Pemberian Oksigen dan Pemantauan Cairan untuk Mengatasi Kegawatan Breathing Circulation Pasien Congestive Heart Failure di IGD RS TK. II Moh. Ridwan Meuraksa

Waruwu, Riang Hartati (2024) Pemberian Oksigen dan Pemantauan Cairan untuk Mengatasi Kegawatan Breathing Circulation Pasien Congestive Heart Failure di IGD RS TK. II Moh. Ridwan Meuraksa. D3 thesis, Universitas Kristen Indonesia.

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Abstract

Kegawatdaruratan pada Gagal Jantung Kongestif terjadi ketika jantung gagal memompa darah dengan efektif, menyebabkan penumpukan cairan dan kesulitan bernapas yang disertai dengan edema. Kondisi ini mengakibatkan pola napas yang tidak efektif dan penurunan output jantung. Tujuan : Melakukan proses asuhan keperawatan darurat, terutama pada tindakan survei primer yang meliputi breathing dan circulation pada pasien dengan Gagal Jantung Kongestif, dengan tujuan mengoptimalkan oksigenasi untuk mengurangi sesak napas, meningkatkan saturasi oksigen hingga ≥95%, mengurangi penggunaan otot bantu pernapasan, serta memperbaiki frekuensi dan pola napas menjadi 16-20 kali per menit, serta membatasi cairan untuk mengurangi edema. Metode: Studi kasus menggunakan pendekatan deskriptif dengan dua sampel pasien yang menjalani proses asuhan keperawatan. Tindakan kolaboratif melibatkan pemberian oksigen melalui nasal kanul 3 liter/menit dan furosemide 10 mg pada pasien 1, sedangkan pasien 2 diberikan oksigen melalui non-rebreathing mask 10 liter/menit. Hasil : Sesak napas pada kedua pasien mengalami penurunan, dengan perbaikan frekuensi napas dan peningkatan saturasi oksigen. Pada pasien 1, frekuensi napas mencapai 22 kali per menit dengan saturasi oksigen 98% dan keseimbangan cairan -1025 cc dalam 5 jam. Sementara itu, pasien 2 memiliki frekuensi napas 24 kali per menit, saturasi oksigen 97%, dengan penggunaan otot bantu napas yang berkurang dan keseimbangan cairan -1546 cc dalam 5 jam. Kesimpulan Peran perawat di instalasi gawat darurat sangat penting dalam memberikan pelayanan yang cepat, sigap, dan responsif untuk menangani kegawatdaruratan pada primary survey breathing dan circulation. Saat mengimplementasikan asuhan keperawatan, diharapkan perawat bersikap penuh perhatian untuk membantu mengurangi kecemasan yang dialami pasien dan keluarga. Kata kunci : Kegawatdaruratan, Breathing, Circulation, Gagal Jantung Kongestif, Caring. / Emergency in Congestive Heart Failure occurs when the heart fails to pump blood effectively, causing fluid buildup and difficulty breathing accompanied by edema. This condition results in an ineffective breathing pattern and decreased cardiac output. Objective: To carry out emergency nursing care processes, especially in primary survey actions that include breathing and circulation in patients with Congestive Heart Failure, with the aim of optimizing oxygenation to reduce shortness of breath, increasing oxygen saturation to ≥95%, reducing the use of accessory respiratory muscles, and improving breathing frequency and pattern to 16-20 times per minute, and limiting fluids to reduce edema. Method: Case study using a descriptive approach with two patient samples undergoing nursing care process. Collaborative actions involve administering oxygen via nasal cannula 3 liters/minute and furosemide 10 mg in patient 1, while patient 2 is given oxygen via non-rebreathing mask 10 liters/minute. Result : Shortness of breath in both patients decreased, with improvement in respiratory rate and increase in oxygen saturation. In patient 1, the respiratory rate reached 22 times per minute with oxygen saturation of 98% and fluid balance of -1025 cc in 5 hours. Meanwhile, patient 2 had a respiratory rate of 24 times per minute, oxygen saturation of 97%, with reduced use of accessory respiratory muscles and fluid balance of -1546 cc in 5 hours. Conclusion: The role of nurses in the emergency installation is very important in providing fast, alert, and responsive services to handle emergencies in the primary survey breathing and circulation. When implementing nursing care, nurses are expected to be attentive to help reduce anxiety experienced by patients and families. Keywords: Emergency, Breathing, Circulation, Congestive Heart Failure, Caring

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