-bedah jantung anak sebesar 12,7% dan mortalitas 30 hari pasca-bedah 13,6%. Komplikasi berat lain pasca-bedah 13,6%. Faktor risiko yang berhubungan dengan meningkatnya komplikasi pasca-bedah jantung yang berat adalah peningkatan kadar laktat darah, PJB sianotik, dan pemakaian inotropik tinggi pasca-bedah jantung. Skor faktor risiko ≥ 3 mampu memprediksi anak yang mengalami komplikasi berat pasca-bedah jantung dengan sensitivitas skor 93,9% dan spesifisitas skor 84,2%.

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ABSTRACTBackground: Outcome of children with cardiac surgery is important to evaluate the performance of cardiac surgery program. Identifying the risk factors for major adverse events after cardiac surgery is also important to improve patient care.Objective: To evaluate the incidence of short-term outcome in children after cardiac surgery, including mortality, complication or morbidity, major complications, and the risk factors associated with major adverse events (major complications) at the Dr Cipto Mangunkusumo Hospital, Indonesia.Methods: A prospective observational study was conducted from April 2014 until March 2015. All children conducted cardiac surgery, were monitored from the time the cardiac surgery performed until patients were discharged or deceased. During the follow up of all recruited patients, factors associated with the risk of developing major adverse events were identified.Results: A total of 258 patients were recruited during the study period. Of the total, 134 (51.9%) were female. The mean age of the patients was 53.3±3.8 months. Among the patients, 217 (84.1%) had complications. The most complications occurred after cardiac surgery were hypocalcaemia in 163 (63.2%), hyperglycemia in 159 (61.6%), low cardiac output syndrome in 52 (20.2%), arrhythmia in 48 (18.6%), sepsis in 45 (17.4%), and pleural effusion in 39 (15.1%) children. Further, 49 (19%) of recruited patients had major adverse events (major complications), including in-hospital mortality in 33 (12.7%) and 30-day mortality in 35 (13.6%), cardiac arrest in 13 (5%), the need for re-operation in 10 (3.9%), and multiple organ failure in 19 (7.4%) children. Factors associated with the occurrence of major complications were increase in blood lactate [OR 30.7 (95% CI 8.1-117.6)], cyanotic congenital heart disease [OR 4.4 (95% CI 1.2-15.8), and high inotropes on leaving operating room [OR 7.8 (95% CI 1.6-38.9)]. Risk factor score ≥3 could predict major complications after cardiac surgery with sensitivity of 93.9% and specificity of 84.2%, and area under receiver operating characteristic (ROC) curve was 0.94.Conclusion: In-hospital mortality after paediatric cardiac surgery at Dr Cipto Mangunkusumo hospital is 12,7% and 30-day mortality is 13,6%. Increase in blood lactate, cyanotic congenital heart disease, and high inotropes on leaving operating room are associated with mortality and other major complications in children following cardiac surgery. Risk score ≥ 3 can predict the development of major complication in children after cardiac surgery with sensitivity 93,9% and specificity 84,2%.;Background: Outcome of children with cardiac surgery is important to evaluate the performance of cardiac surgery program. Identifying the risk factors for major adverse events after cardiac surgery is also important to improve patient care.Objective: To evaluate the incidence of short-term outcome in children after cardiac surgery, including mortality, complication or morbidity, major complications, and the risk factors associated with major adverse events (major complications) at the Dr Cipto Mangunkusumo Hospital, Indonesia.Methods: A prospective observational study was conducted from April 2014 until March 2015. All children conducted cardiac surgery, were monitored from the time the cardiac surgery performed until patients were discharged or deceased. During the follow up of all recruited patients, factors associated with the risk of developing major adverse events were identified.Results: A total of 258 patients were recruited during the study period. Of the total, 134 (51.9%) were female. The mean age of the patients was 53.3±3.8 months. Among the patients, 217 (84.1%) had complications. The most complications occurred after cardiac surgery were hypocalcaemia in 163 (63.2%), hyperglycemia in 159 (61.6%), low cardiac output syndrome in 52 (20.2%), arrhythmia in 48 (18.6%), sepsis in 45 (17.4%), and pleural effusion in 39 (15.1%) children. Further, 49 (19%) of recruited patients had major adverse events (major complications), including in-hospital mortality in 33 (12.7%) and 30-day mortality in 35 (13.6%), cardiac arrest in 13 (5%), the need for re-operation in 10 (3.9%), and multiple organ failure in 19 (7.4%) children. Factors associated with the occurrence of major complications were increase in blood lactate [OR 30.7 (95% CI 8.1-117.6)], cyanotic congenital heart disease [OR 4.4 (95% CI 1.2-15.8), and high inotropes on leaving operating room [OR 7.8 (95% CI 1.6-38.9)]. Risk factor score ≥3 could predict major complications after cardiac surgery with sensitivity of 93.9% and specificity of 84.2%, and area under receiver operating characteristic (ROC) curve was 0.94.Conclusion: In-hospital mortality after paediatric cardiac surgery at Dr Cipto Mangunkusumo hospital is 12,7% and 30-day mortality is 13,6%. Increase in blood lactate, cyanotic congenital heart disease, and high inotropes on leaving operating room are associated with mortality and other major complications in children following cardiac surgery. Risk score ≥ 3 can predict the development of major complication in children after cardiac surgery with sensitivity 93,9% and specificity 84,2%., Background: Outcome of children with cardiac surgery is important to evaluate the performance of cardiac surgery program. Identifying the risk factors for major adverse events after cardiac surgery is also important to improve patient care.Objective: To evaluate the incidence of short-term outcome in children after cardiac surgery, including mortality, complication or morbidity, major complications, and the risk factors associated with major adverse events (major complications) at the Dr Cipto Mangunkusumo Hospital, Indonesia.Methods: A prospective observational study was conducted from April 2014 until March 2015. All children conducted cardiac surgery, were monitored from the time the cardiac surgery performed until patients were discharged or deceased. During the follow up of all recruited patients, factors associated with the risk of developing major adverse events were identified.Results: A total of 258 patients were recruited during the study period. Of the total, 134 (51.9%) were female. The mean age of the patients was 53.3±3.8 months. Among the patients, 217 (84.1%) had complications. The most complications occurred after cardiac surgery were hypocalcaemia in 163 (63.2%), hyperglycemia in 159 (61.6%), low cardiac output syndrome in 52 (20.2%), arrhythmia in 48 (18.6%), sepsis in 45 (17.4%), and pleural effusion in 39 (15.1%) children. Further, 49 (19%) of recruited patients had major adverse events (major complications), including in-hospital mortality in 33 (12.7%) and 30-day mortality in 35 (13.6%), cardiac arrest in 13 (5%), the need for re-operation in 10 (3.9%), and multiple organ failure in 19 (7.4%) children. Factors associated with the occurrence of major complications were increase in blood lactate [OR 30.7 (95% CI 8.1-117.6)], cyanotic congenital heart disease [OR 4.4 (95% CI 1.2-15.8), and high inotropes on leaving operating room [OR 7.8 (95% CI 1.6-38.9)]. Risk factor score ≥3 could predict major complications after cardiac surgery with sensitivity of 93.9% and specificity of 84.2%, and area under receiver operating characteristic (ROC) curve was 0.94.Conclusion: In-hospital mortality after paediatric cardiac surgery at Dr Cipto Mangunkusumo hospital is 12,7% and 30-day mortality is 13,6%. Increase in blood lactate, cyanotic congenital heart disease, and high inotropes on leaving operating room are associated with mortality and other major complications in children following cardiac surgery. Risk score ≥ 3 can predict the development of major complication in children after cardiac surgery with sensitivity 93,9% and specificity 84,2%.]"

"Penelitian ini bertujuan untuk mendapatkan gambaran tentang pengaruh kombinasi teknik relaksasi sistematik dan terapi analgesik terhadap rasa nyeri pasien pasca bedah abdomen di RS Haji Jakarta. Disain penelitian ini menggunakan metode quasi eksperimental dengan pendekatan pretest posttest group design. Sampel berjumlah 46 orang yang diambil secara purposive sampling. Kelompok intervensi menerima terapi analgesik dan teknik relaksasi sistematik dan kelompok kontrol menerima analgesik standar. Peneliti mengajarkan teknik relaksasi sistematik lewat walkmann kepada pasien kelompok intervensi dan pasien mempraktikkan teknik tersebut pada periode preoperasi. Setelah pembedahan pasien mendengarkan instruksi relaksasi melalui walkmann selama 15 menit, dua kali sehari selama dua hari. Pasien diinstruksikan untuk tidur telentang dalam posisi yang nyaman di tempat tidur, menutup kedua mata dan melemaskan bagian-bagian tubuh yang dimulai dari kaki, tungkai, paha dan terus bergerak ke bagian tubuh bagian atas hingga kepala. Pasien diajarkan untuk megendalikan nafas dan bersikap pasif agar merasakan relaksasi pada setiap langkah relaksasi. Pada akhir sesi, pasien diminta membuka mata dan tetap berbaring selama beberapa menit. Rasa nyeri diukur dengan menggunakan visual analogue scale (VAS). Evaluasi penelitian dilakukan pada hari kedua setelah intervensi. Hasil penelitian menunjukkan rata-rata rasa nyeri sebelum intervensi antara kelompok intervensi dan kelompok kontrol adalah berbeda tapi tidak bermakna (p=0,40), namun setelah intervensi terlihat berbeda secara bermakna antara kelompok intervensi dan kelompok kontrol (p=0,004). Umur tidak mempengaruhi rasa nyeri pada pasien pasca bedah abdomen setelah mendapatkan intervensi analgesik ditambah teknik relaksasi sistematik (p=0,97), jenis kelamin berpengaruh terhadap rasa nyeri (p=0,008) dan jenis kelamin laki-laki merasakan nyeri lebih sedikit dibandingkan perempuan dan letak insisi mempengaruhi nyeri pasca bedah abdomen (p=0.09). Rekomendasi hasil penelitian adalah perawat sebaiknya memberikan edukasi tentang cara mengatasi nyeri pasca pembedahan abdomen pada periode pre operasi agar pasien dapat melakukannya secara mandiri.

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The aim of this study was to describe the effects of systematic relaxation technique combined to analgesic therapy on postoperative pain in post abdominal surgery patient in Haji Hospital. The design was an quasi-experimental with pretest-posttest group design. The subjects were forty six (n=46) patients undergoing abdominal surgery. The sampling methode was purposive sampling, a non probability sampling. The intervention group received analgesic and relaxation systematic technique. The control group was given analgesic routine. In the preoperative surgical ward, the researcher taught systematic relaxation to the subjects in intervention group with an introductory walkmann. Subjects practiced using the technique in the preoperative periode.

After surgery, subjects listened to relaxation technique on the walkmann during 15-minutes, two times a day for 2 days postoperatively. Patients were directed by walkmann instruction to lie down in comfortable position in bed, close their eyes, and relax each part of the body, starting with the feet, lower legs, hips and moving up to the head. Patient taught to control their breathing and to maintain a passive attitude and allow relaxation occuring at its own pace. At the end of the session, subjects were asked to open their eyes and lie quitely for a few minutes. Sensation of pain was assessed before and after the test on visual analogue scale (VAS).

No difference was found for pain before treatment using between the intervention group and control group (p=0,40). Changes in pain sensation after the test indicated significantly greater relief in the intervention group compared to the control group. Posttest pain scores were significantly lower in the treatment groups than in the control group (p=0,004). Age did not affect pain sensation in post abdominal surgery patient after given anelgesic intervention combined with systematic relaxation technique (p=0,97). Sex affected pain sensation (p=0,008) and men may be less postoperative pain compared to women, and incisions site did not affected post abdominal surgery pain (p=0,09).

It's recommended to give education technique to alleviate pain in preoperative periode thus the patient can perform it independently after abdominal surgery."

"Latar belakang. Bedah kanker kolorektal (KKR) adalah kasus terbany1k di Divisi Bedah Digestif RSUPNCM, di mana 46% di antaranya adalah karena kanker rektum I (K.R). Trauma pembedahan menimbulkan inflamasi, respon fase akut (RFA), dan stres metabolik. C- reactive protein (CRP) adalah protein fuse akut (PFA) dengan peningkatan tertinggi di antara PFA lainnya dan telah digunakan secara luas sebagai penanda inflamasi. Stres metabolik menyebabkan perubahan metabolisme zat gizi yang ditandai dengan peningkatan kadar glukosa darah sewaktu (GDS) plasma. Secara tidak langsung, pemberian terapi gizi adekuat dapat menekan laju inflamasi dan mempercepat proses penyembuhan pasca bedah. Tujuan. Untuk mengetahui peran terapi gizi adekuat selama tujuh hari terhadap perubahan kadar CRP serum dan GDS plasma pasien pasca bedah KR pada hari ke satu dan ke tujuh pengamatan. Metode. Penelitian ini adalah studi eksperimental dengan desain paralel, acak, dan tidak tersamar. Penelitian dilaksanakan di ruang rawat bedah kelas Ill RSUPNCM, pengumpulan data dilaksanakan pada bulan April- Agustus 2009. .9erdasarkan kriteria penelitian didapatkan 24 subyek yang dibagi menjadi dua, kelompok perlakuan (P) dan kontrol (K). Pengumpulan data dilakukan dengan metode wawancara, pengukuran antropometri, dan pemeriksaan laboratorium. Hasil. Karakteristik awal kedua kelompok adalah sebanding pada HI. Rerata asupan energi kelompok P adalah 1 211 ,23 ± 161 ,95 kkallh ari (82,86 ± 9,91 % kebutuhan energi total atau KET), adekuat, dan lebih tinggi bermakna (p< 0,001) dibandingkan kelompok K yaitu 831,93 ± 129,58 kkal/hari (55,75 ± 9,48% KET). Rerata asupan protein subyek tidak adekuat meskipun asupan protein kelompok P lebih tinggi bennakna (p< 0,001). Kelompok P mengalami peningkatan berat badan (BB) 0,71 ± 0,79 kg sedangkan kelompok K mengalami penurunan BB 0,85 ± 1,06 kg. Penurunan kadar CRP serum kelompok P (7,13 ± 1,43 mg/L) berbeda bermakna (p=0,005) dengan kelompok K (5,20 ± 1,58 mg/L). Peningkatan kadar GDS plasma kelompok P (26,00 ± 29,67 mg/dL) cenderung lebih tinggi dari kelompok K (10,00 ± 24,40 mg/dL), sejalan dengan peningkatan asupan energi yang lebih tinggi. Kadar CRP serum memiliki korelasi positif derajat rendah (r-0,266) dan tidak bennakna (p=0,358) dengan kadar ODS plasma. Kesimpulan. Pemberian terapi gizi adekuat selama tujuh hari berperan untuk mempercepat penurunan kadar CRP serum pasien pasca bedah KR. "

"[ABSTRAKNyeri pembedahan menimbulkan cemas, takut dan perubahan perilaku maladaptif anak. Perlu asuhan keperawatan berkualitas dalam mengatasi nyeri anak. Karya ilmiah akhir bertujuan menggambarkan aplikasi comfort theory Kolcaba dalam memberikan asuhan keperawatan pasien pasca bedah yang mengalami nyeri. Intervensi ditentukan berdasarkan comfort theory yaitu mengukur skala nyeri, memberikan posisi nyaman, memberikan madu, mengajarkan keluarga manajemen nyeri serta memberikan reinforcement positif keterlibatan keluarga dalam perawatan. Evaluasi hasil menunjukkan aplikasi comfort theory dalam keperawatan perlu ditunjang faktor-faktor lain seperti kondisi pasien, lingkungan dan tim pelayanan kesehatan dalam mencegah dan mengatasi nyeri. Rekomendasi karya ilmiah ini adalah teori keperawatan sebaiknya diaplikasikan dalam asuhan keperawatan.

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ABSTRACTSurgical pain causes anxiety, fear and change in children's behaviours. A good quality of nursing care is needed to overcome children's pain. This scientific paper aimed to illustrate the application of comfort theory Kolcaba in providing nursing care to patients suffered post-surgical pain. Intervention was determined based on comfort theory which included: measure pain scale, provide a comfortable position, offer honey, teach families management of pain, and give positive reinforcement on family involvement during the care. Result's evaluation indicated thet comfort application in nursing theory need to be supported by other factors such as the condition of the patient, the environment and health care team to prevent and overcome pain. This scientific paper recommends the application of nursing theory in providing nursing care., Surgical pain causes anxiety, fear and change in children's behaviours. A good quality of nursing care is needed to overcome children's pain. This scientific paper aimed to illustrate the application of comfort theory Kolcaba in providing nursing care to patients suffered post-surgical pain. Intervention was determined based on comfort theory which included: measure pain scale, provide a comfortable position, offer honey, teach families management of pain, and give positive reinforcement on family involvement during the care. Result's evaluation indicated thet comfort application in nursing theory need to be supported by other factors such as the condition of the patient, the environment and health care team to prevent and overcome pain. This scientific paper recommends the application of nursing theory in providing nursing care.]"

"Karya ilmiah akhir ini merupakan kumpulan dari laporan praktik residensi keperawatan medikal bedah yang terdiri dari laporan kasus utama kanker nasofaring dan 30 kasus resume, penerapan Evidence Based Nursing EBN terapi musik dan progressive muscle relaxation, dan laporan inovasi pengkajian luka kanker yang dimodifikasi dari Malignat Wound Assassement Tool MWAT . Praktik ini menerapkan asuhan keperawatan pada pasien kanker dengan menggunakan pendekatan teori Roy Adaptation Model. Masalah keperawatan terbanyak akibat perilaku maladaptif adalah nyeri, resiko infeksi, kecemasan, kebutuhan nutrisi kurang dari kebutuhan tubuh dan ketidakefektifan pola napas. Terapi musik dan progressive muscle relaxation secara signifikan menurunkan depresi dan kecemasan pada pasien kanker payudara setelah menjalani mastektomi. Pengkajian luka kanker modifikasi MWAT mengkaji masalah fisik, psikis, sosial pasien dengan luka kanker. Perawat diharapkan mampu menerapkan teori keperawatan, melaksanakan tindakan berdasarkan EBN, dan melakukan inovasi untuk meningkatkan asuhan keperawatan yang berkualitas.

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The scientific report was a compilation of the report medical surgical nursing residency practice which consists of the main report of nasopharyngeal cancer cases and 30 summaries, the application of music therapy and progressive muscle relaxation on evidence based nursing EBN , and innovation reports of wound cancer assessment tool, that modified from Malignant Wound Assassement Tool MWAT. This practice applying nursing care in cancer patients with approach Roy rsquo s Adaptation Model. Most nursing problems due to maladaptive behavior was pain, risk for infection, anxiety, imbalanced nutrition less than body requirements, and breathing pattern ineffective. The music therapy and progressive muscle relaxation may reduces depression and anxiety in female breast cancer patients after radical mastectomy. MWAT modifications assessment tool, assess physic psychologic social problems in patients with wound cancer. Nurses was expected to apply nursing theory, intervention based on EBN, and innovations to improve the quality of nursing care."

"Penyakit kongenital atau kelainan bawaan pada anak dan neonatus merupakan urutan kelima penyebab kematian di dunia pada anak dan neonatus. Pada tahun 2015 ada sekitar 303 ribu bayi baru lahir meninggal dunia dalam waktu 4 minggu setelah kelahiran setiap tahun, di seluruh dunia karena kelainan bawaan. Polusi udara serta ketidakadekuatan nutrisi pada masa kehamilan menjadi salah satu penyebab terjadinya kelainan bawaan. Tatalaksana pada kelainan bawaan salah satunya adalah dengan prosedur pembedahan. Jenis pembedahan yang sering dilakukan pada anak adalah pembedahan gastrointestinal. Pembedahan memiliki banyak risiko, diantaranya mual muntah pasca bedah. Mual muntah pasca bedah pada anak merupakan masalah yang dapat menimbulkan kecemasan pada orang tua serta dapat mengakibatkan dehidrasi dan lamanya masa pemulihan. Terapi musik merupakan salah satu tindakan yang dapat dilakukan untuk mengatasi mual muntah pasca bedah pada anak. Terapi musik efektif dapat menurunkan mual muntah dan kebutuhsn terhadap antiemetik pada anak pasca bedah. Hasil pemberian terapi musik pada pasien anak pasca bedah berupa penurunan terhadap keluhan mual muntah dan peningkatan perasaan rileks pada anak. Oleh karena itu penanganan mual muntah pasca bedah pada anak perlu disertai dengan pemberian terapi musik sebagai terapi non farmakologis sebagai teknik distraksi dari ketidaknyaman fisik akibat mual muntah.

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Congenital disease or congenital abnormalities in children and neonates is the fifth cause of death in the world in children and neonates. In 2015 there were around 303,000 newborns died within 4 weeks of birth each year, worldwide due to congenital abnormalities. Air pollution and nutrient insufficiency during pregnancy are among the causes of congenital abnormalities. Management of congenital abnormalities is one of them is a surgical procedure. The type of surgery that is often done in children is gastrointestinal surgery. Surgery has many risks, including postoperative nausea and vomiting. Postoperative vomiting in children is a problem that can cause anxiety in the elderly and can lead to dehydration and the length of the recovery period. Music therapy is one of the actions that can be done to overcome postoperative nausea and vomiting in children. Effective music therapy can reduce vomiting nausea and the need for antiementics in postoperative children. The results of the provision of music therapy in postoperative pediatric patients in the form of a decrease in complaints of nausea vomiting and increased feelings of relaxation in children. Therefore handling postoperative vomiting in children needs to be accompanied by the provision of music therapy as non-pharmacological therapy as a distraction technique from physical discomfort due to nausea and vomiting."