MANAJEMEN KEPERAWATAN PADA PASIEN STROKE HEMORAGIK DI RUANG SARAF: SUATU STUDI KASUS

Elvara Dianni Yusnita, Devi Darliana, Riski Amalia

Abstract


Stroke merupakan penyebab mortalitas nomor dua di dunia. Stroke hemoragik menyebabkan pecahnya pembuluh darah sehingga pasien mengalami penurunan kesadaran secara tiba-tiba, disfungsi neurologis dan berbagai komplikasi lain yang dapat memperparah keadaan pasien. Studi kasus ini bertujuan untuk menjelaskan asuhan keperawatan pada pasien yang mengalami stroke hemoragik di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh. Asuhan keperawatan dilakukan selama 5 hari. Hasil pengkajian didapatkan pasien mengalami penurunan kesadaran, hemiparese dextra, batuk berdahak dan anemia. Masalah keperawatan yang muncul antara lain penurunan kapasitas intrakranial, bersihan jalan nafas tidak efektif, perfusi perifer tidak efektif, gangguan mobilitas fisik, risiko gangguan integritas kulit dan risiko defisit nutrisi. Tindakan keperawatan dilakukan sesuai dengan Standar Intervensi Keperawatan Indonesia dan inovasi intervensi dari jurnal penelitian berupa elevasi kepala/head up 30 derajat, terapi murotal Al-Qur’an, pemeriksaan sirkulasi perifer, terapi Passive Range of Motion, pemberian diet melalui NGT, pengkajian resiko dekubitus dan perawatan kulit, dan melakukan pengaturan posisi. Hasil dari asuhan keperawatan yaitu kondisi pasien stabil, bersihan jalan napas tidak efektif teratasi dan gangguan integritas kulit tidak terjadi. Asuhan keperawatan secara komprehensif masih perlu dilanjutkan untuk mengatasi dan mencegah masalah lainnya. 

Full Text:

PDF

References


Amr, A., Yousef, A., Amirah, M., & Alkurdi, M. (2017). A pre-post study evaluating the effectiveness of a new initiative, the “pressure bundle,” compared with standard care in reducing the incidence and prevalence of sacral pressure ulcers in critically ill patients in an intensive care unit in Riyadh, Saudi. Saudi Critical Care Journal, 1(3), 75. https://doi.org/10.4103/sccj.sccj_29_17

An, S. J., Kim, T. J., & Yoon, B. W. (2017). Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: An update. Journal of Stroke, 19(1), 3–10. https://doi.org/10.5853/jos.2016.00864

Batchelor, E. K., Kapitsinou, P., Pergola, P. E., Kovesdy, C. P., & Jalal, D. I. (2020). Iron deficiency in chronic kidney disease: Updates on pathophysiology, diagnosis, and treatment. Journal of the American Society of Nephrology, 31(3), 456–468. https://doi.org/10.1681/ASN.2019020213

Boullata, J. I., Carrera, A. L., Harvey, L., Escuro, A. A., Hudson, L., Mays, A., McGinnis, C., Wessel, J. J., Bajpai, S., Beebe, M. L., Kinn, T. J., Klang, M. G., Lord, L., Martin, K., Pompeii-Wolfe, C., Sullivan, J., Wood, A., Malone, A., & Guenter, P. (2017). Safe practices for enteral nutrition therapy. Journal of Parenteral and Enteral Nutrition, 41(1), 15–103. https://doi.org/10.1177/0148607116673053

Chen, H. J., Chen, J. L., Chen, C. Y., Lee, M., Chang, W. H., & Huang, T. T. (2019). Effect of an oral health programme on oral health, oral intake, and nutrition in patients with stroke and dysphagia in taiwan: A randomised controlled trial. International Journal of Environmental Research and Public Health, 16(12), 1–12. https://doi.org/10.3390/ijerph16122228

Christensen, H., Glipstrup, E., Høst, N., Nørbæk, J., & Zielke, S. (2014). Complications after stroke. In Oxford Textbook of Stroke and Cerebrovascular Disease. https://doi.org/10.1093/med/9780199641208.003.0018

Dodds, M., Roland, S., Edgar, M., & Thornhill, M. (2015). Saliva A review of its role in maintaining oral health and preventing dental disease. BDJ Team, 2(1–8), 1–3. https://doi.org/10.1038/bdjteam.2015.123

Eka, R., Ainy, N., & Nurlaily, A. P. (2021). Asuhan keperawatan pasien stroke hemoragik dalam pemenuhan kebutuhan fisiologis : Oksigenasi. Journal of Advanced Nursing and Health Sciences, 2(1), 21–25.

Frazier, S. K., Higgins, J., Bugajski, A., & Jones, A. R. (2017). Adverse reactions to transfusion of blood products and best practices for prevention. Critical Care Nursing Clinics of North America, 29, 271–290. https://doi.org/10.1016/j.cnc.2017.04.002

Hammad, H., Rijani, M. I., & Marwansyah, M. (2020). Perubahan kadar saturasi oksigen pada pasien dewasa yang dilakukan tindakan suction endotrakeal tube di ruang ICU RSUD Ulin Banjarmasin. Bima Nursing Journal, 1(1), 82. https://doi.org/10.32807/bnj.v1i2.466

Hanna, R. M., Streja, E., & Kalantar-Zadeh, K. (2021). Burden of anemia in chronic kidney disease: Beyond erythropoietin. Advances in Therapy, 38(1), 52–75. https://doi.org/10.1007/s12325-020-01524-6

Hosseini, Z.-S., Peyrovi, H., & Gohari, M. (2019). The effect of early passive range of motion exercise on motor function of people with stroke: A randomized controlled trial. Journal of Caring Sciences, 8(1), 39–44. https://doi.org/10.15171/jcs.2019.006

Lindsay, M. P., Author, C., Norrving, B., Sacco, R. L., Brainin, M., Hacke, W., Martins, S., Pandian, J., & Feigin, V. (2019). Global stroke fact sheet 2019. In World Stroke Organization (WSO): Global Stroke Fact Sheet 2019.

Murphy, S. J., & Werring, D. J. (2020). Stroke: causes and clinical features. Medicine (United Kingdom), 48(9), 561–566. https://doi.org/10.1016/j.mpmed.2020.06.002

Ojaghihaghighi, S., Vahdati, S. S., Mikaeilpour, A., & Ramouz, A. (2017). Comparison of neurological clinical manifestation in patients with hemorrhagic and ischemic stroke. World Journal of Emergency Medicine, 8(1), 34. https://doi.org/10.5847/wjem.j.1920-8642.2017.01.006

Pertami, S. B., Sulastyawati, S., & Anami, P. (2017). Effect of 30° head-up position on intracranial pressure change in patients with head injury in surgical ward of General Hospital of dr. R. Soedarsono Pasuruan. Public Health of Indonesia, 3(3), 89–95. https://doi.org/10.36685/phi.v3i3.131

Pokorná, A., Klugar, M., Kelnarová, Z., & Klugarová, J. (2019). Effectiveness and safety of patientcentred care compared to usual care for patients with pressure ulcers in inpatient facilities: A rapid review. Journal of the European Wound Management Association, 20(1), 61–69. https://doi.org/10.35279/jewma201905.07

Primalia, P., & Hudiyawati, D. (2020). Pencegahan dan perawatan luka tekan pada pasien stroke di ruang ICU. Berita Ilmu Keperawatan, 13(2), 110–116.

Richardson, A., Peart, J., Wright, S. E., & Mccullagh, I. J. (2017). Reducing the incidence of pressure ulcers in critical care units: A 4-year quality improvement. International Journal for Quality in Health Care, 29(3), 433–439. https://doi.org/10.1093/intqhc/mzx040

Riskesdas. (2018). Laporan Nasional RISKESDAS 2018. In Badan Penelitian dan Pengembangan Kesehatan. http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf

Salvadori, E., Papi, G., Insalata, G., Rinnoci, V., Donnini, I., Martini, M., Falsini, C., Hakiki, B., Romoli, A., Barbato, C., Polcaro, P., Casamorata, F., Macchi, C., Cecchi, F., & Poggesi, A. (2021). Comparison between ischemic and hemorrhagic strokes in functional outcome at discharge from an intensive rehabilitation hospital. Diagnostics, 11(38), 11–12. https://doi.org/https://doi.org/10.3390/diagnostics11010038

Scaglione, F., & Petrini, O. (2019). Mucoactive agents in the therapy of upper respiratory airways infections: fair to describe them just as mucoactive? Clinical Medicine Insights: Ear, Nose and Throat, 12, 1–9. https://doi.org/10.1177/1179550618821930

Sari, S. W., Sensussiana, T., & Safitri, W. (2021). Asuhan Keperawatan Pasien Asma Bronkial Dalam Pemenuhan Kebutuhan Oksigenasi (Doctoral dissertation, Universitas Kusuma Husada Surakarta).

Setiawan, P. A. (2020). Diagnosis dan tatalaksana stroke hemoragik. Jurnal Medika Utama, 02(01), 402–406.

Tarwoto. 2013. Keperawatan medikal bedah : Gangguan sistem pernafasan. Jakarta : Sagung Seto.

Tim Pokja SDKI DPP PPNI. 2017. Standar diagnosis keperawatan indonesia.(1st ed.). Jakarta : PPNI

Whitty, J. A., McInnes, E., Bucknall, T., Webster, J., Gillespie, B. M., Banks, M., Thalib, L., Wallis, M., Cumsille, J., Roberts, S., & Chaboyer, W. (2017). The cost-effectiveness of a patient centred pressure ulcer prevention care bundle: Findings from the INTACT cluster randomised trial. International Journal of Nursing Studies, 75, 35–42. https://doi.org/10.1016/j.ijnurstu.2017.06.014

Williams, L. S., & Hopper, P. D. (2015). Understanding medical surgical nursing.(5th ed.).Philadelphia : F.A Davis Company.


Refbacks

  • There are currently no refbacks.



JIM FKEP

JURNAL ILMIAH MAHASISWA FAKULTAS KEPERAWATAN

ISSN (Online) : 2716-3555

Fakultas Keperawatan, Universitas Syiah Kuala

Jl. Tgk. Tanoh Abee, Darussalam, Banda Aceh 23111,

Phone/Fax. Telp: +62651 7555249.

e-mail:jim.fkep@unsyiah.ac.id