tag:blogger.com,1999:blog-44679734533293220662024-02-06T17:57:42.423-08:00Perawat Masa DepankuWelcome to my blog... for you nurses, we provide nursing care on definitions, etiology, simpomtom, clinical manifestations, pathways, diagnostic examination, diagnosis, intervention, implementation and evaluation.Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.comBlogger263125tag:blogger.com,1999:blog-4467973453329322066.post-74125967937448427942014-11-15T00:31:00.001-08:002014-11-15T00:31:45.040-08:00PAKET WISATA PULAU TIDUNG KEPULAUAN SERIBU<div dir="ltr"><br></div> Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-45089128590093535732014-11-09T20:44:00.001-08:002014-11-09T20:44:30.812-08:00resep<div dir="ltr"><br></div> Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-52146244060792518132013-02-25T05:03:00.001-08:002013-02-25T05:03:11.674-08:00EMPIEMA<div dir="ltr" style="text-align: left;" trbidi="on">
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<b>EMPIEMA</b></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">A.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Pengertian.</span></div>
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<span style="mso-ansi-language: IN;">Empiema yaitu adanya nanah (pus) alam
rongga/ kavum pleura.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">B.</span></span><span style="mso-ansi-language: IN;">Etiologi.</span></div>
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<span style="mso-ansi-language: IN;">Berasal dari: </span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Pneumonia.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Abses paru.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Adanya fistel bronkopleura.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Bronkiektasis.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Tuberculosis paru.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Jamur paru.</span></div>
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<span style="mso-ansi-language: IN;">Infeksi dari luar paru:</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Trauma dari otak.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Pembedahan otak.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Torasenteris.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Subfrenik abses.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Abses hati karena amoeba.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">C.</span></span><span style="mso-ansi-language: IN;">Patofisiologi.</span></div>
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Akibat invasi
kuman pyogenik ke pleura timbul peradangan akut, diikuti dengan pembentukan
eksudat serous. Dengan banyaknya sel-sel PMN baik yang hidup atau yang mati,
serta meningkatnya kadar protein, maka cairan menjadi keruh dan kental. Adanya
endapan fibrin akan membentuk kantong-kantong yang melokalisir nanah tersebut.</div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">D.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Gejala Klinis.</span></div>
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<span style="mso-ansi-language: IN;">Perjalanan klinis dibagi 2 stadium
yaitu: akut dan kronis.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Empiema akut.</span></div>
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<span style="mso-ansi-language: IN;">Gejala mirip dengan pneumonia, panas
tinggi, nyeri peuritik apabila stadium ini dibiarkan dalam beberapa minggu akan
timbul toksemia, <u>anemia dan jari tabuh</u>. Jika nanah tidak segera
dikeluarkan akan timbul fistel bronkopleura dan “Empyema <u>nelessitatis</u>”</span></div>
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<span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span>Empiema kronis.</div>
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<span style="mso-ansi-language: IN;">Batas yang tegas antara akut dan
kronis sukar ditentukan, disebut kronis apabila empiema berjalan lebih dari 3
bulan.</span></div>
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<span style="mso-ansi-language: IN;">Penderita mengeluh badannya lemah,
kesehatan penderita tampak mundur, pucat dan ada jari tabuh.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">E.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Diagnostik.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">1.</span></span><span style="mso-ansi-language: IN;">Pemeriksaan fisik.</span></div>
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<span style="mso-ansi-language: IN;">Didapatkan adanya tanda-tanda cairan
disertai pergerakan hemithoraks yang sakit berkurang. Redengar suara redup pada
perkusi. Pada auskultasi, suara napas menurun sampai menghilang di sisi
hemithoraks yang sakit.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">2.</span></span><span style="mso-ansi-language: IN;">X foto dada.</span></div>
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Pada foto thorakis PA dan
lateral didapatkan gambaran “opacity” yang menunjukkan adanya cairan dengan
atau tanpa kelainan paru.</div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">3.</span></span><span style="mso-ansi-language: IN;">Aspirasi pleura akan menunjukkan adanya nanah di
dalam kavum pleura. Selanjutnya nanah dipakai untuk bahan pemeriksaan:
sitologi, bakteriologi jamur, amoeba, dilakukan pembiakan (kultur) dan kepekaan
terhadap antibiotika.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">F.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Penatalaksanaan.</span></div>
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<span style="mso-ansi-language: IN;">Prinsip pengobatan pada empiema:</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Pengosongan rongga pleura dari nanah.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Aspirasi sederhana.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Drainase tertutup.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Pemasangan open drainase.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Antibiotika.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Penutupan rongga pleura.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Pengobatan kausal.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Pengobatan tambahan dan fisioterapi, untuk
memperbaiki KU.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">G.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Komplikasi.</span></div>
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Komplikasi yang sering
timbul adalah fistula bronkopleural. Komplikasi lain yang sering terjadi adalah
syok, sepsis, kegagalan jantung kongestif dan otitis media.</div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">H.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Diagnosa yang mungkin muncul yaitu.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Pola nafas tidak efektif b.d nafas pendek, lendir,
bronkokonstriksi, kelelahan.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Bersihan jalan nafas tidak efektif b.d peningkatan
sekret, batuk tidak efektif.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Intoleransi aktifitas b.d berkurangnya suplai
oksigen.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Defisit perawatan diri b.d kelelahan.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Ketidakseimbangan nutrisi: kurang dari kebutuhan
tubuh b.d anoreksia.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">Kerusakan pertukaran gas b.d ketidakseimbangan
ventilasi-perfusi.</span></div>
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<span style="mso-ansi-language: IN;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="mso-ansi-language: IN;">PK: anemia.</span></div>
</div>
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 130%; mso-ansi-language: IN; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<h4 class="MsoNormal" style="line-height: 130%; text-align: justify;">
DIAGNOSA KEPERAWATAN YANG MUNGKIN MUNCUL<span style="mso-ansi-language: IN;"> </span></h4>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 18.0pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed; width: 943px;">
<tbody>
<tr style="height: 17.3pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="background: #E6E6E6; border: solid windowtext 1.0pt; height: 17.3pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 32.4pt;" width="43">
<h4 style="line-height: 125%;">
NO</h4>
</td>
<td style="background: #E6E6E6; border-left: none; border: solid windowtext 1.0pt; height: 17.3pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.0pt;" width="180">
<h4 align="center" class="MsoNormal" style="line-height: 125%; text-align: center;">
<b><span style="mso-ansi-language: IN;">DX. KEPERAWATAN</span></b></h4>
</td>
<td style="background: #E6E6E6; border-left: none; border: solid windowtext 1.0pt; height: 17.3pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" width="216">
<h4 align="center" class="MsoNormal" style="line-height: 125%; text-align: center;">
<b><span style="mso-ansi-language: IN;">NOC</span></b></h4>
</td>
<td style="background: #E6E6E6; border-left: none; border: solid windowtext 1.0pt; height: 17.3pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 207.0pt;" width="276">
<h4 align="center" class="MsoNormal" style="line-height: 125%; text-align: center;">
<b><span style="mso-ansi-language: IN;">NIC</span></b></h4>
</td>
<td style="background: #E6E6E6; border-left: none; border: solid windowtext 1.0pt; height: 17.3pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" width="228">
<div align="center" class="MsoNormal" style="line-height: 125%; text-align: center;">
<b><span style="mso-ansi-language: IN;">RASIONAL</span></b></div>
</td>
</tr>
<tr style="height: 21.35pt; mso-yfti-irow: 1;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 32.4pt;" valign="top" width="43">
<div align="center" class="MsoNormal" style="line-height: 125%; text-align: center;">
<span style="mso-ansi-language: IN;">1.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.0pt;" valign="top" width="180">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Inefektif bersihan jalan nafas.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" valign="top" width="216">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">NOC outcome:</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l4 level1 lfo5; tab-stops: list 12.6pt; text-align: justify; text-indent: -9.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Status
respiratori: ventilasi.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l4 level1 lfo5; tab-stops: list 12.6pt; text-align: justify; text-indent: -9.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Status
respiratori: kepatenan jalan nafas.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l4 level1 lfo5; tab-stops: list 12.6pt; text-align: justify; text-indent: -9.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Kontrol
aspirasi.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l4 level1 lfo5; tab-stops: list 12.6pt; text-align: justify; text-indent: -9.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Kontrol
respirasi: pertukaran gas.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Klien outcome:</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 30.6pt; mso-list: l2 level1 lfo6; tab-stops: list 12.6pt; text-align: justify; text-indent: -27.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Suara nafas
bersih.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 30.6pt; mso-list: l2 level1 lfo6; tab-stops: list 12.6pt; text-align: justify; text-indent: -27.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Bebas
sianosis dan dipsnea.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 30.6pt; mso-list: l2 level1 lfo6; tab-stops: list 12.6pt; text-align: justify; text-indent: -27.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Jalan nafas
paten.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 30.6pt; mso-list: l2 level1 lfo6; tab-stops: list 12.6pt; text-align: justify; text-indent: -27.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Sekret dapat
dikeluarkan.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 207.0pt;" valign="top" width="276">
<div class="MsoBodyText" style="line-height: 125%;">
<i>Manajemen jalan nafas.</i></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l14 level1 lfo7; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Bersihkan/
suction sekret.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l14 level1 lfo7; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
status respiratori dan oksigenasi.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l14 level1 lfo7; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Auskultasi
suara nafas.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l14 level1 lfo7; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Berikan
oksigen sesuai program.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l14 level1 lfo7; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Atur posisi
klien aman sesuai terapi.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<i><span style="mso-ansi-language: IN;">Suctioning jalan nafas.</span></i></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l0 level1 lfo8; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Tentukan
kebutuhan oral/ trakheal suction.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l0 level1 lfo8; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Auskultasi
pernafasan sebelum dan sesudah suction.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l0 level1 lfo8; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Informasikan
pada klien tentang tindakan suction.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l0 level1 lfo8; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Gunakan
peralatan steril setiap kali tindakan suction.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l0 level1 lfo8; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Observasi
sekret yang keluar.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<i><span style="mso-ansi-language: IN;">Monitoring pernafasan.</span></i></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l5 level1 lfo9; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
kecepatan, ritme, kedalaman dan sesak nafas. </span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l5 level1 lfo9; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
pola nafas.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l5 level1 lfo9; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
kepatenan jalan nafas.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Memberikan kepastian bahwa bersihan jalan nafas
paten.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Membebaskan jalan nafas dari akumulasi sekret
sehingga klien terpenuhi kebutuhan oksigennya.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
</td>
</tr>
<tr style="height: 21.35pt; mso-yfti-irow: 2;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 32.4pt;" valign="top" width="43">
<div align="center" class="MsoNormal" style="line-height: 125%; text-align: center;">
<span style="mso-ansi-language: IN;">2.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.0pt;" valign="top" width="180">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Nutrisi kurang dari kebutuhan tubuh.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" valign="top" width="216">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">NOC outcome:</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 30.6pt; mso-list: l21 level1 lfo10; tab-stops: list 12.6pt; text-align: justify; text-indent: -27.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Status
nutrisi: intake nutrisi.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 30.6pt; mso-list: l21 level1 lfo10; tab-stops: list 12.6pt; text-align: justify; text-indent: -27.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Kontrol
berat badan.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Klien outcome:</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l19 level1 lfo11; tab-stops: list 12.6pt; text-align: justify; text-indent: -9.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">BB normal
sesuai TB dan usia.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l19 level1 lfo11; tab-stops: list 12.6pt; text-align: justify; text-indent: -9.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Konsumsi
nutrisi adekuat.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l19 level1 lfo11; tab-stops: list 12.6pt; text-align: justify; text-indent: -9.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Bebas dari
tanda-tanda malnutrisi.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l19 level1 lfo11; tab-stops: list 12.6pt; text-align: justify; text-indent: -9.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Dapat
mengidentifikasikan kebutuhan nutrisi.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l19 level1 lfo11; tab-stops: list 12.6pt; text-align: justify; text-indent: -9.0pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Mengidentifikasikan
faktor yang mempengaruhi penurunan BB.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 207.0pt;" valign="top" width="276">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<i><span style="mso-ansi-language: IN;">Manajemen nutrisi.</span></i></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l7 level1 lfo12; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Tentukan
kebutuhan kalori klien.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l7 level1 lfo12; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Identifikasi
kemampuan klien memenuhi kebutuhan nutrisi.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l7 level1 lfo12; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Pastikan
diet klien sesuai dengan kondisi penyakitnya.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l7 level1 lfo12; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Atur gaya
hidup: pola makan klien sesuai diit yang diprogramkan ahli gizi.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l7 level1 lfo12; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Berikan
informasi tentang kebutuhan nutrisi klien.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<i><span style="mso-ansi-language: IN;">Monitoring nutrisi.</span></i></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l18 level1 lfo13; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
kondisi lingkungan saat klien makan.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l18 level1 lfo13; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
kulit, turgor, rambut rontok.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l18 level1 lfo13; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
nausea dan vomiting.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<i><span style="mso-ansi-language: IN;">Konseling nutrisi.</span></i></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l17 level1 lfo14; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Bantu klien
mengubah perilaku makannya.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l17 level1 lfo14; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Diskusikan
makanan yang disukai dan tidak disukai.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l17 level1 lfo14; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Diskusikan
pengetahuan klien dan keluarga tentang nutrisi.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<i><span style="mso-ansi-language: IN;">Terapi nutrisi.</span></i></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Anjurkan
klien makan sedikit tapi sering.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Pertahankan
kebersihan mulut klien.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Mengetahui kebutuhan nutrisi yang diperlukan klien
sesuai dengan diit yang diprogramkan.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Mengetahui terpenuhi tidaknya kebutuhan nutrisi
klien.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Meningkatkan pemahaman klien mengenai nutrisi
dan diitnya.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Meningkatkan upaya pemenuhan nutrisi klien.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
</td>
</tr>
<tr style="height: 21.35pt; mso-yfti-irow: 3;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 32.4pt;" valign="top" width="43">
<div align="center" class="MsoNormal" style="line-height: 125%; text-align: center;">
<span style="mso-ansi-language: IN;">3.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.0pt;" valign="top" width="180">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Pola nafas tidak efektif.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" valign="top" width="216">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Setelah dilakukan tindakan keperawatan selama 3
x 24 jam, pola nafas klien baik atau menunjukkan ventilasi yang adekuat
dengan kriteria hasil:</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l13 level1 lfo16; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Tak ada
dipsnea.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l13 level1 lfo16; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Tidak ada
nafas pendek.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l13 level1 lfo16; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Tidak ada
retraksi/ penggunaan otot bantu nafas.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 207.0pt;" valign="top" width="276">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<i><span style="mso-ansi-language: IN;">Monitor pernafasan.</span></i></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l12 level1 lfo17; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
frekuensi, irama, kedalaman dan usaha respirasi.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l12 level1 lfo17; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Perhatikan
pergerakan dada, amati kesimetriasan, penggunaan otot bantu, retraksi otot
supra klavikular dan interkostal.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l12 level1 lfo17; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
bunyi abnormal.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l12 level1 lfo17; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
pola nafas, bradipnea, takipnea, hiperventilasi, dll.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l12 level1 lfo17; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Perhatikan
lokasi trakea.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l12 level1 lfo17; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
peningkatan ketidakmampuan istirahat, kecemasan.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l12 level1 lfo17; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Perhatikan
perubahan SaO<sub>2</sub>, CO<sub>2</sub>, dan nilai GDA.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<i><span style="mso-ansi-language: IN;">Pengelolaan jalan nafas.</span></i></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l8 level1 lfo18; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Atur posisi
untuk mengoptimalkan potensial ventilasi dan mengurangi dipsnea.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l8 level1 lfo18; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Dukung
untuk bernafas pelan dalam berpindah dan batuk.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l8 level1 lfo18; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Lakukan
fisioterapi dada sesuai kebutuhan.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l8 level1 lfo18; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
status pernafasan dan oksigenasi sesuai kebutuhan.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l8 level1 lfo18; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Auskultasi
suara nafas.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l8 level1 lfo18; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Perkusi
adanya cairan.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l8 level1 lfo18; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Bersihkan
sekret dengan mendukung batuk efektif.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Mengetahui keabnormalan pengembangan paru dan
kemajuannya.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Memberikan kebersihan jalan nafas paten.</span></div>
</td>
</tr>
<tr style="height: 21.35pt; mso-yfti-irow: 4;">
<td style="border-top: none; border: solid windowtext 1.0pt; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 32.4pt;" valign="top" width="43">
<div align="center" class="MsoNormal" style="line-height: 125%; text-align: center;">
<span style="mso-ansi-language: IN;">4.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.0pt;" valign="top" width="180">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">PK: Anemia</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" valign="top" width="216">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Perawat dapat meminimalkan komplikasi anemia
dengan kriteria:</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l6 level1 lfo19; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Warna kulit
klien normal.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l6 level1 lfo19; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Nilai
hematologi dbn.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l6 level1 lfo19; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Tidak
mengalami perdarahan.</span></div>
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<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l3 level1 lfo20; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Pantau
hitung sel darah merah dan kadar Hct sesuai indikasi.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l3 level1 lfo20; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Kolaborasi
medis: pemberian suplemen besi, asam folat serta multivitamin.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l3 level1 lfo20; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Hindari
mengambil spesimen darah tidak perlu.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l3 level1 lfo20; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Jelaskan
pada klien bagaimana mencegah perdarahan dan anjurkan pakai sikat gigi
lembut.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l3 level1 lfo20; tab-stops: list 12.6pt; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Berikan tranfusi
sesuai indikasi.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Mengkaji keparahan anemia.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Zat ini berguna dalam produksi sel darah.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Perdarahan memperparah kondisi anemia.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Diperlukan jika simtomatik.</span></div>
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<div align="center" class="MsoNormal" style="line-height: 125%; text-align: center;">
<span style="mso-ansi-language: IN;">5.</span></div>
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<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">PK: Hipoalbumin</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 162.0pt;" valign="top" width="216">
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Perawat dapat meminimalkan komplikasi dengan
kriteria:</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l9 level1 lfo21; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Kadar Alb:
3,5-5,0 g/ dl</span></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 207.0pt;" valign="top" width="276">
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l15 level1 lfo22; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor KU
klien.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l15 level1 lfo22; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
hasil Albumin.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l15 level1 lfo22; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Monitor
keadekuatan nutrisi (protein).</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l15 level1 lfo22; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Kolaborasi
medis: tranfusi albumin.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l15 level1 lfo22; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Kolaborasi
gizi: diit tinggi protein.</span></div>
<div class="MsoNormal" style="line-height: 125%; margin-left: 12.6pt; mso-list: l15 level1 lfo22; text-align: justify; text-indent: -12.6pt;">
<span style="mso-ansi-language: IN; mso-hansi-font-family: Arial;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="mso-ansi-language: IN;">Observasi
balance cairan.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 21.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoBodyText" style="line-height: 125%;">
Hipoalbumin menurunkan KU.</div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Pantau kadar lbumin.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Protein sumber albumin.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Mengatasi penurunan albumin.</span></div>
<div class="MsoNormal" style="line-height: 125%; text-align: justify;">
<span style="mso-ansi-language: IN;">Diit tinggi protein meningkatkan albumin.</span></div>
</td>
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Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-11982248051205503482013-02-25T04:57:00.001-08:002013-02-25T04:57:15.008-08:00DIARE AKUT DENGAN DEHIDRASI TAK BERAT PADA ANAK<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span lang="EN-US">DIARE AKUT DENGAN DEHIDRASI TAK BERAT </span></b></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; font-size: 16.0pt; line-height: 150%; mso-bidi-font-size: 12.0pt;">PADA ANAK</span></b></div>
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<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Definisi
Diare</span></b></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif";">Diare akut
adalah buang air besar dengan frekuensi yang meningkat lebihdari 3x perhari
dengan konsistensi tinja cair, bersifat mendadak, dan berlangsung dalam waktu
kurang dari 1 minggu</span></div>
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<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Etiologi</span></b></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif";">Penyebab diare
akut adalah :</span></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Virus
: rotavirus</span></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Bakteri
: E. Coli, Salmonella, Shigella, Vibrio</span></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Campylobacter
jejuni, clostridium perfringens</span></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Penyebab
lain : parasit (entamuba histolitica)</span></div>
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<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Patofisiologi</span></b></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Mikroorganisme/makanan
dimasukkan ke dalam alat pencernaan</span></div>
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berkembang biak setelah berhasil melewati sawar asam lambung</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Mikroorganisme membentuk
toksin (endotoksin)</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Terjadinya rangsangan pada
mukosa usus sehingga terjadi hiperperilstaltik dan sekresi cairan untuk
membuang mikroorganisme/makanan tersebut, sehingga terjadilah diare.</span></div>
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<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Gejala
Klinik</span></b></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Mula mula anak cengeng,
gelisah, suhu tubuh meningkat, nafsu makan berkurang atau tidak ada</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Tinja menjadi cair dan
mungkin mengandung darah atau lendir</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Gejala muntah dapat terjadi
sebelum dan sesudah diare</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Bila penderita sudah banyak
kehilangan cairan dan elektrolit, maka timbullah dehidrasi</span></div>
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<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Akibat
Dari diare akut</span></b></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Kehilangan air dan
elektrolit : dehidrasi, asidosis metabolic, hipokalsemia dan syok</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Masalah gizi ; maldigesti,
malabsorbsi, kehilangan zat gizi langsung, katabolisme</span></div>
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</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Diagnosis</span></b></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif";">Diagnosis diare
akut didasarkan pada definisi di atas. Namun demikian harus pula dikerjakan hal
hal tersebut di bawah ini :</span></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Riwayat
diare sekarang</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Lama diare kurang dari 1
minggu</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Total diare dalam 24 jam,
diperkirakan dari frekuensi diare dan jumlah tinja</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Keadaan klinis tinja
(konsistensi, darah)</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Muntah</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Demam</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">BAK 6 jam terakhir</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Tindakan yang telah diambil
ibu</span></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Riwayat
diare sebelumnya</span></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Riwayat
penyakit penyerta saat ini</span></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Riwayat
imunisasi</span></div>
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<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Riwayat
makanan sebelum diare</span></div>
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<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Pemeriksaan
fisik</span></b></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Suhu tubuh</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Berat badan</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Status gizi</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Tanpa dehidrasi</span></div>
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<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Kemungkinan komplikasi lain</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l8 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Pemantauan</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo6; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Keadaan diare, muntah,
dehidrasi dan komplikasi yang mungkin ditimbulkan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo6; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Jumlah cairan yang masuk</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l5 level1 lfo6; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Kemampuan orang tua
untukmemberikan oralit</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l8 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Tata
laksana pemberian makanan</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level1 lfo7; tab-stops: list 54.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Makanan sangat penting
untukpenderita diare. Makanan diberikan sesegera mungkin termasuk susu. Susu
buatan khusus (rendah lactose) hanya diberikan atas indikasi yang jelas.
Makanan untuk penderita diare:</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; mso-list: l6 level2 lfo7; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">ASI
tidak dihentikan, seoptimal mungkin</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; mso-list: l6 level2 lfo7; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Kualitas
dan kuantitas mencukupi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; mso-list: l6 level2 lfo7; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Mudah
diabsorbsi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; mso-list: l6 level2 lfo7; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Tidak
merangsang</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; mso-list: l6 level2 lfo7; tab-stops: list 90.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Diberikan
dalam porsi kecil tapi sering</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l8 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">10.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Dasar
dasar penatalaksanaan Tatalaksana</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">5D : </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level1 lfo7; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Dehidrasi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level1 lfo7; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Diagnosis</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level1 lfo7; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Diet</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level1 lfo7; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Defisiensi disakarida</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l6 level1 lfo7; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Drugs</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l8 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">11.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Penilaian
dehidrasi penderita diare</span></b></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 18.0pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 112.8pt;" valign="top" width="150">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Yang dinilai</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">A</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">B</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">C</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 112.8pt;" valign="top" width="150">
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">1. Riwayat:</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l6 level2 lfo7; tab-stops: list 27.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">diare</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l6 level2 lfo7; tab-stops: list 27.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">muntah</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l6 level2 lfo7; tab-stops: list 27.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">rasa
haus</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 27.0pt; mso-list: l6 level2 lfo7; tab-stops: list 27.0pt; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">berkemih</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">< 4 x/hari cair</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">sedikit/tidak</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">normal</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">normal</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">4-10 kali/hari cair</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">beberapa kali</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">lebih, haus sekiali</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">sedikit gelap</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">. 10 kali/hari cair</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">sangat<span style="mso-spacerun: yes;"> </span>sering</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">tidak dapat minum</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">tidak ada dalam 6 jam</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 112.8pt;" valign="top" width="150">
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">2. Periksa:</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level2 lfo7; tab-stops: list 18.0pt; text-indent: -9.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Keadaan
umum</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level2 lfo7; tab-stops: list 18.0pt; text-indent: -9.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Air
mata</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level2 lfo7; tab-stops: list 18.0pt; text-indent: -9.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Mata</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level2 lfo7; tab-stops: list 18.0pt; text-indent: -9.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level2 lfo7; tab-stops: list 18.0pt; text-indent: -9.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Mulut/lidah</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level2 lfo7; tab-stops: list 18.0pt; text-indent: -9.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Nafas</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Sehat, sakit</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Ada</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Normal</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Basah</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Normal</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Tampak sakit, mengantuk, lesu, rewel</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Tidak ada</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Cekung</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Kering</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Agak cepat</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Sangat mengantuk, tidak sadar, lemah</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Tidak ada</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Kering, sangat cekung</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Sangat kering</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Cept dan dalam</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 112.8pt;" valign="top" width="150">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Yang dinilai</span></div>
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<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">A</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">B</span></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">C</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 112.8pt;" valign="top" width="150">
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">3. Raba</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level2 lfo7; tab-stops: list 18.0pt; text-indent: -9.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">kulit
(dicubit)</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level2 lfo7; tab-stops: list 18.0pt; text-indent: -9.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";"> </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level2 lfo7; tab-stops: list 18.0pt; text-indent: -9.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">denyut
nadi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l6 level2 lfo7; tab-stops: list 18.0pt; text-indent: -9.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">ubun
ubun</span></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Kembali normal</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Normal</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Normal</span></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Kembali lambat</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Agak cepat</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">cekung</span></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Kembali sangat lambat</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Sangat cepat, lemah, tidak teraba</span></div>
</td>
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<tr style="mso-yfti-lastrow: yes;">
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<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">4. Kehilangan</span></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">- berat badan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">< 40 gram/kgBB</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">40-100 g/kgBB</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.2pt;" valign="top" width="148">
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">> 100 g/KgBB</span></div>
</td>
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</tbody></table>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l8 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">12.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Dehidrasi</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Pada dehidrasi ringan
diberikan :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level1 lfo8; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Oralit + cairan</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level1 lfo8; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">ASI / susu yangs esuai</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 54.0pt; mso-list: l0 level1 lfo8; tab-stops: list 54.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">Antibiotik</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Pada dehidrasi sedang,
penderita tak perlu di rawat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Pada dehidrasi berat,
penderita harus dirawat</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l8 level1 lfo1; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<b><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">13.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b><span lang="EN-US" style="font-family: "Arial","sans-serif";">Rehidrasi</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt;">
<span lang="EN-US" style="font-family: "Arial","sans-serif";">Dasarnya adalah :</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">jumlah
cairan yang hilang pada bayi</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l3 level1 lfo9; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">dehidrasi ringan =
kehilangan cairan 0-5 % atau rata rata 25 ml/kgBB</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l3 level1 lfo9; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">dehidrasi sedang =
kehilangan cairan 5 – 10 % atau rata rata 75 ml/kgBB</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l3 level1 lfo9; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">dehidrasi berat –
kehilangan cairan 10 – 15 % atau rata rata 125 ml/kgBB</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; mso-list: l8 level2 lfo1; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">tonisitas
cairan tubuh</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level1 lfo10; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">isotonic : kadar NA<sup>+</sup>
: 131 – 150 mEq/L</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level1 lfo10; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">hipertonik : kadar NA<sup>+</sup>
: lebih dari 150 mEq/L</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; mso-list: l4 level1 lfo10; tab-stops: list 72.0pt; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">v<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="EN-US" style="font-family: "Arial","sans-serif";">hipotonik : kurang 131
mEq/L</span></div>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-68435308130857604552013-02-25T04:53:00.002-08:002013-02-25T04:53:47.029-08:00INFARK MIOKARD<div dir="ltr" style="text-align: left;" trbidi="on">
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<div align="center" class="MsoNormal" style="text-align: center;">
<a href="http://perawatmasadepanku.blogspot.com/" target="_blank"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">INFARK MIOKARD</span></b></a></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24.0pt; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -24.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Definisi</span></b></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Infark miokard adalah kematian jaringan miokard
yang diakibatkan oleh kerusakan aliran darah koroner moikard (Carpenito, 2001).</span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Hudak & Gallo, 1994, infark miokard adalah
akibat dari penyakit arteri koroner (PAK) dengan kerusakan jaringan<span style="mso-spacerun: yes;"> </span>yang menyertai dan nekrosis. </span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Infark miokard adalah kematian jaringan otot
jantung yang ditandai adanya sakit dada yang khas: lama sakitnya lebih dari 30
menit, tidak hilang dengan istirahat atau pemberian anti angina ( PKJPDN
Harapan Kita, 2001).</span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24.0pt; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -24.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Etiologi</span></b></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="EN-US">Ketidakadekuatan aliran darah akibat dari penyempitan, sumbatan,
arteri koronaria akibat terjadinya aterosklerosis, atau penurunan aliran darah
akibat syok atau perdarahan</span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="EN-US">Faktor resiko menurut Framingham
:</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Hiperkolesterolemia : > 275
mg/dl</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Merokok sigaret : > 20/hari</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Kegemukan : > 120 % dari BB
ideal</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Hipertensi : > 160/90 mmHg</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Gaya</span><span lang="EN-US"> hidup monoton</span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Faktor-faktor lain yang dapat memungkinkan
berkembangnya PAK adalah sbb :</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l2 level1 lfo2; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Riwayat
penyakit jantung keluarga</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l2 level1 lfo2; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Kepribadian
tipe A (sangat ambisius, pandangan kompetitif, serba cepat)</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l2 level1 lfo2; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Diabetes
militus atau ters toleransi glukosa abnormal</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l2 level1 lfo2; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Jenis
kelamin pria</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l2 level1 lfo2; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Menggunakan
kontrasepsi oral</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l2 level1 lfo2; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Menopause</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l2 level1 lfo2; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Diet
kolesterol tinggi dan lemak tinggi</span></div>
<a name='more'></a><br />
<div class="MsoNormal" style="margin-left: 42.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24.0pt; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -24.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Tanda dan gejala</span></b></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Secara khas nyeri dirasakan di daerah perikardial
sering dirasakan sebagai suatu desakan, diperas, ditekan, dicekik, dan nyeri
seperti terbakar, rasanya tajam dan menekan atau sangat nyeri, nyeri terus
menerus, dan dangkal.</span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Nyeri dapat melebar ke belakang strenum sampai
dada kiri, lengan kiri, leher, rahang, atau bahu kiri.</span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24.0pt; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -24.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Patofisiologi</span></b></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Iskemia yang berlangsung lebih dari 30 – 45 menit
akan menyebabkan kerusakan seluler yang irreversibel dan kematian otot atau
nekrosis. Bagian miokardium yang mengelami infark atau nekrosis akan berhenti
berkontraksi secara permanen. Jaringan yang mengalami infark dikelilingi oleh
suatu daerah iskemik yang berpotensi dapat hidup. Bila pinggir daerah infark
mengalami nekrosis maka besar dearah infark akan bertambah besar, sedangkan
perbaikan iskemia akan memperkecil daerah nekrosis.</span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Infark miokardium biasanya menyerang daerah
ventrikel kiri. Infark trasmural mengenai seluruh tebal dinding yang
bersangkutan, sedangkan infark subendokardial terbatas pada separuh bagian
dalam miokardium. Daerah lain yang biasanya terserang infark adalah bagian
inferoir, lateral, posterior, dan septum, infark luas yang melibatkan bagian
besar ventrikel dinyatakan sesuai dengan lokasi infark yaitu anteroseptal,
anterolateral, inferolateral. Infark dinding ventrikel kanan juga ditemukan
pada sekitar seperempat kasus infark dinding posterior kiri, pada kondisi ini
disebut sebagai infark biventrikuler.</span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Otot yang mengalami infark akan mengalami
serangkaian perubahan selama berlangsungnya proses penyembuhan, mula-mula otot
yang mengalami infark tampak memar dan sianotik akibat terputusnya alioran
darah regional kemudian dalam jangka waktu 24 jam akan timbul edema pda
sel-sel, respon peradangan disertai infiltrasi leukosit. Enzim-enzim jantung
akan terlepas dari sel-sel ini, menjelang hari kedua atau ketiga mulai terjadi
proses degradasi ringan dan pembuangan semua serabut nekrotik. Selama fase ini
dinding nekrotik relatif tipis, kira-kira pada minggu ketiga mulai terbentuk
jaringan parut. Lambat laun jaringan penyambung fibrosa menggantikan otot yang
nekrosis dan mengalami penebalan yang progresif. Pada minggu keenam parut sudah
terbentuk dengan jelas.</span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Akibat yang terjadi karena infark miokardiun
adalah daya kontraksi menurun, gerakan dinding abnormal, perubahan daya kembang
dinding ventrikel, pengurangan curah sekuncup, pengurangan fraksi ejeksi,
peningkatan volume akhir sistolok dan akhir diastolik ventrikel serta
peningkatan akhir diastolik ventrikel kiri.</span></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Derajat gangguan fungsional akibat infark
tergantung dari :</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Ukuran
infark : infark yang melebihi 40 % miokardium berkaitan dengan insiden syok
kardiogenik tinggi.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Lokasi
infark : lokasi di dinding anterior lebih besar kemungkinannya mengurangi
fungsi mekanik dibandingkan dengan kerusakan dinding inferior.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Fungsi
miokardium yang terlibat : infark tua akan membahayakan fungsi miokardium
sisanya.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Sirkulasi
kolateral : baik melalui anastomosis arteria yang sudah ada atau melalui
saluran yang baru terbentuk, dapat berkembang sebagai respon terhadap iskemia
yang kronik dan hipoperfusi regional guna memperbaiki aliran darah yang menuju
ke miokardium terancam.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Mekanisme
kompensasi dari kardiovaskular : mekanisme ini<span style="mso-spacerun: yes;">
</span>bekerja untuk mempertahankan curah jantung dan perfusi perifer.</span></div>
<div class="MsoNormal" style="margin-left: 42.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Kompensasi terhadap infark adalah sebagai berikut
:</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l1 level1 lfo3; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Peningkatan
frekuensi jantung dan daya kontraksi.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l1 level1 lfo3; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Vasokonstriksi
umum.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l1 level1 lfo3; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Retensi
natrium dan air.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l1 level1 lfo3; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Dilatasi
ventrikel.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l1 level1 lfo3; tab-stops: list 60.0pt; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="SV" style="mso-ansi-language: SV;">Hipertropi
ventrikel.</span></div>
<div class="MsoNormal" style="margin-left: 42.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24.0pt; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -24.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Pemeriksaan diagnostik</span></b></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l1 level2 lfo3; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">a.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Elektrokardiografi</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<span lang="EN-US">Pada EKG 12 lead, jaringan iskemik tetapi masih berfungsi akan
menmghasilkan perubahan gelombang T, menyebabkan inervasi saat aliran listrik
diarahkan<span style="mso-spacerun: yes;"> </span>menjauh dari jaringan iskemik,
lebih serius lagi, jaringan iskemik akan mengubah segmen ST menyebabkan depresi
ST.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pada infark, miokard yang mati tidak<span style="mso-spacerun: yes;"> </span>mengkonduksi listrik dan gagal untuk
repolarisasi secara normal, mengakibatkan elevasi segmen ST. Saat nekrosis
terbentuk, dengan penyembuhan cincin iskemik disekitar area nekrotik, gelombang
Q terbentuk. Area nekrotik adalah jaringan parut yang tak aktif secara
elektrikal, tetapi zona nekrotik akan menggambarkan perubahan gelombang T saat
iskemik terjasi lagi. Pada awal infark miokard, elevasi ST disertai dengan
gelombang T tinggi. Selama berjam-jam atau berhari-hari berikutnya, gelombang T
membalik. Sesuai dengan umur infark miokard, gelombang Q menetap dan segmen ST
kembali normal.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Perubahan elektrokardiogram speifik pada infark
moikard transmural akut :</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 65.4pt; mso-border-alt: solid windowtext .5pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 90.0pt;" valign="top" width="120">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Daerah infark</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 330.0pt;" valign="top" width="440">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Perubahan EKG</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 90.0pt;" valign="top" width="120">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Anterior</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 330.0pt;" valign="top" width="440">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Elevasi segmen ST pada lead V3 -V4, perubahan resiprokal (depresi ST)
pada lead II, III, aVF.</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 90.0pt;" valign="top" width="120">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Inferior</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 330.0pt;" valign="top" width="440">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Elevasi segmen T pada lead II, III, aVF, perubahan resiprokal (depresi
ST) V1 – V6, I, aVL.</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 3;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 90.0pt;" valign="top" width="120">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Lateral</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 330.0pt;" valign="top" width="440">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Elevasi segmen ST pada I, aVL, V5 – V6.</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 4;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 90.0pt;" valign="top" width="120">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Posterior</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 330.0pt;" valign="top" width="440">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Perubahan resiprokal (depresi ST) pada II, III, aVF, terutama gelombang R
pada V1 – V2.</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 5; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 90.0pt;" valign="top" width="120">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Ventrikel kanan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 330.0pt;" valign="top" width="440">
<div class="MsoNormal" style="text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Perubahan gambaran dinding inferior</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l1 level2 lfo3; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">b.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Enzim-enzim jantung</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pemeriksaan seri enzim-enzi9m jantung diperoleh
dari gambaran contoh darah tiap 8 jam selama 1 sampai 2 hari. Ketika terjadi
cedera jaringan maka banyak protein terlepas dari bagian dalam sel otot jantung
ke dalam sirkulasi, enzim-enzim yang harus diobservasi adalah kreatinkinase
(CK), laktat dehidrogenase (LDH) dan transaminase oksaloasetat glutamik serum
(SGOT)</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l1 level2 lfo3; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">c.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Vektokardiografi</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Pengukuran noninvasif aksis listrik untuk
kecepatan dan arah konduksi dan gangguan seperti hipertropi ventrikel kanan dan
ventrikel jantung serta blok jantung.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l1 level2 lfo3; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">d.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Angiografi</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<span lang="SV" style="mso-ansi-language: SV;">Ters diagnostik invasif dengan memasukan
katerterisasi jantung yang memungkinkan visualisasi langsung terhadap arteri
koroner<span style="mso-spacerun: yes;"> </span>besar dan pengukuran langsung
terhadap ventrikel kiri.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l1 level2 lfo3; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US"><span style="mso-list: Ignore;">e.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Skintigrafi talium</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<span lang="EN-US">Memungkinkan untuk <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">imaging </i></b>miokard setelah injeksi
talium-201, suatu “cold spot” terjadi pada gambaran yang menunjukan area
iskemia.</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24.0pt; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -24.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Pengobatan</span></b></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Obat anti koagulasi</span></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="EN-US">Trombolitik</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24.0pt; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -24.0pt;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Diagnosa keperawatan yang mungkin muncul</span></b></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">Nyeri akut b/d agen injuri fisik</span></b></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">Intoleransi aktifitas b/d insufisiensi O2</span></b></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">Cemas b/d ancaman kematian</span></b></div>
<div class="MsoNormal" style="margin-left: 60.0pt; mso-list: l0 level2 lfo1; text-align: justify; text-indent: -18.0pt;">
<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">PK : Trombosis vena dalam</span></b></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">PK : Syok kardiogenik</span></b></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">PK : Gagal jantung kongestif</span></b></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">PK : IM kambuhan</span></b></div>
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<span lang="SV" style="font-family: Symbol; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">PK : Disritmia</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="SV" style="mso-ansi-language: SV;">Sumber Pustaka</span></b></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-indent: -24.0pt;">
<span lang="EN-US">Bulecheck, 1996, <i style="mso-bidi-font-style: normal;">Nursing Intervention Classification</i>
(NIC), Mosby-Year Book, USA</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-indent: -24.0pt;">
<span lang="SV" style="mso-ansi-language: SV;">Carpenito,
1999, <i style="mso-bidi-font-style: normal;">Rencana Asuhan & Dokumentasi
Keperawatan, Diagnosa keperawatan dan masalah kolaboratif, EGC, Jakarta</i></span></div>
<div class="MsoBodyText" style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-indent: -24.0pt;">
<span lang="EN-US">Ignatavicius D. Donna & Workman
L.M, 2002, <i style="mso-bidi-font-style: normal;">Medical Sugical Nursing:
Critical Thinking for Collaborative Care</i>, 4<sup>th</sup><span style="mso-spacerun: yes;"> </span>edition, W.B Saunders: Philadelphia</span></div>
<div class="MsoBodyText" style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-indent: -24.0pt;">
<span lang="EN-US">LeMone. Pricilla & Burke M.
Karen, 1996, <i style="mso-bidi-font-style: normal;">Medical Surgical Critical
Thinking in Clien Care</i>, Addison Wesley Nursing: California</span></div>
<div class="MsoBodyText" style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-indent: -24.0pt;">
<span lang="EN-US">Luckmann & Sorensen’s, 1993,
Medical Surgical Nursing, 4<sup>th</sup> ed,
W.B Saunders: Philadelphia</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-indent: -24.0pt;">
<span lang="EN-US">Nanda, 2001, <i style="mso-bidi-font-style: normal;">Nursing Diagnoses Definition dan Classification</i>, Philadelpia </span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-indent: -24.0pt;">
<span lang="EN-US">Price & Wilson, 1995, <i style="mso-bidi-font-style: normal;">Patofisiologi</i><i style="mso-bidi-font-style: normal;"> Konsep
Klinis</i><i style="mso-bidi-font-style: normal;"> Proses-Proses Penyakit</i>, EGC, Jakarta.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 24.0pt; text-align: justify; text-indent: -24.0pt;">
<span lang="EN-US">WwwI.Us.Elsevierhealth.Com, 2004, <i style="mso-bidi-font-style: normal;">Nursing Diagnosis : A Guide to Planning Care</i>,
fifth Edition.</span></div>
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Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-32843873035565947782013-01-03T02:19:00.000-08:002013-01-03T02:19:21.320-08:00STROKE<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: center; text-indent: -18pt;">
<span lang="EN-US"><b>STROKE </b><o:p></o:p></span></div>
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<span lang="EN-US"><b><br /></b></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">A.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Pengertian<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Stroke adalah penyakit gangguan fungsional
otak fokal maupun global akut dengan gejala dan tanda sesuai bagian otak yang
terkena, yang sebelumnya tanpa peringatan, dan yang dapat sembuh sempurna,
sembuh dengan cacat atau kematian, akibat gangguan aliran darah ke otak karena
perdarahan ataupun non perdarahan (Junaidi Iskandar, 2002)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Stroke adalah sindrom klinis yang awal
timbulnya mendadak, progresi cepat, berupa defisit neurologis fokal dan atau
global yang berlangsung 24 jam atau lebih atau langsung menimbulkan kematian,
dan semata-mata disebabkan oleh gangguan peredaran darah otak non traumatic
(Kapita Selekta Kedokteran, 2000)<o:p></o:p></span></div>
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<br /></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">B.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Etiologi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Menurut Brunner dan Suddarth (2001),
etiologi stroke adalah :<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Trombosist<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Adalah gumpalan darah yang ada didalam
dinding pembuluh darah, perlahan akan menutup akibat penyimpanan kolesterol
dalam dinding arteri. Tanda-tanda trombosit bervariasi, misal : sakit kepala,
pusing kejang dan kehilangan bicara sementara, paralysis dan tanda ini tidak
terjadi secara tiba-tiba.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Embolisme Serebral<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Adalah bekuan darah yang dibawa ke otak
dari bagian tubuh yang lain. Emboli ini berasal dari thrombus dalam jatung
sehingga emboli ini merupakan perwujudan dari penyakit jantung. <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Ischemia<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Adalah penurunan aliran darah ke otak<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Hemorragic Serebral<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Adalah perdarahan pada otak akibat
pecahnya pembuluh darah serebral sehingga darah masuk ke dalam jaringan otak
atau disekitar otak.<o:p></o:p></span></div>
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<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">C.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Patofisiologi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Menurut Lany Sustiyani
Syamsir Alam dan Iwan Hadibroto, 2003 dalam kehidupan sehari-hari otak
membutuhkan suplai darah yang konstan di mana dalam hal ini semua
perubahan-perubahan tekanan perfusi dari sistem sirkulasi sentral dipelihara
oleh suatu fenomena auto regulasi. Adanya gangguan peredaran darah otak dapat
menimbulkan jejas atau cidera pada otak melalui empat mekanisme, yaitu :<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Penebalan dinding arteri serebral yang
menimbulkan penyempitan atau penyumbatan lumen sehingga aliran darah dan
suplainya ke bagian otak tidak adekuat, serta selanjutnya akan mengakibatkan
perubahan-perubahan iskhematik otak. Bila hal ini terjadi sedemikian rupa
hebatnya, dapat menimbulkan nekrosis (infark)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Pecahnya dinding arteri serebral akan
menyebabkan hancurnya darah ke jaringan (hemorrhage)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Pembesaran sebuah atau sekelompok
pembuluh darah yang menekan jaringan otak.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Rdema serebri yang merupakan pengumpulan
cairan di ruang interstisiel jaringan otak.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: 36pt;">
<span lang="EN-US">Konstriksi lokal sebuah
arteri mula-mula hanya menyebabkan sedikit perubahan pada aliran darah dan baru
setelah stenosis cukup hebat dan melampui batas kristis terjadi pengurangan
aliran secara drastic dan cepat.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Akulasi suatu arteri otak akan
menimbulkan Reduksi perfusi suatu area di mana jaringan otak normal sekitarnya
masih mempunyai pendarahan yang baik berusaha untuk membantu mensuplai darah
melalui jalur-jalur anastomosis yang ada. Selanjutnya akan terjadi edema di
daerah ini. Selama berlangsungnya peristiwa ini, otoregulasi sudah tidak
berfungsi, sehingga aliran darah akan mengikuti secara pasif segala perubahan
tekanan darah arteri. Disamping itu reaktifitas serebrovaskuler terhadap PCO<sub>2</sub>
terganggu. Berkurangnya aliran darah serebral sampai tahap ambang tertentu akan
melalui serangkaian gangguan fungsi neuroral. Bila aliran darah berkurang
sampai di bawah ambang fungsi elektrik, fungsi kortikal terganggu, namun
neuron-neuron masih tetap hidup sampai aliran darah turun di bawah ambang kerusakan
permanen, dan saat ini akan terjadi kerusakan jaringan yang permanen.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US"> Pathway</span><br />
<a name='more'></a><span lang="EN-US"><o:p></o:p></span></div>
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<span style="height: 29px; left: 0px; margin-left: 249px; margin-top: 15px; position: absolute; text-align: justify; width: 14px; z-index: 251655168;"><img height="29" src="file:///C:/Users/Toshiba/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1047" width="14" /></span><u></u></div>
<div style="text-align: justify;">
<u><u><span lang="EN-US">Hipertensi, DM, Merokok, Penyakit Jantung, Kegemukan / obesitas</span></u></u></div>
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<span style="height: 785px; left: -32px; position: relative; top: 13px; width: 644px; z-index: 251633664;"><img height="772" src="file:///C:/Users/Toshiba/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1026 _x0000_s1027 _x0000_s1028 _x0000_s1029 _x0000_s1030 _x0000_s1031 _x0000_s1032 _x0000_s1033 _x0000_s1034 _x0000_s1035 _x0000_s1036 _x0000_s1037 _x0000_s1038 _x0000_s1039 _x0000_s1040 _x0000_s1041 _x0000_s1042 _x0000_s1043 _x0000_s1044 _x0000_s1045 _x0000_s1046 _x0000_s1048 _x0000_s1049 _x0000_s1050 _x0000_s1051 _x0000_s1052 _x0000_s1053 _x0000_s1054 _x0000_s1055 _x0000_s1056 _x0000_s1057 _x0000_s1058 _x0000_s1059 _x0000_s1060 _x0000_s1061 _x0000_s1062 _x0000_s1063 _x0000_s1064 _x0000_s1065 _x0000_s1066 _x0000_s1067 _x0000_s1068 _x0000_s1069 _x0000_s1070 _x0000_s1071 _x0000_s1072" width="644" /></span><b><span lang="EN-US"> </span></b></div>
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<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">D.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Gejala Klinis<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Menurut Junaidi Iskandar (2002), gejala
klinis stroke berupa:<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kesemutan atau gangguan sensibilitas dan
kelemahan dari anggota gerak termasuk wajah.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kesulitan berbicara memahami pembicaraan
atau tiba-tiba menjadi bingung<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Gangguan penglihatan pada satu atau kedua
mata<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kesulitan berjalan, sempoyongan atau
kehilangan keseimbangan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Nyeri kepala hebat dengan sebab yang
tidak jelas disertai mual dan muntah<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">6.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Perubahan mendadak tingkah laku / status
mental<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">7.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Disartria (bicara pelo/ cedal)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">E.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Klasifikasi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Klasifikasi dari stroke ada dua macam,
menurut Lanny Sustiani, Syamsir Alam dan Iwan Hadibroto (2003), adalah :<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Stroke Non Haemorragic<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Stroke disebabkan oleh faktor-faktor
sebagai berikut :<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Menumpuknya lemak pada pembuluh darah
yang menyebabkan mulai terjadinya pembekuan darah.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Benda asing dalam pembuluh darah jantung<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Adanya lubang pada pembuluh darah
sehingga darah bocor yang mengakibatkan aliran darah ke otak berkurang.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Stroke Haemorragic<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Stroke ini disebabkan karena salah satu
pembuluh darah di otak bocor atau pecah sehingga darah mengisi ruang sel-sel
otak.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Darah tinggi yang dapat menyebabkan
pembuluh darah pecah<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Peleburan pada pembuluh darah yang
menyebabkan pembuluh darah pecah<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tumor pada pembuluh darah<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Perbedaan Stroke Non Haemorragic dan
Stroke Haemorragic<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 18pt; text-align: justify; width: 535px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 137.4pt;" valign="top" width="183"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">Gejala<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 138.0pt;" valign="top" width="184"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">Stroke Non Haemorragic<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.0pt;" valign="top" width="168"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">Stroke Haemorragic<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 137.4pt;" valign="top" width="183"><div class="MsoSubtitle">
<span lang="EN-US">Saat kejadian <o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Nyeri kepala <o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Kejang <o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Muntah <o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Adanya tanda peringatan<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 138.0pt;" valign="top" width="184"><div class="MsoSubtitle">
<span lang="EN-US">Mendadak, istirahat<o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Ringan <o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Tidak ada<o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Tidak ada <o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Ada <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.0pt;" valign="top" width="168"><div class="MsoSubtitle">
<span lang="EN-US">Mendadak, sedang aktif<o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Hebat <o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Ada <o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Ada <o:p></o:p></span></div>
<div class="MsoSubtitle">
<span lang="EN-US">Tidak ada<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">F.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Faktor-Faktor Resiko<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Menurut Junaidi Iskandar, (2002)
faktor-faktor resiko stroke terdiri dari: <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Faktor resiko yang dapat dikontrol,
adalah :<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Hipertensi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Diabetes Melitus<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Merokok<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Penyakit jantung <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">e.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kegemukan / obesitas<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">f.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Hiperkolesterolemia dan hiperurikemia<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">g.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kelainan arteri karotis<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">h.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Hiperkoagulasi (darah mudah menggumpal)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">i.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Konsumsi
alkohol berlebihan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">j.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penyalahgunaan
obat<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">k.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Gangguan pernafasan saat tidur (sleep
apnea)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">l.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pernah
terjadi serangan / Transient Ischemic Attack (TIA) sebelumnya.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Faktor yang tidak dapat dikontrol, adalah
:<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Usia<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Jenis Kelamin<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Ras / Suku Bangsa<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kelainan bawaan / herediter<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">e.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Riwayat stroke / TIA sebelumnya<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">G.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Komplikasi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Menurut Sjaifoellah Noer, (2002),
komplikasi dari stroke yaitu :<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Depresi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Dampak yang menyulitkan penderita dan
orang di sekitarnya. Oleh karena itu keterbatasan akibat kelumpuhan, sulit
berkomunikasi sehingga penderita stroke dapat mengalami depresi.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Darah beku<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Terbentuk pada jaringan yang lumpuh
(kaki) dapat mengakibatkan pembengkakan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Radang paru-paru / pneumonia<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Dampak stroke dapat memungkinkan
penderita kesulitan menelan, batuk-batuk sehingga cairan terkumpul di
paru-paru.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Dekubitus<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Saat mengalami stroke usahakan untuk
selalu berpindah dan bergerak secara teratur. Bagian yang biasa mengalami memar
adalah pinggul, pantat, sendi kaki dan tumit. Bila memar ini tidak dirawat bisa
menjadi infeksi, keadaan ini dapat menjadi parah bila berbaring di tempat tidur
yang basah. <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">H.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Pemeriksaan Radiologi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify;">
<span lang="EN-US">Menurut Junaidi Iskandar, (2002) pemeriksaan
radiologi berupa: <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">CT. SCAN<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Untuk membedakan antara stroke
hemorrhagic dan non hemorrhagic <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Angigrafi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Untuk melihat gambaran pembuluh darah
yang patologis<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">EEG<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Untuk melihat area yang spesifik dari
lesi otak<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">MRI<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Untuk mengetahui adanya perdarahan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Brainplan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Untuk mengetahui adanya infark
hemorrhagic, hematoma dan malformasi dari arteri dan vena.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">6.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Dopler Ultrasonography<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Untuk mengetahui ukuran dan kecepatan
aliran darah yang melalui pembuluh darah<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">7.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Skuli Rontgenogram<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Untuk mengetahui klasifikasi intra
kranial<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">8.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Digital Substraction Angiography<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Untuk mengetahui adanya aklusi atau
penyempitan pembuluh darah terutama kolusi arteri karotif<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">9.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Eshoencephalography<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Untuk mengetahui adanya pergeseran dari
struktur midline<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">10.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">B. Mode Ultrasound<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<span lang="EN-US">Untuk mengukur tekanan darah melalui
pembuluh darah leher.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">I.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Nursing Care Plan (NCP) <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Pengkajian (Doenges, 2001)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Riwayat kesehatan pasien<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Keluhan utama<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Penyakit sekarang<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Penyakit dahulu <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Riwayat sosial<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Aktivitas istirahat<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gejala : Kesulitan beraktivitas karena
hemiplegia / hemiparase<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 96pt; text-align: justify; text-indent: -42pt;">
<span lang="EN-US">Tanda : Gangguan tonus otot
(flaksid/spastik) dan terjadi kelemahan umum, gangguan penglihatan, gangguan
tingkat kesadaran<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sirkulasi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gejala : Adanya penyakit jantung dan riwayat
hipotensi postural<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Tanda : - Hipertensi vaskuler<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 126pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Frekuensi
nadi yang bervariasi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 126pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Disaritmia<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 126pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">-<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Desiran
karotis, femoralis, arteri iliaka<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Integritas ego<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gejala : Perasaan tidak berdaya<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Tanda : emosi lebih </span><span lang="EN-US" style="font-family: Wingdings;">à</span><span lang="EN-US">
kesulitan mengekspresikan diri<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">e.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Eliminasi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gejala : Inkontinensia / anuria, distensi
abdomen, ileus paralitik<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">f.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Makanan / cairan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gejala : Anoreksia, mual , muntah pada
fase akut, kehilangan sensasi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Tanda : kesulitan menelan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">g.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Neurosensori<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 96pt; text-align: justify; text-indent: -42pt;">
<span lang="EN-US">Gejala : Sinkope, sakit
kepala, hilangnya sensibilitas, hemiplegia, atau hemiparese, penglihatan
menurun<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 96pt; text-align: justify; text-indent: -42pt;">
<span lang="EN-US">Tanda : Penurunan tingkat
kesadaran, paralysis wajah, afasia motoril / sensorik, penurunan respon
terhadap rangsang, penurunan kemampuan motoris, ukuran dan reaksi pupil yang
tidak sama <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 96pt; text-align: justify; text-indent: -42pt;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">h.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Nyeri / ketidakseimbangan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gejala : Headache<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Tanda : Tingkah laku tidak stabil,
gelisah, ketegangan pada otot / facia<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">i.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pernafasan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gejala : Merokok (faktor resiko)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Tanda : ketidakmampuan menelan / batuk,
sonki, dispnoe<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">j.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Keamanan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Tanda : Perubahan persepsi terhadap
sensori, tidak mampu mengenal objek, kesulitan menelan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">k.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Interaksi sosial<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Tanda : Masalah bicara / ketidakmampuan
komunikasi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">l.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penyuluhan
/ pembelajaran<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gejala : Riwayat hipertensi keluarga<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Pengkajian fungsi saraf cranial<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Olfaktorius ( I )<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Menunjukkan penurunan sensori penciuman /
penghidup<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Obtikus ( II )<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Adanya penurunan ketajaman penglihatan
karena penurunan sensorik<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Okulomotorius ( III )<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Klien tidak mampu mengangkat kelopak
mata, pupil akan miosis atau tidak dapat mengkontraksikan pupil dan sebagian
gerakan ekstra okuler terganggu.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Troklearis ( IV )<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Klien tidak dapat menggerakkan mata ke
bawah dan ke dalam<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">e.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Trigeminus ( V )<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gangguan pada otot temporalis dan
masseter serta gerak rahang ke lateral. Penurunan respon sensorik pada
rangsangan di kulit wajah 2/3 depan kulit kepala mukosa mata, dan hidung,
rongga mulut, lidah dan gigi, gangguan reflek berkedip.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">f.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Fasialis ( VI )<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Ekspresi wajah tidak norma, gangguan
laktima dan salvias, penurunan fungsi pengecapan bagian depan lidah (manis,
asam, asin)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">g.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Vestibulo koklearis ( VII )<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Keseimbangan tubuh dan pendengaran
terganggu / menurun<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">h.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Glosofaringeus ( VIII )<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Sulit menelan, tidak ada reflek muntah,
gangguan salivasi gangguan pengecapan, lidah belakang, gangguan pada faring<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">i.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Vagus
( IX )<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gangguan pada saluran pencernaan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">j.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Accesorius
( X )<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Ketidakmampuan menggerakkan kepala dan
bahu<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">k.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Hyplogossus<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<span lang="EN-US">Gangguan pergerakan lidah<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 36pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Diagnosa keperawatan (Suddarth &
Brunner, 2001)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Ketidakefektifan perfusi jaringan
cerebral yang berhubungan dengan adanya sumbatan pembuluh darah otak,
perdarahan otak, vasospasmus otak, oedem cerebral.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 120pt; text-align: justify; text-indent: -66pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tujuan : Perfusi jaringan otak dapat
dipertahankan secara adekuat setelah dilakukan tindakan keperawatan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 120pt; text-align: justify; text-indent: -66pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kriteria hasil <o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 432px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.35pt;" width="180"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">Indikator<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">1<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">2<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">3<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">4<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">5<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.35pt;" valign="top" width="180"><div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Peningkatan sensori <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Perbedaan rangsang <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tidak parestesia <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tidak hiperparesia <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify;">
<span lang="EN-US">Ket: <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sangat tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sering tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kadang tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Jarang tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Intervensi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kaji faktor penyebab penurunan perfusi
cerebral dan potensial peningkatan tekanan intrakranial<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Monitor status neurologi setiap hari<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Monitor tanda-tanda vital tiap jam<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Evaluasi pupil, ukuran, bentuk kesamaan,
respon terhadap cahaya<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">e)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kaji perubahan penglihatan kabur, lapang
pandang menurun<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">f)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Beri tirah baring dan lingkungan yang
nyaman<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">g)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Cegah mengejan saat BAB dan menahan nafas<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">h)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kolaborasi dengan dokter untuk pemberian
O<sub>2</sub> <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Ketidakefektifan bersihan jalan nafas
yang berhubungan dengan tidak sadar atau batuk tidak efektif<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 120pt; text-align: justify; text-indent: -66pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tujuan : Bersihan jalan nafas kembali
efektif setelah dilakukan tindakan keperawatan. (Marion Johnson, 2000)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 120pt; text-align: justify; text-indent: -66pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kriteria hasil (Marion Johnson, 2000)<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 432px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 168.0pt;" width="224"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">Indikator<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 31.2pt;" width="42"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">1<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 31.2pt;" width="42"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">2<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 31.2pt;" width="42"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">3<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 31.2pt;" width="42"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">4<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 31.2pt;" width="42"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">5<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 168.0pt;" valign="top" width="224"><div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tidak ada demam <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tidak ada kecemasan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">RR dalam batas normal <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Irama nafas normal <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tidak ada suara tambahan <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 31.2pt;" valign="top" width="42"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 31.2pt;" valign="top" width="42"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 31.2pt;" valign="top" width="42"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 31.2pt;" valign="top" width="42"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 31.2pt;" valign="top" width="42"><div class="MsoSubtitle">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify;">
<span lang="EN-US">Ket: <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sangat tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sering tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kadang tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Jarang tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Intervensi (Joanne Mc.Closkey, 1996)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kaji dan pantau pernafasan, reflek batuk
dan sekresi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kaji program analgetik<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Posisikan tubuh dan kepala untuk
menghindari obstruksi jalan nafas dan memberikan pengeluaran sekresi yang
optimal<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Pasang bantuan alat nafas<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">e)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Atur posisi kepala lebih tinggi </span><span lang="EN-US" style="font-family: Symbol;">±</span><span lang="EN-US"> 30 <sup>o</sup><o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">f)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Berikan cairan </span><span lang="EN-US" style="font-family: Symbol;">±</span><span lang="EN-US"> 3 liter
untuk mengencerkan sekresi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kurang perawatan diri yang berhubungan
dengan gangguan neuro muscular, penurunan kekuatan dan ketahanan otot serta
penurunan Koordinasi otot<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 126pt; text-align: justify; text-indent: -72pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tujuan : Perawatan diri pasien meningkat
setelah diberikan tindakan keperawatan. (Marion Johnson, 2000)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 126pt; text-align: justify; text-indent: -72pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kriteria hasil (Marion Johnson, 2000)<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 432px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.35pt;" width="180"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">Indikator<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">1<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">2<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">3<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">4<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">5<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.35pt;" valign="top" width="180"><div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Makan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Ganti pakaian <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Toileting <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Mandi <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Berhias <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">6.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">ambulasi jalan <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify;">
<span lang="EN-US">Ket: <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tergantung penuh<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Butuh bantuan alat dan orang <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Butuh bantuan orang <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Butuh bantuan alat <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Mandiri <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Intervensi (Joanne Mc.Closkey, 1996)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kaji kemampuan klien untuk melakukan
kegiatan sehari-hari<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Berikan bantuan seperlunya pada hal-hal
yang pasien mampu melakukannya<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Gangguan sensori perceptual yang
berhubungan dengan gangguan sensori penerimaan, transmisi dan integrasi.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 120pt; text-align: justify; text-indent: -66pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tujuan : Mengembalikan fungsi persepsi
sensorik agar mengarah ke pemulihan / normal dan komplikasi dapat dicegah atau
seminimal mungkin tidak terjadi (Marion Johnson, 2000)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kriteria hasil (Marion Johnson, 2000)<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 432px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.35pt;" width="180"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">Indikator<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">1<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">2<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">3<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">4<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">5<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.35pt;" valign="top" width="180"><div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Penglihatan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Reflek mata <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tidak ada pusing <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Fungsi saraf otonom <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Gerakan otot wajah <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify;">
<span lang="EN-US">Ket: <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sangat tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sering tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kadang tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Jarang tidak sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sesuai <o:p></o:p></span></div>
<div class="MsoSubtitle" style="text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Intervensi (Joanne Mc.Closkey, 1996)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kaji respon sensorik terhadap rabaan
panas / dingin / tajam / tumpul dan catat perubahan yang terjadi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b)<span style="font-size: 7pt;"> </span></span><span lang="EN-US"> Koreksi kemampuan pasien berorientasi terhadap
orang, tempat dan waktu<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Bicara dengan pasien, dengan tenang,
gunakan kalimat sederhana<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Berikan pengamanan di sisi tempat tidur<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">e.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Gangguan eliminasi urine : inkontinensia
yang berhubungan dengan hilangnya kemampuan kontrol eliminasi urin sekunder
pada gangguan motor saraf unilateral.<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tujuan : Klien dapat mengontrol
pengeluaran urine (Marion Johnson, 2000)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kriteria hasil (Marion Johnson, 2000)<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 432px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.35pt;" width="180"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">Indikator<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">1<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">2<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">3<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">4<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">5<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.35pt;" valign="top" width="180"><div class="MsoSubtitle" style="margin-left: 25.5pt; text-indent: -25.5pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Mengenal
sensasi BAK yang urgen<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 25.5pt; text-indent: -25.5pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">memperkirakan
pola BAK <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 25.5pt; text-indent: -25.5pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Berespon
waktu atau kebiasaan untuk Bak <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 25.5pt; text-indent: -25.5pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Bebas
urine tertahan diantara berkemih <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify;">
<span lang="EN-US">Ket:<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tidak pernah bisa melakukan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Jarang bisa melakukan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kadang bisa melakukan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sering bisa melakukan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Selalu bisa melakukan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Intervensi (Joanne Mc.Closkey, 1996)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Monitor dan catat inkontinensia urine<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tawarkan urinal, bila mungkin ke kamar
mandi setiap 2 – 3 jam <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Ajarkan dan anjurkan pasien melakukan
latihan parineal : dengan cara menahan kemih dan mengeluarkan kembali pada
pertengahan berkemih, meregangkan dan melemaskan otot-otot untuk memperbaiki
tonus spinchter uretra<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Atur agar intake cairan lebih sedikit
pada sore hari untuk mengurangi kemungkinan inkontinensia pada malam hari<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">e)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Anjurkan pasien menghindari minum-minuman
yang mengandung kafein (kafein adalah sejenis diuretic)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">f)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Konsultasikan ke dokter, bila memerlukan
pemasangan DC<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">f.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kerusakan mobilitas fisik yang
berhubungan dengan adanya kelemahan parestesia, kelumpuhan flacsial, hipotonik,
kelumpuhan spastik<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 120pt; text-align: justify; text-indent: -72pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Tujuan
: Mobilitas fisik klien tidak tergantung setelah dilakukan tindakan keperawatan
(Marion Johnson, 2000)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kriteria hasil (Marion Johnson, 2000)<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 432px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.35pt;" width="180"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">Indikator<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">1<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">2<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">3<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">4<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">5<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 135.35pt;" valign="top" width="180"><div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Menjaga keseimbangan tubuh <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Menjaga posisi tubuh <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Pergerakan otot (ekstremitas) <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Pergerakan sendi (ekstremitas)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Ambulasi jalan <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify;">
<span lang="EN-US">Ket:<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tergantung penuh<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Butuh bantuan orang lain dan alat <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Butuh bantuan orang lain <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Butuh bantuan alat <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Mandiri <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Intervensi (Joanne Mc.Closkey, 1996)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kaji tingkat kemampuan dalam melakukan
aktivitas tiap hari<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Observasi keadaan integritas kulit<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Lakukan alih baring tiap 2 – 4 jam<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Anjurkan klien untuk melakukan aktivitas
sesuai kemampuannya<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">e)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kolaborasi dengan fisioterapi <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 54pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">g.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kerusakan komunikasi verbal yang
berhubungan dengan gangguan sirkulasi cerebral, gangguan saraf dan otot,
kehilangan otot wajah / mulut umumnya karena kelemahan, kelelahan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 126pt; text-align: justify; text-indent: -72pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tujuan : Komunikasi klien tidak terganggu
setelah dilakukan tindakan keperawatan (Marion Johnson, 2000)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kriteria hasil (Marion Johnson, 2000)<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 448px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 147.15pt;" width="196"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">Indikator<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">1<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">2<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">3<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">4<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" width="50"><div class="MsoSubtitle" style="text-align: center;">
<span lang="EN-US">5<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 147.15pt;" valign="top" width="196"><div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Menggunakan bahasa tulisan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Menggunakan bahasa lisan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Menggunakan gambar <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Menggunakan bahasa non verbal <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 37.75pt;" valign="top" width="50"><div class="MsoSubtitle">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify;">
<span lang="EN-US">Ket: <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Tidak pernah sesuai harapan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Jarang sesuai harapan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kadang sesuai harapan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Sering sesuai harapan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Selalu sesuai harapan <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Intervensi (Joanne Mc.Closkey, 1996)<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">a)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Kaji tingkat ketidakmampuan pesan<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">b)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Dengarkan dengan seksama pembicaraan
pasien dari feed bed oleh perawat, arti kata-kata yang dimaksud <o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">c)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Libatkan keluarga untuk melatih bicara<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 90pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">d)<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Konsultasikan dengan speech terapi sesuai
indikasi<o:p></o:p></span></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">II.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Diabetes Mellitus<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l17 level2 lfo4; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">A.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pengertian</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 18.2pt 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diabetes mellitus (DM) adalah
gangguan metabolik yang dikarakteristikkan oleh hiperglikemia, dan diakibatkan
dari kerusakan produksi insulin (Sandra M. Nettina, 2002).</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 18.2pt 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diabetes mellitus adalah
keadaan hiperglikemia kronis yang disertai berbagai kelainan metabolik akibat
gangguan hormonal, yang menimbulkan berbagai komplikasi kronik pada mata,
ginjal, saraf, dan pembuluh darah, disertai lesi pada membran basalis dalam
pemeriksaan dengan mikroskop elektron (Arif Mansjoer, 1999). </span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; tab-stops: list 53.7pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l17 level2 lfo4; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">B.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Etiologi (Suddarth & Brunner,
2001) </span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Insulin dependent diabetes mellitus (IDDM) disebabkan
oleh destruksi sel β pulau langerhans akibat proses autoimun. Diabetes mellitus
tidak tergantung insulin (DM TTI) disebabkan kegagalan relatif sel β dan
resistensi insulin.</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Serangan autoimun pada DM tipe I dapat timbul setelah
infeksi virus misalnya gondongan (MUMPS), rubeia, sitomegali virus tronik atau
gotongan obat nitro samin yang terdapat pada daging yang diawetkan. Pada saat
diagnosis DM tipe I ditegakkan, ditemukan antibodi terhadap sel-sel pulau
langerhans pada sebagian besar pasien. Salah satu kemungkinan seseorang
membentuk antibodi terhadap sel-sel pulau langerhans adalah bahwa terdapat
suatu agen lingkungan yang secara antigens mengubah sel-sel pankreas untuk
merangsang pembentukan autoantobodi.</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">DM tipe II tampaknya berkaitan dengan kegemukan.
Selain itu pengaruh genetik yang menentukan kegemukan seseorang mengidap
penyakit ini, cukup kuat.</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l17 level2 lfo4; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">C.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Patofisiologis</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: 35.7pt;">
<span lang="EN-US">Hipoglikemia adalah glukosa darah yang kurang dari 50
mg/100 ml darah. Hipoglikemia dapat disebabkan oleh puasa, atau khususnya puasa
yang disertai olah raga, karena olah raga meningkatkan pemakaian glukosa oleh
sel-sel, otot rangka. Namun hipoglikemia lebih sering disebabkan oleh kebiasaan
dosis insulin pada pengidap diabetes dependen-insulin. Karena otak memerlukan
glukosa darah sebagai sumber energi utama. Maka hipoglikemia menyebabkan
timbulnya berbagai gejala gangguan fungsi susunan saraf pusat (SSP) berupa
konfusi, iritabilitas kejang dan koma. Hipoglikemia dapat menyebabkan nyeri
kepala, akibat perubahan aliran darah otak dan perubahan keseimbangan air.
Secara sistematis, hipoglikemia menyebabkan pengaktivan sistem saraf simpatis
yang merangsang rasa lapar, kegelisahan, berkeringat dan takikardia.</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Hiperglikemia didefinisikan sebagai kadar glukosa
darah yang tinggi dari pada rentang kadar puasa normal 80-90 ml/100 ml darah,
atau rentang nono puasa sekitar 140-160 mg/100 ml darah. Hiperglikemia biasanya
disebabkan oleh defisiensi insulin, seperti dijumpai pada diabetes tipe I, atau
karena penurunan responsivitas sel terhadap insulin, seperti dijumpai pada
diabetes tipe II hiperkortisolemia, yang terjadi pada sindrom cushing dan
sebagai respon terhadap stress kronik, dapat menyebabkan hiperglikemia melalui
perangsangan glukoneogenesis hati. Keadaan akut kelebihan hormon tiroid,
prolaktin, dan hormon pertumbuhan dapat menyebabkan peningkatan glukosa darah.
Peningkatan kadar hormon-hormon tersebut dalam jangka panjang, terutama hormon
pertumbuhan dianggap diabetogenik (menimbulkan diabetes). </span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Pengolahan bahan makan dimulai di mulut kemudian ke
lambung dan selanjutnya ke usus, didalam saluran pencernaan itu makan dipecah
menjadi bahan dasar dari makanan itu. Karbohidrat menjadi glukosa, protein
menjadi asam amino dan lemak menjadi asam lemak. Ketiga zat makanan itu akan
diserap oleh usus kemudian masuk kedalam pembuluh darah dan diedarkan ke
seluruh tubuh untuk dipergunakan oleh organ-organ didalam tubuh sebagai bahan
bakar. Supaya dapat berfungsi dengan bahan bakar, zat makanan itu harus masuk dulu
kedalam sel supaya dapat diolah. Didalam sel, zat makanan terutama glukosa
dibakar melalui proses kimia yang rumit, yang hasil akhirnya adalah timbulnya
energi. Proses ini disebut metabolisme. Dalam proses metabolisme itu insulin
memegang peran yang sangat penting yaitu bertugas memasukkan glukosa kedalam
sel, untuk selanjutnya dapat digunakan sebagai bahan bakar. Insulin ini adalah
suatu zat atau hormon yang dikeluarkan oleh sel beta di pankreas.</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pankreas</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Pankreas adalah sebuah kelenjar yang letaknya
dibelakang lambung. Didalamnya terdapat kumpulan sel yang berbentuk seperti
pulau pada beta, karena itu disebut pulau-pulau Langerhans yang berisi sel beta
yang mengeluarkan hormon insulin, yang sangat berperan dalam mengatur kadar
glukosa darah.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Kerja insulin</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Insulin yang dikeluarkan oleh sel beta tadi dapat
diibaratkan sebagai anak kunci yang dapat membuka pintu masuknya glukosa
kedalam sel, untuk kemudian didalam sel glukosa itu dimetabolisasikan menjadi
tenaga. Bila insul;in tidak ada, maka glukosa tak dapat masuk sel dengan akibat
glukosa akan tetap berada didalam pembuluh darah yang artinya kadarnya didalam
darah meningkat. Dalam keadaan seperti ini badan akan jadi lemah karena tidak
ada sumber energi didalam sel. Inilah yang terjadi pada diabetes mellitus tipe
I.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Pada diabetes mellitus tipe II jumlah insulin normal,
malah mungkin lebih banyak tetapi jumlah reseptor insulin yang terdapat pada
permukaan sel yang kurang. Reseptor insulin ini dapat diibaratkan sebagai
lubang kunci pintu masuk kedalam sel. Pada keadaan tadi jumlah lubang kuncinya
yang kurang, hingga meskipun anak kuncinya (insulin) banyak, tetapi karena
lubang kuncinya (reseptor) kurang, maka glukosa yang masuk sel akan sedikit,
sehingga sel akan kekurangan bahan bakar (glukosa) dan glukosa didalam pembuluh
darah meningkat. </span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Kadar gula yang tinggi dalam waktu yang lama
mengakibatkan gula darah pekat dan terjadi pengendapan yang menimbulkan
aterosklerosis sehingga meningkatkan tekanan darah/ hipertensi.</span></div>
<div class="MsoNormal" style="margin-left: 17.85pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l17 level2 lfo4; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">D.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Klasifikasi </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Menurut Tjokro Pawiro Askandar, (2001) klasifikasi
Diabetes mellitus terdiri dari: </span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diabetes mellitus tipe I (DM
tergantung insullin/ IDDM)</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Gambaran kliniknya biasanya timbul pada masa
kanak-kanak, tetapi ada juga yang timbul pada masa dewasa. </span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diabetes melitus tipe 2 (Tidak
tergantung insullin/ NIDDM) </span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Timbul makin sering setelah umur 40 tahun dengan
catatan pada dekade ke 7 kekerapatan diabetes mencapai 3 sampai 4 kali lebih
tinggi dari pada rata-rata orang dewasa. Pada keadaan dengan kadar glukosa
darah tidak terlalu tinggi atau belum ada komplikasi, biasanya pasien tidak berobat
ke rumah sakit atau dokter.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify; text-indent: 36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l17 level2 lfo4; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">E.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Tanda dan Gejala</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: .3pt;">
<span lang="EN-US">Menurut Arief Mansjoer, (1999) tanda dan gejala DM
terdiri dari: </span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Poliuri</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify;">
<span lang="EN-US">Ketika kadar glukosa darah meningkat ke tingkat pada saat jumlah
glukosa yang difiltrasi melebihi kapasitas. Sel-sel tubulus melakukan
reabsorbsi, glukosa akan timbul di urin (glukosuria), glukosa di urin
menimbulkan efek osmotik yang menarik H<sub>2</sub>O bersamanya menimbulkan
diuresis osmotik yang ditandai oleh poliuria.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Polidipsi</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify;">
<span lang="EN-US">Cairan yang berlebihan keluar dari tubuh menyebabkan dehidrasi, yang
pada gilirannya dapat menyebabkan tegangan sirkulasi perifer karena volume
cairan turun mencolok. Sehingga sel-sel kehilangan air karena tubuh mengalami
dehidrasi akibat perpindahan osmotik air dari dalam sel ke cairan ekstra sel
yang hipertonik. Rasa haus yang berlebih sebenarnya merupakan kompensasi untuk
mengatasi dehidrasi.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Polifagia</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify;">
<span lang="EN-US">Akibat penurunan penyerapan glukosa oleh sel-sel, disertai oleh
peningkatan pengeluaran glukosa oleh hati meningkat karena proses yang
menghasilkan glukosa yaitu glikogenolisis dan glikoneogenesis, berlangsung
tanpa hambatan karena insulin tidak ada, karena sebagian besar sel tubuh tidak
dapat menggunakan glukosa tanpa bantuan insulin, sehingga terjadi kelebihan
glukosa di ekstrasel sementara terjadi defisiensi glukosa intra sel akibatnya
nafsu makan meningkat.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify;">
<br /></div>
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<span lang="EN-US">F.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Komplikasi </span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify;">
<span lang="EN-US">Menurut Tjokro Pawiro Askandar, (2001) komplikasi DM terdiri dari: </span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Komplikasi akut</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Hipoglikemia</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diabetes Ketoasidosis</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Sindrom HHNIK (Koma
Hiperglikemik Hiperosmoler)</span></div>
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<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Komplikasi jangka panjang </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Komplikasi makrovaskuler</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penyakit arteri koroner</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penyakit serebrovaskuler</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penyakit vaskuler perifer</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Komplikasi Mikrovakuler</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Retinopati diabetik</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; text-align: justify;">
<span lang="EN-US">Kelainan patologis mata yang disebut retinopati diabetik disebabkan
oleh perubahan dalam pembuluh-pembuluh darah kecil pada retina mata.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Nefropati</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; text-align: justify;">
<span lang="EN-US">Bila kadar glukosa darah tinggi maka mekanisme filtrasi ginjal akan
mengalami stres yang menyebabkan kebocoran protein darah ke dalam urin. Sebagai
akibatnya, tekanan dalam pembuluh darah ginjal meningkat, kenaikan tekanan
tersebut diperkirakan berperan sebagai stimulus untuk terjadinya nefropati.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l17 level2 lfo4; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">G.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pemeriksaan Penunjang</span></div>
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<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pemeriksaan penunjang menurut
Donges, (2000) adalah sebagai berikut</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Glukosa darah : Meningkat 200-100
mg/dL atau lebih</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Aseton plasma (keton) : Positif
secara mencolok</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Asam lemak bebas : Kadar lipd
dan kolesterol meningkat</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Osmolalitas : Meningkat tetapi
biasanya kurang dari 330 mOsn/lt</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">e.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Elektrolit</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Natrium : Mungkin normal,
meningkat atau menurun</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Kalium : Normal atau
peningkatan semua (perpindahan selulosa) selanjutnya akan menurun</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Fosfor : lebih sering menurun</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">f.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Gas darah arteri. Biasanya
menunjukkan pH rendah dan penurunan pada HCO<sub>3</sub> (asidosis metabolik)
dengan kompensasi alkalosis respiratorik.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">g.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Trombosit darah. Ht mungkin
meningkat (dehidrasi) leukositosis hemokonsentrasi merupakan respons
terhadapstress atau infeksi.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">h.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Ureum/ kreatinin. Mungkin
meningkat atau normal (dehidrasi/ penurunan fungsi ginjal)</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">i.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Amilase darah. Mungkin
meningkat yang mengindikasikan adanya pakreatitis akut sebagai penyebab dari
DKA</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l17 level2 lfo4; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">H.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penatalaksanaan Medis (Askandar
Tjokro Pawiro, 2001) </span></div>
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<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diet</span></div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
<span lang="EN-US"> Penentuan jumlah kalori diet
diabetes disesuaikan dengan status gizi penderita. Penentuan gizi penderita
dilaksanakan dengan menghitung percentage of relative body weight (BBR : berat
badan relatif) dengan rumus:</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify;">
<span lang="EN-US"><span style="position: relative; top: 15pt;"><img height="45" src="file:///C:/Users/Toshiba/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_i1025" width="160" /></span> (BB = kg, TB : cm)</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l6 level1 lfo5; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Kurus (= BBR < 90%)</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l6 level1 lfo5; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Normal (ideal) : BBR 90-110%</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l6 level1 lfo5; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Gemuk : BBR > 110%</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l6 level1 lfo5; tab-stops: list 71.6pt left 240.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Obesitas, apabila BBR > 20%
: </span></div>
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<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Obesitas ringan 120-130%</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt left 240.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Obesitas ringan 130-140%</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt left 240.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Obesitas berat 140-200%</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt left 240.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Obesitas Morbid > 200%</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; text-align: justify;">
<span lang="EN-US">Dalam praktek, sebagai pedoman jumlah kalori yang diperlukan sehari
untuk penderita DM yang bekerja biasa adalah :</span></div>
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<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Kurus : BB x 40-60 kalori sehari</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt left 120.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Normal : BB x 30 kalori sehari</span></div>
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<span lang="EN-US">d.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Gemuk : BB x 20 kalori sehari</span></div>
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<span lang="EN-US">e.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Obesitas : BB x 10-15 kalori sehari</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Latihan Fisik</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Manfaat</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Meningkatkan kepekaan Insulin
apabila dikerjakan setiap 11/2 jam sesudah makan, berarti pula mengurangi
insulin resistance pada penderita dengan kegemukan atau menambah jumlah
reseptor insulin dan meningkatkan sensitivitas insulin dengan reseptornya.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Memperbaiki aliran darah
perifer dan menambah oxygen supply.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Menurunkan kolesterol dan
trigliserida dalam darah, karena pembakaran asam lemak menjadi lebih baik.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pemantauan </span></div>
<div class="MsoBodyTextIndent3" style="text-align: justify; text-indent: 30pt;">
<span lang="EN-US"> Pemantauan kadar glukosa
darah secara mandiri, dengan cara ini memungkinkan deteksi dan pencegahan
hipoglikemi dan hiperglikemi, dan berperan dalam menentukan kadar glukosa darah
normal yang kemungkinan akan mengurangi komplikasi diabetes jangka panjang.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l17 level3 lfo4; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pengobatan/ Terapi</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Golongan sulfonilurea</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Short acting: Tolbutamide,
Glycodiazine, Tolazamide mempunyai waktu paruh sekitar 4 jam, kerja cepat,
diberikan 1-3 kali sehari (pagi, siang, sore). Apabila pemberian cukup dua kali
sehari maka berikan pagi dan siang dan bila pemberiannya cukup sekali, berikan
pada pagi hari.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Intermediate</span></div>
<div class="MsoNormal" style="margin-left: 87.95pt; text-align: justify;">
<span lang="EN-US">Mempunyai waktu paruh antara 5-8 jam, diberikan 1-2 kali sehari
(pagi dan siang) jangan pagi dan malam. Apabila diberikan satu kali, maka
diberikan pada pagi hari saja.</span></div>
<div class="MsoNormal" style="margin-left: 87.95pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 88.5pt; text-align: justify;">
<span lang="EN-US">Contoh :</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l17 level6 lfo4; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Glibenclamide (Euglocon,
Daonil)</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l17 level6 lfo4; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Gliclazide (Diamicron)</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l17 level6 lfo4; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Gliquidone (Glurenorm)</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Long acting</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; text-align: justify;">
<span lang="EN-US">Mempunyai waktu paruh antara 24-36 jam, diberikan sekali saja setiap
pagi.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; text-align: justify;">
<span lang="EN-US">Contoh : Chlorpropamide.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Golongan Biguanide</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Obat ini hanya dapat digunakan jika masih terdapat insulin.
biguanide tidak memberikan efek-efek pada sel beta pankreas.</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Contoh: Metformin (Glucophage)</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Arkbose (Cepobay)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Diberikan bersamaan dengan suap pertama tiap makan, umumnya 3x1
tablet/ hari.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Repaglinide (Novonorm)</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Diberikan setiap sebelum makan utama.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l17 level4 lfo4; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">e.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Insulin</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Short acting insulin</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; text-align: justify;">
<span lang="EN-US">Contoh: insulin reguler (yang ditandai “R” pada botolnya) </span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; text-align: justify;">
<span lang="EN-US">Awitan kerja human insulin regular adalah ½ hingga 1 jam, puncaknya
2 hingga 3 jam durasi kerjanya 4 hingga 6 jam. Insulin reguler diberikan 20-30
menit sebelum makan.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Intermediate acting insulin</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l17 level6 lfo4; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">NPH insulin (neutral protamine
Hagedorn) </span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l17 level6 lfo4; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Lente Insulin (L)</span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span lang="EN-US">Awitan kerja human insulin intermediate acting adalah 3 hingga 4 jam
puncaknya 4 hingga 12 jam durasi kerjanya 16-12 jam, biasanya diberikan sesudah
makan.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l17 level5 lfo4; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Long acting insulin</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l17 level6 lfo4; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Ultralente insulin (UL)</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; text-align: justify;">
<span lang="EN-US">Awitan kerja long acting human insulin adalah 6-8 jam, puncaknya
12-16 jam durasi 20-30 jam. Insulin long acting kadang-kadang disebut sebagai
insulin durasi 20-30 jam. Insulin long acting kadang-kadang disebut sebagai
insulin tanpa puncak kerja karena preparat ini cenderung memiliki kerja yang
panjang, perlahan dan bertahan. Long acting insulin ini digunakan terutama
untuk mengendalikan kadar glukosa darah puasa.</span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 114.0pt; text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="margin-left: 18pt; text-align: justify; text-indent: -18pt;">
<span lang="EN-US">III.<span style="font-size: 7pt;"> </span></span><span lang="EN-US">Hipertensi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l11 level2 lfo6; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">A.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Definisi</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Hipertensi adalah tekanan
sistolik lebih tinggi dari 140 mmHg menetap atau tekanan diastolic > 90
mmHg. Diagnosis dipastikan dengan mengukur rata-rata dua atau lebih pengukiran
tekanan darah pada waktu yang terpisah (Engram, 1998).</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Hipertensi adalah tekanan darah
persisten dimana tekanan sistoliknya diatas 140 mmHg dan tekanan diastolnya
diatas 90 mmHg (Brunner and Suddarth, 2001).</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Hipertensi adalah peningkatan
sistole, yang tingginya tergantung umur individu yang terkena. Tekanan darah
berfluktuasi dalam batas-batas tertentu, tergantung posisi tubuh, umur dan
tingkat stress yang dialami (Tamboyong,
2000).</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l11 level2 lfo6; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">B.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Etiologi (Sjaifoellah Noer,
2001) </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span lang="EN-US">Berdasarkan penyebabnya hipertensi dibagi menjadi dua :</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Hipertensi Esensial</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span lang="EN-US">Yaitu hipertensi yang belum diketahui penyebabnya dan meliputi 90 %
dari seluruh penderita hipertensi, faktor-faktor yang mempengaruhi antara lain </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Genetik</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Peran faktor genetik terhadap hipertensi esensial dibuktikan bahwa
kejadian hipertensi lebih banyak dijumpai pada penderita kembar monozigot dari
pada heterozigot, apabila salah satu diantara menderita hipertensi. Pada 70 %
kasus hipertensi esensial didapatkan riwayat hipertensi esensial.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Usia</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Insiden hipertensi makin meningkat dengan meningkatnya usia.
Hipertensi pada yang berusia kurang dari 35 tahun dengan jelas menaikkan
insiden penyakit arteri koroner dan kematian prematur.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Obesitas</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Adanya penumpukan lemak terutama pada pembuluh darah mengakibatkan
penurunan tahanan perifer sehingga meningkatkan aktivitas saraf simpatik yang
mengakibatkan peningkatan vasokontriksi dan penurunan vasodilatasi dimana hal
tersebut dapat merangsang medula adrenal untuk mensekresi epinerpin dan
norepineprin yang dapat menyebabkan hipertensi.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Hiperkolesterol</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Lemak pada berbagai proses akan menyebabkan pembentukan plaque pada
pembuluh darah. Pengembangan ini menyebabkan penyempitan dan pengerasan yang
disebut aterosklerosis.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">e.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Asupan Natrium meningkat
(keseimbangan natrium) </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Kerusakan ekskresi natrium ginjal merupakan perubahan pertama yang
ditemukan pada proses terjadinya HT. Retensi Na<sup>+</sup> diikuti dengan
ekspansi volume darah dan kemudian peningkatan output jantung. Autoregulasi
perifer meningkatkan resistensi pembuluh darah perifer dan berakhir dengan HT.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">f.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Rokok</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Asap rokok mengandung nikotin yang memacu pengeluaran adrenalin yang
merangsang denyutan jantung dan tekanan darah. Selain itu asap rokok mengandung
karbon monoksida yang memiliki kemampuan lebih kuat dari pada Hb dalam menarik
oksigen. Sehingga jaringan kekurangan oksigen termasuk ke jantung.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">g.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Alkohol</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Penggunaan alkohol atau etanol jangka panjang dapat menyebabkan
peningkatan lipogenesis (terjadi hiperlipidemia) sintesis kolesterol dari
asetil ko enzim A, perubahan seklerosis dan fibrosis dalam arteri kecil.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">h.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Obat-obatan tertentu atau pil
anti hamil</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Pil anti hamil mengandung hormon estrogen yang juga bersifat retensi
garam dan air, serta dapat menaikkan kolesterol darah dan gula darah.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">i.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Stres psikologis</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Stres dapat memicu pengeluaran hormon adrenalin dan katekolamin yang
tinggi, yang bersifat memperberat kerjaya arteri koroner sehingga suplay darah
ke otot jantung terganggu.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Stres dapat mengaktifkan saraf simpatis yang dapat meningkatkan
tekanan darah secara intermiten.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Hipertensi sekunder</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; text-align: justify;">
<span lang="EN-US">Disebabkan oleh penyakit tertentu, misalnya :</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penyakit ginjal</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Kerusakan pada ginjal menyebabkan renin oleh sel-sel juxtaglomerular
keluar, mengakibatkan pengeluaran angiostensin II yang berpengaruh terhadap
sekresi aldosteron yang dapat meretensi Na dan air.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diabetes Mellitus</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Disebabkan oleh kadar gula yang tinggi dalam waktu yang sama
mengakibatkan gula darah pekat dan terjadi pengendapan yang menimbulkan
arterosklerosis meningkatkan tekanan darah.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l11 level2 lfo6; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">C.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Klasifikasi</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; tab-stops: list 108.0pt left 141.6pt; text-align: justify;">
<span lang="EN-US">Klasifikasi Stadium hipertensi Menurut Sjaifoellah Noer, (2001)
terdiri dari: </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt left 141.6pt list 144.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Stadium 1 (ringan) </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; tab-stops: 141.6pt; text-align: justify;">
<span lang="EN-US">Tekanan sistolik antara 140 – 159 mmHg. Tekanan
diastolik antara 90-99 mmHg. </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt left 141.6pt list 144.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Stadium 2 (sedang). </span></div>
<div class="MsoBodyTextIndent3" style="margin-left: 71.45pt; text-align: justify; text-indent: 0cm;">
<span lang="EN-US">Tekanan sistolik antara 160 – 179 mmHg.
Tekanan diastolik antara 100 – 109 mmHg. </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt left 141.6pt list 144.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Stadium 3 (berat) </span></div>
<div class="MsoBodyTextIndent3" style="margin-left: 71.45pt; text-align: justify; text-indent: 0cm;">
<span lang="EN-US">Tekanan sistolik antara 180 – 209 mmHg.
Tekanan diastolik antara 110 – 119 mmHg. </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt left 141.6pt list 144.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Stadium 4 (sangat berat) </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Tekanan sistolik lebih atau sama dengan 210 mmHg. Tekanan diastolik
antara <u>></u> 120 mmHg.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Klasifikasi ini tidak untuk seseorang yang memakai obat
antihipertensi dan tidak sedang sakit akut. Apabila tekanan sistolik dan
diastolik terdapat pada kategori yang berbeda. Maka harus dipilih kategori yang
tinggi untuk mengklasifikasi status tekanan darah seseorang. </span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; tab-stops: 141.6pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l11 level2 lfo6; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">D.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Tanda dan Gejala</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Menurut Tambayong (2000) gejala dan tanda dapat dikarakteristikkan
sebagai berikut :</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Sakit kepala</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Nyeri atau berat di tengkuk</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Sukar tidur</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Mudah lelah dan marah</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Tinnitus</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">6.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Mata berkunang-kunang</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">7.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Epistaksis</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">8.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Gemetar</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">9.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Nadi cepat setelah aktivitas</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">10.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Sesak napas</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">11.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Mual, muntah</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l11 level2 lfo6; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">E.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Komplikasi</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Komplikasi yang mungkin terjadi pada hipertensi adalah
sebagai berikut : </span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Payah jantung (gagal jantung)</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pendarahan otak (stroke)</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Hipertensi maligna : kelainan
retina, ginjal dan cerabrol</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Hipertensi ensefalopati :
komplikasi hipertensi maligma dengan gangguan otak.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt 143.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Infark miokardium </span></div>
<div class="MsoNormal" style="margin-left: 53.55pt; text-align: justify;">
<span lang="EN-US">Dapat terjadi apabila arteri koroner yang arterosklerotik tidak
dapat menyuplai cukup oksigen kemiokardium atau apabila terbentuk trombus yang
menghambat aliran darah melalui pembuluh darah tersebut.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt 143.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">6.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Gagal ginjal</span></div>
<div class="MsoNormal" style="margin-left: 53.55pt; text-align: justify;">
<span lang="EN-US">Karena kerusakan progresif akibat tekanan tinggi pada
kapiler-kapiler ginjal, glomerulus. Dengan rusaknya glomerulus darah akan
mengalir ke unit-unit fungsional ginjal. Nefron terganggu dan dapat berlanjut
menjadi hipoksia dan kemataian. Dengan rusaknya membran glomerulus,proteinakan
keluar melalui urin sehingga tekanan osmotik koloid plasma
berkurang,menyebabkan edema,yang sering dijumpai pada hipertensi kronik.</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l11 level2 lfo6; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">F.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pemeriksaan Penunjang</span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US">Pemeriksaan penunjang yang dapat digunakan untuk
menegakkan diagnosa hipertensi menurut Doenges (2000) antara lain :</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">EKG : Hipertropi ventrikel kiri
pada keadaan kronis lanjut.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Kalium dalan serum : meningkat
dari ambang normal.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pemeriksaan gula darah post
prandial jika ada indikasi DM.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Urine :</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Ureum, kreatinin : meningkat
pada keadaan kronis dan lanjut dari ambang normal.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Protein urine : positif</span></div>
<div class="MsoNormal" style="margin-left: 17.85pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l11 level2 lfo6; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">G.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penatalaksanaan </span></div>
<div class="MsoNormal" style="margin-left: 35.7pt; text-align: justify;">
<span lang="EN-US">Menurut Engram (1999), penatalaksanaanya antara lain :</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pengobatan hipertensi sekunder
mendahulukan pengobatan kausal.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pengobatan hipertensi esensial
ditujukan untuk menurunkan tekanan darah dengan obat hipertensi.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pengobatan hipertensi adalah
pengobatan jangka panjang bahkan seumur hidup.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pengobatan dengan menggunakan
standar triple therapy (STT) terdiri dari:</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diuretik, misalnya : tiazid,
furosemid, hidroklorotiazid.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Betablocker : metildopa,
reserpin.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Vasodilator : dioksid,
pranosin, hidralasin.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Angiotensin, Converting Enzyme
Inhibitor.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Modifikasi gaya hidup, dengan :</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penurunan berat badan.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pengurangan asupan alkohol. </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Aktivitas fisik teratur.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pengurangan masukan natrium.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">e.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penghentian rokok.</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.7pt; mso-list: l11 level2 lfo6; tab-stops: list 35.85pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">H.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Nursing Care Plan </span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pengkajian data dasar (Doenges,
2000) </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diabetes Mellitus</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Aktivitas</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Lemah, letih, sulit
bergerak/berjalan. Kram otot, tonus otot menurun, gangguan tidur/istirahat.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Takirkadia dan takipnea pada
keadaan istirahat atau dengan aktivitas.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Sirkulasi</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Adanya riwayat hipertensi.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Takikardia.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Perubahan tekanan darah
posturral, hipertensi.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Nadi yang menurun/tak ada.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Disritmia.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Integritas ego</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Stress, tergantung pada orang
lain.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Ansietas, peka rangsang.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Eliminasi </span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Perubahan pola berkemih
(poliuria), nokturia.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Rasa nyeri/terbakar, kesulitan
berkemih (infeksi), ISK baru/berulang.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Nyeri tekan abdomen.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Diare.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Makanan/cairan</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Hilang nafsu makan</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Mual/muntah</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Tidak mengikuti<span style="letter-spacing: -0.1pt;"> diet ; peningkatan masukan glukosa/karbohidrat.</span></span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Haus</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Kulit kering, turgor jelek</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Ketakutan/distensi abdomen,
muntah.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Pembesaran tiroid (peningkatan
kebutuhan metabolik dengan peningkatan gula darah)</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Bau halitosis/manis, bau buah
(napas aseton).</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">6)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Neurosensori</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Pusing/pening</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Sakit kepala</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Kesemutan, kebas kelemahan pada
otot, parastesia.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Gangguan penglihatan.</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Disorientasi; mengantuk</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">7)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Nyeri</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Abdomen yang tegang/nyeri
(sedang/berat).</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Wajah meringis dengan
palpitasi; tampak sangat berhati-hati.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">8)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pernapasan</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; text-align: justify;">
<span lang="EN-US">Merasa kekurangan oksigen, batuk dengan/tanpa sputum purulen
(tergantung adanya infeksi/tidak)</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">9)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Seksualitas</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Rabas vagina (cenderung
infeksi).</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Masalah impoten pada pria,
kesulitan orgasme pada wanita.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt left 134.1pt 142.5pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Hipertensi </span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt left 174.0pt 186.0pt; text-align: justify; text-indent: -114.55pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Aktivitas : lemah,
letih, lesu, takipnea, peningkatan HR, perubahan irama jantung.</span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt left 174.0pt 186.0pt; text-align: justify; text-indent: -114.55pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Sirkulasi : riwayat
hipertensi, palpitasi, kenaikan TD perubahan warna kulit, suhu dingin, pucat,
sianosis, diaporesis.</span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt left 174.0pt 186.0pt; text-align: justify; text-indent: -114.55pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Integritas ego : ansietas,
depresi, marah, gelisah, otot muka tegang, peningkatan pola bicara.</span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt left 174.0pt 186.0pt; text-align: justify; text-indent: -114.55pt;">
<span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Makanan/cairan : mual/muntah,
BB normal/obesitas, edema.</span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt left 174.0pt 186.0pt; text-align: justify; text-indent: -114.55pt;">
<span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Neurosensori : pusing,
sakit kepala, gangguan penglihatan, epistaksis.</span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt left 174.0pt 186.0pt; text-align: justify; text-indent: -114.55pt;">
<span lang="EN-US">6)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Nyeri : angina,
nyeri hilang timbul pada tungkai, sakit kepala, nyeri abdomen.</span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt left 174.0pt 186.0pt; text-align: justify; text-indent: -114.55pt;">
<span lang="EN-US">7)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Pernapasan : dispnea
takipnea, riwayat merokok, bunyi nafas tambahan.</span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt left 174.0pt 186.0pt; text-align: justify; text-indent: -114.55pt;">
<span lang="EN-US">8)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Eliminasi : gangguan
gunjal saat ini atau yang lalu.</span></div>
<div class="MsoNormal" style="margin-left: 186.0pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt left 174.0pt 186.0pt; text-align: justify; text-indent: -114.55pt;">
<span lang="EN-US">9)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Keamanan : gangguan
koordinasi, hipotensi postural.</span></div>
<div class="MsoNormal" style="margin-left: 53.6pt; mso-list: l11 level3 lfo6; tab-stops: list 53.7pt; text-align: justify; text-indent: -17.9pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diagnosa keperawatan </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">a.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Intoleransi aktivitas yang
berhubungan dengan kelemahan</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Tujuan :</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Klien dapat toleransi terhadap aktivitas setelah dilakukan tindakan
keperawatan selama 3x24 jam kriteria</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Kriteria Hasil :</span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 70.85pt; text-align: justify; width: 438px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Indikator
</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Berat
</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Agak
berat </span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Sedang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Agak
ringan </span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Ringan
</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">HR DBN dalam
respon terhadap aktivitas</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">RR DBN dalam
respon aktivitas</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">TD sistolik
dalam aktivitas</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">TD diastolik
dalam aktivitas</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Warna kulit</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Melaporkan
pelaksanaan ADL</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="margin-left: 12.15pt; text-indent: -12.15pt;">
<span lang="EN-US">Fase berjalan </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal">
<span lang="EN-US">Toleransi menapak lantai</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Kemampuan
untuk berbicara saat latihan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="margin-left: 12.15pt; text-indent: -12.15pt;">
<span lang="EN-US">Jarak berjalan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 121.55pt;" valign="top" width="162"><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 11.45pt; margin-right: -5.4pt; margin-top: 0cm; text-indent: -11.45pt;">
<span lang="EN-US">Kekuatan </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 36.8pt;" valign="top" width="49"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 46.15pt;" valign="top" width="62"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.5pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span lang="EN-US">Intervensi</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Mengidentifikasi faktor
penyebab intoleransi aktivitas faktor fisik atau psikologis</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Kaji kemampuan aktivitas klien
setiap hari secara tepat.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Lakukan alih baring secara
bertahap dan teratur</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Monitor dan catat kemampuan
untuk mentoleransi aktivitas meliputi nadi, TD, RR, warna kulit sebelum dan
selama aktivitas.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Anjurkan klien untuk
menghentikan aktivitas bila ada keluhan: rasa tidak nyaman yang semakin hebat,
rasa tertekan atau berat pada dada, punggung, leher, palpitasi, pusing.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">6)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Kolaborasi dengan ahli gizi
untuk menentukan kebutuhan kalori.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">7)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Berikan tambahan O<sub>2</sub>
bila diperlukan</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">b.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Kekurangan volume cairan yang
berhubungan dengan kehilangan volume cairan secara aktif.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Tujuan :</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Status cairan : intake cairan dapat adekuat setelah dilakukan
tindakan keperawatan selama 3 x 24 jam</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Kriteria hasil:</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 496px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; page-break-inside: avoid;">
<td rowspan="2" style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" width="169"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Indikator</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 54.2pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Tercapai</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.75pt;" width="60"><div class="MsoBodyText">
<span lang="EN-US">Sering</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 52.5pt;" width="70"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Kadang-kadang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.8pt;" width="60"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Jarang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 49.25pt;" width="66"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Tak
tercapai</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1; page-break-inside: avoid;">
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 54.2pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.75pt;" width="60"><div class="MsoBodyText">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 52.5pt;" width="70"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.8pt;" width="60"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 49.25pt;" width="66"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Vital sign DBN</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">24 jam intake
dan output seimbang</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 54.2pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.75pt;" width="60"><div class="MsoBodyText">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 52.5pt;" width="70"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.8pt;" width="60"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 49.25pt;" width="66"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Hidrasi kulit
DBN</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 54.2pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.75pt;" width="60"><div class="MsoBodyText">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 52.5pt;" width="70"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.8pt;" width="60"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 49.25pt;" width="66"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Membran mukosa
lembab</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 54.2pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.75pt;" width="60"><div class="MsoBodyText">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 52.5pt;" width="70"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.8pt;" width="60"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 49.25pt;" width="66"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Hematokrit
dalam batas normal (36-42 vol%)</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 54.2pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.75pt;" width="60"><div class="MsoBodyText">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 52.5pt;" width="70"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.8pt;" width="60"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 49.25pt;" width="66"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Berat badan
stabil</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 54.2pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.75pt;" width="60"><div class="MsoBodyText">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 52.5pt;" width="70"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.8pt;" width="60"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 49.25pt;" width="66"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Asites tidak
ada</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 54.2pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.75pt;" width="60"><div class="MsoBodyText">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 52.5pt;" width="70"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.8pt;" width="60"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 49.25pt;" width="66"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Oedem perifer
tidak ada</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 54.2pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.75pt;" width="60"><div class="MsoBodyText">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 52.5pt;" width="70"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.8pt;" width="60"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 49.25pt;" width="66"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Mata tidak
cowong</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 54.2pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.75pt;" width="60"><div class="MsoBodyText">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 52.5pt;" width="70"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 44.8pt;" width="60"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 49.25pt;" width="66"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Management cairan</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor vital sign / 4 jam</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Berikan terapi cairan infus
sesuai terapi</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor status hidrasi</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor laboratory (HCT)</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Monitor cairan</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Kaji intake dan out put</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Observasi warna, kualitas dari
urine</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor membran mukosa, turgor
kulit</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">c.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Ketidakseimbangan nutrisi lebih
dari kebutuhan tubuh ybd intake yang berlebih</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Tujuan :</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Status nutrisi: Intake makanan dan output seimbang setelah dilakukan
tindakan perawatan selama 3 x 24 jam</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Kriteria :</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 493px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; page-break-inside: avoid;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" width="169"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Indikator</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Tak
adequat</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" width="64"><div class="MsoBodyText">
<span lang="EN-US">Kurang adequat </span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Kadang-kadang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Sering</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Sangat
adequat</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l22 level1 lfo7; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Intake makanan oral DBN</span></div>
<div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l22 level1 lfo7; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Intake cairan oral DBN</span></div>
<div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l22 level1 lfo7; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Monitor BB</span></div>
<div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l22 level1 lfo7; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Nutrisi suplement yang
dibutuhkan</span></div>
<div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l22 level1 lfo7; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Melaporkan tanda dan gejala
ketidakseimbangan cairan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Monitoring Nutrisi</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor BB</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor turgor kulit</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor untuk mual dan muntah</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor HCT</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor cairan elektrolit </span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Sediakan nutrisi makanan dan
cairan</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Berikan makanan kesukaan dan
yang dipilih sesuai terapi</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Monitor cairan</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor BB</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor intake dan output</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor vital sign</span></div>
<div class="MsoNormal" style="margin-left: 107.15pt; mso-list: l11 level6 lfo6; tab-stops: list 107.3pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US" style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span lang="EN-US">Monitor membran mukosa, turgor
kulit</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">d.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Nyeri akut ybd agen injuri
biologi</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Tujuan: Klien mampu mentoleransi level nyerinya </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Kriteria :</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 52.15pt; text-align: justify; width: 493px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; page-break-inside: avoid;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" width="169"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Indikator</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Selalu
</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" width="64"><div class="MsoBodyText">
<span lang="EN-US">Sering</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Kadang-kadang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Jarang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Tidak
pernah</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Melaporkan
nyeri</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Frekuensi
terhadap nyeri</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Lamanya nyeri</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Ekspresi wajah
nyeri</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menjaga daerah
nyeri</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menyebutkan
faktor penyebab</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menggunakan
tindakan non analgetik</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menggunakan
tindakan pencegahan </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Melaporkan
gejala pada tim kesehatan </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Berkeringat
saat nyeri</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Intervensi :</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Kaji ulang secara komprehensif
meliputi lokasi, karakteristik, durasi frekuensi, skala nyeri dan faktor
pencetus.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Observasi tanda-tanda vital.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Beri posisi yang nyaman pada
klien.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Ajarkan teknik relaksasi napas
dalam </span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Anjurkan penggunaan cara
mengontrol nyeri</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">6)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Laksanakan terapi analgetik.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">e.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Gangguan pola tidur yang
berhubungan dengan sering terbangun </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Tujuan : Kebutuhan tidur klien terpenuhi setelah dilakukan tindakan
keperawatan selama 3 x 24 jam.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Kriteria :</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 493px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; page-break-inside: avoid;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" width="169"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Indikator</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Selalu adequat</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" width="64"><div class="MsoBodyText">
<span lang="EN-US">Agak adequat </span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Kadang-kadang
adequat </span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Jarang
adequat</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Tidak
pernah adequat</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Jumlah jam
tidur</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Kualitas tidur</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Sering
terbangun</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Perasaan segar
setelah bangun tidur</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Keefektifan
tidur</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menunjukkan
gangguan tidur</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menunjukkan
tidur yang rutin</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Terjaga
beberapa waktu</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Observasi pola
tidur</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US"> </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">f.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Perfusi jaringan otak tidak
efektif yang berhubungan dengan perlemahan alirah darah</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Tujuan :</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Perfusi jaringan otak klien efektif setelah dilakukan tindakan
keperawatan selama 3 x 24 jam.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Kriteria :</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 483px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; page-break-inside: avoid;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" width="142"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Indikator</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Sangat
kompromi</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" width="58"><div class="MsoBodyText">
<span lang="EN-US">Sering </span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Kadang-kadang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Sedikit
</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Tidak
</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" valign="top" width="142"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Tidak pusing</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" valign="top" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" valign="top" width="58"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" valign="top" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" valign="top" width="142"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Tidak mual</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" valign="top" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" valign="top" width="58"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" valign="top" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" valign="top" width="142"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Tidak pingsan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" valign="top" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" valign="top" width="58"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" valign="top" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" valign="top" width="142"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">TIK dalam
batas normal</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" valign="top" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" valign="top" width="58"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" valign="top" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" valign="top" width="142"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Fungsi
neurologi</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" valign="top" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" valign="top" width="58"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" valign="top" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" valign="top" width="142"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Tidak muncul
bruit karotis </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" valign="top" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" valign="top" width="58"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" valign="top" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" valign="top" width="142"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Tidak muncul
kelemahan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" valign="top" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" valign="top" width="58"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" valign="top" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" valign="top" width="142"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Tidak muncul
kecemasan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" valign="top" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" valign="top" width="58"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" valign="top" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" valign="top" width="142"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Tidak muncul
agitasi</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" valign="top" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" valign="top" width="58"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" valign="top" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.5pt;" valign="top" width="142"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Tidak ada lesu
yang dirasakan </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 61.5pt;" valign="top" width="82"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.45pt;" valign="top" width="58"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.4pt;" valign="top" width="65"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Intervensi :</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Monitor keadaan umum klien dan
respon terhadap aktivitas </span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Observasi TTV</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Berikan O<sub>2</sub> sesuai
program </span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Posisikan kepala 30<sup>o</sup>.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Laksanakan terapi dokter.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">g.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Resiko untuk jatuh yang
berhubungan dengan perubahan fungsi cerebral.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Tujuan : </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Resiko jatuh klien dapat diminimalkan setelah dilakukan tindakan
keperawatan selama 3 x 24 jam.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Kriteria :</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 493px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; page-break-inside: avoid;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" width="169"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Indikator</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Tidak
pernah diperlihatkan </span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" width="64"><div class="MsoBodyText">
<span lang="EN-US">Jarang </span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Kadang-kadang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Sering</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Selalu
</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Ketidak-tahuan
resiko jatuh</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Monitor
keadaan lingkungan beresiko</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Tingkatkan
kontrol resiko efektif</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Sarankan
kontrol resiko yang dibutuhkan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Pertahankan
strategi kontrol resiko</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Modifikasi
gaya hidup</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Gunakan
layanan perawatan kesehatan yang optimal</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Gunakan
komunikasi untuk mengontrol resiko</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Monitor
perubahan status kesehatan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Intervensi :</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Identifikasi faktor penyebab
jatuh klien.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Anjurkan klien untuk meminta
bantuan bila akan beraktifitas </span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Monitor kelelahan klien dengan
ambulasi</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Libatkan keluarga untuk
membantu kebutuhan klien.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">h.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Resiko infeksi yang berhubungan
dengan tidak adekuat pertahanan sekunder terhadap penekanan respon inflamasi</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Tujuan : Resiko infeksi dapat diminimalkan setelah dilakukan
tindakan keperawatan selama 3 x 24 jam.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Kriteria :</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 493px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; page-break-inside: avoid;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" width="169"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Indikator</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Berat</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" width="64"><div class="MsoBodyText">
<span lang="EN-US">Agak berat</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Kadang-kadang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Jarang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Tidak
pernah</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menunjukkan
penyebaran infeksi</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">infeksi </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menunjukkan
penambahan penularan</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menunjukkan
tanda dan gejala infeksi</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menunjukkan
peningkatan aktifitas resisten terhadap infeksi</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menunjukkan
prosedur screening </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US">Menunjukkan
praktek untuk mengurangi transmisi</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.0pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.25pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.9pt;" valign="top" width="72"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 42.7pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 48.3pt;" valign="top" width="64"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Intervensi :</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Observasi tanda-tanda vital.</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Observasi tanda dan gejala
infeksi baik lokal dan sistemik</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Jelaskan pada keluarga tentang
tanda-tanda infeksi</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Anjurkan makan-makanan yang
tinggi protein</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Beri terapi antibiotik sesuai
advis dokter</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; mso-list: l11 level4 lfo6; tab-stops: list 71.6pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">i.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Defisit pengetahuan tentang
proses penyakit dan penatalaksanaannya yang berhubungan dengan kurangnya
informasi</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Tujuan : </span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Pengetahuan kognitif : Pemahaman klien bertambah tentang proses
penyakit DM dan penatalaksanaannya setelah dilakukan penkes selama 20 menit.</span></div>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Kriteria :</span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 77.4pt; text-align: justify; width: 476px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; page-break-inside: avoid;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" width="169"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Indikator</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.0pt;" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Tidak</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.4pt;" width="71"><div class="MsoBodyText">
<span lang="EN-US">Terbatas </span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 47.35pt;" width="63"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Sedang</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Cukup</span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.3pt;" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">Luas
</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 126.5pt;" valign="top" width="169"><div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l18 level1 lfo8; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Definisi DM</span></div>
<div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l18 level1 lfo8; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Penyebab DM</span></div>
<div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l18 level1 lfo8; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Tanda dan gejala DM </span></div>
<div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l18 level1 lfo8; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">4.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Komplikasi DM</span></div>
<div class="MsoNormal" style="margin-left: 17.85pt; mso-list: l18 level1 lfo8; tab-stops: list 18.0pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">5.<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Menjelaskan penatalaksanaan
DM</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 43.0pt;" valign="top" width="57"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 53.4pt;" valign="top" width="71"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 47.35pt;" valign="top" width="63"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 45.5pt;" valign="top" width="61"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 41.3pt;" valign="top" width="55"><div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="EN-US">5</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 71.45pt; text-align: justify;">
<span lang="EN-US">Intervensi :</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">1)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Kaji tingkat pengetahuan klien
dan keluarga </span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">2)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Berikan informasi tentang DM</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">3)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Deskripsikan secara umum tanda
gejala DM</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">4)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Identifikasi penyebab DM</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">5)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Diskusikan penatalaksanaan DM</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">6)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Deskripsikan kemungkinan
komplikasi DM</span></div>
<div class="MsoNormal" style="margin-left: 89.3pt; mso-list: l11 level5 lfo6; tab-stops: list 89.45pt; text-align: justify; text-indent: -17.85pt;">
<span lang="EN-US">7)<span style="font-size: 7pt;">
</span></span><span lang="EN-US">Berikan kesempatan pada klien
dan keluarga untuk bertanya</span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify; text-indent: 34.5pt;">
<br /></div>
<b></b><br />
<div style="text-align: justify;">
<b><span style="font-family: 'Times New Roman', serif;"><br /></span></b></div>
<b>
</b>
<br />
<div class="MsoNormal" style="text-align: center;">
<b><span lang="EN-US">DAFTAR
PUSTAKA</span></b><b><span lang="EN-US" style="font-size: 14pt;"><o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: center;">
<span style="position: relative; z-index: 251681792;"><span style="height: 40px; left: 504px; position: absolute; top: -100px; width: 44px;">
</span></span></div>
<table cellpadding="0" cellspacing="0" style="text-align: justify;">
<tbody>
<tr>
<td bgcolor="white" height="40" style="background: white; vertical-align: top;" width="44"><span style="left: 0pt; position: absolute; z-index: 251681792;">
</span><br />
<table cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td><div class="shape" style="padding: 3.6pt 7.2pt 3.6pt 7.2pt;" v:shape="_x0000_s1073">
<div class="MsoNormal">
<br /></div>
</div>
</td>
</tr>
</tbody></table>
<span style="left: 0pt; position: absolute; z-index: 251681792;">
</span> </td>
</tr>
</tbody></table>
<b></b><br />
<div style="text-align: justify;">
</div>
<br />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Brunner & Suddarth. 2001. <i>Buku Ajar
Keperawatan Medikal Bedah</i>”, Edisi 8, Vol 2, Jakarta: EGC</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Doenges Marilynn E., et. al. 2000. <i>Rencana Asuhan
Keperawatan</i>, Jakarta: EGC</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Engram, Barbara. 1999. <i>Rencana Asuhan Keperawatan
Medikal Bedah</i>, Vol 2, Jakarta: EGC</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Underwood, J. C. E. 2000. <i>Patologi Umum dan
Sistematik</i>. Volume II. Jakarta: EGC</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Iskandar, Junaidi. 2002. <i>Panduan Praktis Stroke</i>.
PT. Buana Ilmu Populer. Jakarta. </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Mansjoer Arif et. al. 1999. <i>Kapita Selekta
Kedokteran</i>. Edisi 3. Jilid I. Jakarta: Media Aesculapius</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Noer Sjaifoellah. 2002. <i>Ilmu Penyakit Dalam</i>. Edisi
3. Jilid I. Jakarta: FKUI</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Nanda. 2002. <i>Diagnosis Keperawatan Nanda</i>.
Terjemahan Mahasiswa PSIK-B FK UGM. Yogyakarta: UGM </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Nettina Sandra. M. 2002. <i>Pedoman Praktek
Keperawatan</i>. Jakarta : EGC</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Iowa Outcome Project. 2000. <i>Nursing Outcomes
Clasification</i> (NOC). Second edition. Mosby</span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Iowa Outcome Project. 2000. <i>Nursing Intervention
Clasification</i> (NIC). Second edition. Mosby </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Soeharso Imam, 2001. <i>Penyakit Jantung Koroner dan
Serangan Jantung</i>, Edisi Kedua Jakarta: PT. Gramedia Pustaka Utama</span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Sustiani, Lanny, Syamsir Alam dan Iwan Hadibroto. 2003.
<i>Stroke</i>. Jakarta ; PT. Gramedia Pustaka Utama. </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Tambayong Jon. 2000. “<i>Patofisiologi Untuk
Keperawatan</i>”, Jakarta, EGC </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: -36.0pt;">
<span lang="EN-US">Tjokropawiro, Askandar. 2001. <i>Diabetes Melitus,
Klasifikasi, Diagnosis dan Terapi</i>. Edisi 3. Jakarta: PT Gramedia Pustaka
Utama.</span></div>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-88388069933646263952013-01-03T02:16:00.000-08:002013-01-03T02:16:16.020-08:00Rencana Keperawatan Benigna Prostat Hyperplasia ( BPH )<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="MsoNormal" style="margin-left: 0.25in; text-align: justify;">
<b>Rencana Keperawatan Benigna Prostat Hyperplasia ( BPH )<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: .25in;">
<b><br /></b></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 191; width: 951px;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 25.5pt;" valign="top" width="34">
<div align="center" class="MsoNormal" style="text-align: center;">
<b>No<o:p></o:p></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 105.9pt;" valign="top" width="141">
<div align="center" class="MsoNormal" style="text-align: center;">
<b>DX Keperawatan<o:p></o:p></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 171.0pt;" valign="top" width="228">
<div align="center" class="MsoNormal" style="text-align: center;">
<b>Tujuan<o:p></o:p></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 3.75in;" valign="top" width="360">
<div align="center" class="MsoNormal" style="text-align: center;">
<b>Intervensi<o:p></o:p></b></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 140.8pt;" valign="top" width="188">
<div align="center" class="MsoNormal" style="text-align: center;">
<b>Rasionalisasi<o:p></o:p></b></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 25.5pt;" valign="top" width="34">
<div class="MsoNormal">
<b>1.<o:p></o:p></b></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 105.9pt;" valign="top" width="141">
<div class="MsoNormal">
<b>Nyeri akut</b></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal">
<span lang="SV">Setelah dilakukan tindakan keperawatan
selama 3x24 jam pasien mampu menunjukkan :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.05in;">
<span lang="SV"> -
Tingkat nyeri<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 0in;">
<span lang="SV"> -
Nyeri terkontrol<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2" style="margin-left: 0.05in;">
<span lang="SV"> - Tingkat kenyamanan<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 3.75in;" valign="top" width="360">
<div class="MsoNormal" style="margin-left: 12.6pt; mso-list: l2 level1 lfo1; tab-stops: list 12.6pt; text-indent: -.25in;">
<!--[if !supportLists]--><b><span style="font-size: 11.0pt; line-height: 150%;">1.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></span></b><!--[endif]--><b><span style="font-size: 11.0pt; line-height: 150%;">Manajemen nyeri<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Kaji keluhan nyeri,
lokasi, karakteristik, onset/durasi, frekuensi, kualitas, dan beratnya nyeri.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span style="font-family: "Courier New"; font-size: 11.0pt; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 11.0pt;">Observasi
respon ketidaknyamanan secara verbal dan non verbal.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Pastikan pasien
menerima perawatan analgetik dengan tepat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Gunakan strategi
komunikasi yang efektif untuk mengetahui respon penerimaan pasien terhadap
nyeri.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span style="font-family: "Courier New"; font-size: 11.0pt; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 11.0pt;">Evaluasi
keefektifan penggunaan kontrol nyeri <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Monitoring perubahan
nyeri baik aktual maupun potensial.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span style="font-family: "Courier New"; font-size: 11.0pt; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 11.0pt;">Sediakan
lingkungan yang nyaman.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Kurangi faktor-faktor
yang dapat menambah ungkapan nyeri.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Ajarkan penggunaan
tehnik relaksasi sebelum atau sesudah nyeri berlangsung .<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Kolaborasi dengan tim
kesehatan lain untuk memilih tindakan selain obat untuk meringankan nyeri.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.45pt; text-indent: -12.45pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Tingkatkan istirahat
yang adekuat untuk meringankan nyeri.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo1; tab-stops: list 9.7pt; text-indent: -.5in;">
<!--[if !supportLists]--><b><span style="font-size: 11.0pt; line-height: 150%;">2.<span style="font-size: 7pt; font-weight: normal; line-height: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 11.0pt; line-height: 150%;"> Manajemen pengobatan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.7pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Tentukan obat yang dibutuhkan pasien dan cara mengelola
sesuai dengan anjuran/ dosis.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Pasien mampu mengelola obat sendiri.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.7pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Monitor efek teraupetik dari pengobatan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.7pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Monitor tanda dan gejala serta efek samping dari obat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.7pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 11.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 11.0pt;">Monitor interaksi obat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.7pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Ajarkan pasien dan keluarga cara mengelola pengobatan
yang tepat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.7pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Ajarkan pada pasien dan keluarga cara mengatasi efek
samping pengobatan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.7pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Jelaskan manfaat pengobatan yang dapat mempengaruhi
gaya hidup pasien.<o:p></o:p></span></div>
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<b><span style="font-size: 11.0pt; line-height: 150%;">3. Pengelolaan analgetik <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Wingdings 2"; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Wingdings 2"; mso-fareast-font-family: "Wingdings 2";">â</span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Periksa perintah medis tentang
obat, dosis dan frekuensi obat analgetik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span style="font-family: "Wingdings 2"; font-size: 11.0pt; mso-bidi-font-family: "Wingdings 2"; mso-fareast-font-family: "Wingdings 2";">â</span><!--[endif]--><span style="font-size: 11.0pt;">Periksa riwayat alergi pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Wingdings 2"; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Wingdings 2"; mso-fareast-font-family: "Wingdings 2";">â</span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Pilih obat berdasarkan tipe dan
beratnya nyeri.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Wingdings 2"; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Wingdings 2"; mso-fareast-font-family: "Wingdings 2";">â</span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Pilih cara pemberian IV atau IM
untuk pengobatan, jika mungkin.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span style="font-family: "Wingdings 2"; font-size: 11.0pt; mso-bidi-font-family: "Wingdings 2"; mso-fareast-font-family: "Wingdings 2";">â</span><!--[endif]--><span style="font-size: 11.0pt;">Monitor vital sign sebelum dan sesudah pemberian
analgetik. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Wingdings 2"; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Wingdings 2"; mso-fareast-font-family: "Wingdings 2";">â</span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Kelola jadwal pemberian
analgetik yang sesuai. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Wingdings 2"; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Wingdings 2"; mso-fareast-font-family: "Wingdings 2";">â</span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Evaluasi efektifitas dosis
analgetik dan observasi tanda dan gejala dari efek samping, misal depresi
pernafasan, mual dan muntah, mulut kering, dan konstipasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Wingdings 2"; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Wingdings 2"; mso-fareast-font-family: "Wingdings 2";">â</span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Kolaborasi dengan dokter untuk
obat, dosis dan cara pemberian yang diindikasikan.</span></div>
<a name='more'></a><o:p></o:p><br />
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<br /></div>
</td>
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<br /></div>
</td>
</tr>
<tr>
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<b><span lang="SV">2.<o:p></o:p></span></b></div>
</td>
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<b><span lang="SV">Resiko
infeksi<o:p></o:p></span></b></div>
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<span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Pasien menunjukkan kontrol terhadap resiko
setelah dilakukan perawatan 3x24 jam dengan indikator :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Bebas dari tanda dan gejala infeksi.<o:p></o:p></span></div>
<div align="left" class="MsoNormal" style="margin-left: 0.25in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Mampu menjelaskan tanda dan gejala infeksi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Leukosit dalam batas normal<o:p></o:p></span></div>
<div align="left" class="MsoNormal" style="margin-left: 0.25in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Tanda vital dalam batas normal<o:p></o:p></span></div>
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<br /></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 3.75in;" valign="top" width="360">
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<b><span lang="SV" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: SV;">1.Infection Control<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Terapkan pencegahan universal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Berikan hiegine yang baik lingkungan atau personal<o:p></o:p></span></div>
<div align="left" class="MsoNormal" style="margin-left: 0.25in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Batasi jumlah pengunjung dan anjurkan cuci tangan
ketika kontak dengan klien<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Lakukan dresing pada IV line dan Kateter<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Tingkatkan intake nutrisi dan istirahat yang cukup<o:p></o:p></span></div>
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<b><span lang="SV" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: SV;">2. Infection Protection<o:p></o:p></span></b></div>
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</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Monitor tanda dan gejala infeksi lokal/sistemik<o:p></o:p></span></div>
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</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Pantau hasil pemeriksaan laboratorium yang
mengindikasikan infeksi (WBC)<o:p></o:p></span></div>
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</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Amati faktor2 yang dapat meningkatkan infeksi<o:p></o:p></span></div>
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</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Observasi area invasive<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Pertahankan tekhnik aseptic dalam perawatan klien<o:p></o:p></span></div>
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<b><span lang="SV" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: SV;">3. Monitor Vital Sign</span></b><span lang="SV" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: SV;"><o:p></o:p></span></div>
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</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Pantau suhu tubuh setiap 8 jam<o:p></o:p></span></div>
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<b><span lang="SV" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: SV;">4. Enviroment management<o:p></o:p></span></b></div>
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</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Batasi pengunjung yang sedang demam/influensa/sakit
infeksi<o:p></o:p></span></div>
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<b><span lang="SV" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: SV;">5. Health education<o:p></o:p></span></b></div>
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</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Jelaskan mengapa sakit dan pengobatan meningkatkan
resiko infeksi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Anjurkan untuk menjaga kesehatan personal untuk
melindungi dari infeksi<o:p></o:p></span></div>
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</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Ajarkan metode aman untuk pengamanan/penyiapan makanan<o:p></o:p></span></div>
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</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Pengendalian infeksi : Ajarkan tekhnik cuci tangan<o:p></o:p></span></div>
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</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Ajarkan tanda2 infeksi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Anjurkan untuk lapor perawat/dokter bila dirasakan
muncul tanda2 infeksi<o:p></o:p></span></div>
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<b><span lang="SV" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: SV;">6. Medication Administration<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Kelola Therapi sesuai advis<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Pantau efektifitas, keluhan yang muncul pasca pemberian
antibiotik <o:p></o:p></span></div>
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<span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Cegah infeksi, melindungi dari resiko terjadinya
infeksi<o:p></o:p></span></div>
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<span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Dengan HE dharapka pasien dan keluarga tahu hal2
yang dapat beresiko mendatangkan infeksi</span><b><span lang="SV"><o:p></o:p></span></b></div>
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<b><span lang="SV" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: SV;">3<o:p></o:p></span></b></div>
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<span lang="IN" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Cemas <o:p></o:p></span></div>
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<span lang="IN" style="font-size: 11.0pt; mso-ansi-language: IN;">Setelah dilakukan perawatan selama 3x24 jam cemas berkurang atau hilang<o:p></o:p></span></div>
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<span lang="IN" style="font-size: 11.0pt; mso-ansi-language: IN;">Dengan kriteria :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; mso-ansi-language: IN;">-<span style="font-size: 7pt;"> </span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; mso-ansi-language: IN;">keluarga dapat
mengekspresikan secara verbal perasaannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; mso-ansi-language: IN;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; mso-ansi-language: IN;">keluarga optimis terhadap kesembuhan klien<o:p></o:p></span></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 98.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 3.75in;" valign="top" width="360">
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</span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; mso-ansi-language: IN;">Kaji perasaan keluarga dan beri perasaan empati serta
dengarkan seluruh keluhan<o:p></o:p></span></div>
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</span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; mso-ansi-language: IN;">Berikan penjelasan kepada keluarga mengenai kondisi, ,
rencana keperawatan dan prognosa klien secara akurat dan mempertahankan
kondisi serta situasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="IN" style="font-size: 11.0pt; mso-ansi-language: IN;">-<span style="font-size: 7pt;"> </span></span><!--[endif]--><span lang="IN" style="font-size: 11.0pt; mso-ansi-language: IN;">Libatkan keluarga dalam
pertemuan tim kesehatan terutama
dalam pengambilan keputusan dan perencanaan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Gunakan pendekatan
dengan ketenangan dan ketentraman.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Jelaskan tingkah laku
yang di harapkan.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Anjurkan pasien untuk
mengerti situasi yang terjadi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Sediakan informasi yang
mudah dimengerti tentang diagnosa, tindakan dan prognosis.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Marlett; font-size: 11.0pt; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 11.0pt;">Anjurkan aktivitas yang biasa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Jaga tindakan yang
diluar kemampuan pasien.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Marlett; font-size: 11.0pt; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 11.0pt;">Dengarkan dengan penuh perhatian.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Beri pujian pada
tingkah laku yang positif.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Ciptakan lingkungan
yang penuh kenyamanan.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Anjurkan pasien untuk
mengungkapkan secara verbal rasa takutnya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span style="font-family: Marlett; font-size: 11.0pt; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 11.0pt;">Identifikasi tingkat perubahan kecemasan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Support pasien dalam
menggunakan mekanisme pertahanan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Kaji kemampuan pasien
dalam mengambil tindakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Anjurkan pasien untuk
menggunakan tehnik relaksasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Marlett; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Marlett; mso-fareast-font-family: Marlett;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Kelola pengobatan untuk
menurunkan kecemasan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 42pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-weight: bold;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;"> </span></b></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 98.35pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 140.8pt;" valign="top" width="188">
<div class="MsoNormal">
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</td>
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<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 25.5pt;" valign="top" width="34">
<div class="MsoNormal">
<b><span lang="SV" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: SV;">4.<o:p></o:p></span></b></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 105.9pt;" valign="top" width="141">
<div class="MsoNormal">
<b><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Kurang pengetahuan<o:p></o:p></span></b></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 171.0pt;" valign="top" width="228">
<div class="MsoNormal">
<span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Setelah tindakan keperawatan 3x 24 jam pasien
dan keluarga mampu :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 12.6pt; text-indent: -12.6pt;">
<span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">a.mengetahui
tentang proses penyakit<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="SV">b</span><span lang="SV" style="font-size: 11.0pt; line-height: 150%; mso-ansi-language: SV;">.
mengetahui cara perawatan</span><span lang="SV"><o:p></o:p></span></div>
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<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 3.75in;" valign="top" width="360">
<div class="MsoNormal" style="margin-left: 0.3in; text-indent: -0.3in;">
<!--[if !supportLists]--><span style="font-family: "Courier New"; font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 11.0pt;">Mengajarkan proses penyakit.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 0.25in; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Kaji tingkat pengetahuan dalam menilai proses penyakit <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.25in; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Berikan penjelasan pada pasien tentang penyakitnya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.25in; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Terangkan tanda dan gejala yang biasa muncul pada
penyakit tersebut.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.25in; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Sediakan informasi tentang kondisi pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.25in; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 11.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 11.0pt;">Hindari harapan yang kosong.<o:p></o:p></span></div>
<div align="left" class="MsoNormal" style="margin-left: 0.25in; text-align: left; text-indent: -0.25in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: Symbol; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">©<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Diskusikan tentang
perubahan gaya hidup sehingga dapat mencegah komplikasi dan dapat mengontrol
proses penyakit.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.3in; text-indent: -0.3in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-bidi-font-weight: bold; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Diskusikan tentang tindakan yang dipilih<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l3 level1 lfo12; tab-stops: list 12.6pt; text-indent: -1.0in;">
<!--[if !supportLists]--><span style="font-family: "Courier New"; mso-bidi-font-weight: bold; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b>Mengajarkan
prosedur perawatan<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 0.3in; text-indent: -0.3in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Beritahu pasien dan
keluarga tentang kapan dan dimana prosedur/ tindakan akan dilakukan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.3in; text-indent: -0.3in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Beritahu pasien dan
keluarga tentang berapa lama prosedur/ tindakan dilakukan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.3in; text-indent: -0.3in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Beritahu pasien dan
keluarga tentang siapa yang akan melakukan prosedur.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.3in; text-indent: -0.3in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Jelaskan tentang tujuan
dilakukan tindakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.3in; text-indent: -0.3in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Beri gambaran aktivitas
sebelum prosedur/ tindakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.3in; text-indent: -0.3in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Anjurkan pasien untuk
bekerjasama dalam prosedur/ tindakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.3in; text-indent: -0.3in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Perkenalkan tim yang
terlibat dalam prosedur/ tindakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.3in; text-indent: -0.3in;">
<!--[if !supportLists]--><span lang="SV" style="font-family: "Courier New"; font-size: 11.0pt; mso-ansi-language: SV; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV" style="font-size: 11.0pt; mso-ansi-language: SV;">Sediakan waktu untuk
pasien bertanya.<o:p></o:p></span></div>
<div align="left" class="MsoNormal" style="margin-left: 0.3in; text-align: left; text-indent: -0.3in;">
<!--[if !supportLists]--><span style="font-family: "Courier New"; font-size: 11.0pt; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 11.0pt;">Libatkan
keluarga dalam perawatan.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 140.8pt;" valign="top" width="188">
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</td>
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</tbody></table>
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Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-59711278929051290732013-01-03T02:11:00.000-08:002013-01-03T02:11:15.924-08:00BENIGNA PROSTAT HYPERPLASIA (BPH)<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="MsoNormal" style="text-align: center;">
<b><span lang="SV">BENIGNA PROSTAT HYPERPLASIA</span></b></div>
<div class="MsoNormal" style="text-align: center;">
<b><span lang="SV">(BPH)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="SV">a. Pengertian
BPH<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="margin-left: 12pt; text-align: justify;">
<span lang="SV"> Adalah
hiperplasia kelenjar periuretra yang mendesak jaringan prostat yang asli ke
perifer dan menjadi kapsul bedah. (Anonim FK UI 1995).<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="text-align: justify;">
<span lang="SV"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 60pt; text-align: justify; text-indent: -60pt;">
<b><span lang="SV">b.Patofisiologi<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent3" style="margin-left: 12pt; text-align: justify;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;"> Proses pembesaran prostat terjadi secara
perlahan-lahan sehingga perubahan pada saluran kemih juga terjadi secara
perlahan-lahan. Pada tahap awal setelah terjadinya pembesaran prostat,
resistensi pada leher buli-buli dan daerah prostat meningkat, serta otot
destrusor menebal dan merenggang sehingga timbul sakulasi atau divertikel. Fase
penebalan destrusor ini disebut fase kompensasi. Apabila keadaan berlanjut,
maka destrusor menjadi lelah dan akhirnya mengalami dekompensasi dan tidak
mampu lagi untuk berkontraksi sehingga terjadi retensio urin yang selanjutnya
dapat menyebabkan hidronefrosis dan disfungsi saluran kemih atas.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 60pt; text-align: justify; text-indent: -60pt;">
<b><span lang="SV">c. Etiologi<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent3" style="margin-left: 12pt; text-align: justify;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;"> Penyebab secara pasti belum diketahui,
namun terdapat faktor resiko umur dan hormon androgen. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 60pt; text-align: justify; text-indent: -60pt;">
<b><span lang="SV">d. Gambaran klinis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 12pt; text-align: justify;">
<span lang="SV"> Gejala-gejala pembesaran
prostat jinak dikenal sebagai <i>Lower Urinary Tract Symptoms</i> (LUTS),yang
dibedakan menjadi: <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 30pt; text-align: justify; text-indent: -0.25in;">
<span lang="SV">1). Gejala iritatif, yaitu sering miksi
(frekuensi), terbangun pada malam hari untuk miksi (<i>nokturia</i>),perasaan
ingin miksi yang sangat mendesak (<i>urgensi</i>),dan nyeri pada saat miksi (<i>disuria).</i><o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 30pt; text-align: justify; text-indent: -0.25in;">
<span lang="SV">2). Gejala
obstruktif adalah pancaran melemah, rasa tidak puas setelah miksi, kalau mau
miksi harus menunggu lama<i>,</i> harus mengedan,kencing terputus-putus,dan
waktu miksi memanjang yang akhirnya menjadi retensi urin dan inkontinen karena <i>overflow.</i></span></div>
<a name='more'></a>
<o:p></o:p><br />
<div class="MsoNormal" style="margin-left: 60pt; text-align: justify; text-indent: -60pt;">
<b><span lang="SV">e. Pemeriksaan
penunjang<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify; text-indent: -12pt;">
<span lang="SV">1).Pemeriksaan
laboratorium<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 24pt; text-align: justify; text-indent: -12pt;">
<span lang="SV"> Analisis urin dan pemeriksaan mikroskopik
urin, elektrolit, kadar ureum kreatinin. Bila perlu <i>Prostate Spesific
Antigen</i> (PSA), untuk dasar penentuan biopsi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify; text-indent: -12pt;">
<span lang="SV">2).Pemeriksaan
radiologis<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 24pt; text-align: justify; text-indent: -12pt;">
<span lang="SV"> Foto polos abdomen, USG, BNO-IVP, Systocopy,
dan Cystografi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 60pt; text-align: justify; text-indent: -60pt;">
<b>f. Penatalaksanaan<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 1in; text-align: justify; text-indent: -60pt;">
<!--[if !supportLists]-->1)<span style="font-size: 7pt;">
</span><!--[endif]-->Terapi medikamentosa</div>
<div class="MsoNormal" style="margin-left: 66pt; text-align: justify; text-indent: -24pt;">
<!--[if !supportLists]--><span lang="SV">a)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV">Penghambat
andrenergik </span><span style="font-family: "UniversalMath1 BT"; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: "UniversalMath1 BT";">a</span><span lang="SV">, misalnya prazosin, doxazosin, alfluzosin atau </span><span style="font-family: "UniversalMath1 BT"; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: "UniversalMath1 BT";">a</span><span lang="SV"> 1a (tamsulosin).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 66pt; text-align: justify; text-indent: -24pt;">
<!--[if !supportLists]--><span lang="SV">b)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV">Penghambat
enzim 5-</span><span style="font-family: "UniversalMath1 BT"; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: "UniversalMath1 BT";">a</span><span lang="SV">-reduktase, misalnya finasteride (Poscar)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 66pt; text-align: justify; text-indent: -24pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;">
</span><!--[endif]-->Fitoterapi, misalnya eviprostat</div>
<div class="MsoNormal" style="margin-left: 1in; text-align: justify; text-indent: -60pt;">
<!--[if !supportLists]-->2)<span style="font-size: 7pt;">
</span><!--[endif]-->Terapi bedah</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify;">
<span lang="SV">Waktu penanganan untuk tiap pasien bervariasi tergantung beratnya gejala
dan komplikasi. </span>Indikasi terapi bedah yaitu :</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;"> </span><!--[endif]-->Retensio
urin berulang</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;"> </span><!--[endif]-->Hematuria</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;"> </span><!--[endif]-->Tanda
penurunan fungsi ginjal</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]-->d)<span style="font-size: 7pt;"> </span><!--[endif]-->Infeksi
saluran kencing berulang</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]--><span lang="SV">e)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="SV">Tanda-tanda
obstruksi berat yaitu divertikel,hidroureter, dan hidronefrosis.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]-->f)<span style="font-size: 7pt;"> </span><!--[endif]--><st1:city w:st="on">Ada</st1:city> batu saluran kemih.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b>1. Prostatektomi<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 0.25in; text-align: justify;">
<b><span lang="SV"> a. Prostatektomi Supra pubis. <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 0.5in; text-align: justify;">
<span lang="SV">
Adalah salah satu metode mengangkat kelenjar melalui insisi abdomen.
Yaitu suatu insisi yang dibuat kedalam kandung kemih dan kelenjar prostat
diangkat dari atas. <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="SV"> b. Prostatektomi Perineal.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 0.5in; text-align: justify;">
<span lang="SV"> Adalah mengangkat kelenjar
melalui suatu insisi dalam perineum. Cara ini lebih praktis dibanding cara yang
lain, dan sangat berguna untuk biopsi terbuka. Lebih jauh lagi inkontinensia,
impotensi, atau cedera rectal dapat mungkin terjadi dari cara ini. Kerugian lain adalah
kemungkinan kerusakan pada rectum dan spingter eksternal serta bidang operatif terbatas.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="SV">
c. Prostatektomi retropubik.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 0.5in; text-align: justify;">
<span lang="SV"> Adalah insisi abdomen lebih
rendah mendekati kelenjar prostat, yaitu antara arkus pubis dan kandung kemih tanpa memasuki kandung
kemih. Keuntungannya adalah periode pemulihan lebih singkat serta kerusakan
spingter kandung kemih lebih sedikit. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="SV">2. Insisi
Prostat Transuretral ( TUIP ).<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;">
<span lang="SV">
Yaitu suatu prosedur menangani
BPH dengan cara memasukkan instrumen melalui uretra. Satu atau dua buah insisi
dibuat pada prostat dan kapsul prostat untuk mengurangi tekanan prostat pada
uretra dan mengurangi kontriksi uretral. Cara ini diindikasikan ketika kelenjar
prostat berukuran kecil ( 30 gram/kurang ) dan efektif dalam mengobati banyak
kasus BPH. Cara ini dapat dilakukan di
klinik rawat jalan dan mempunyai angka komplikasi lebih rendah di banding cara
lainnya. <o:p></o:p></span></div>
<h4 style="margin-bottom: 0.0001pt; margin-left: 36.85pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -36.85pt;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">3. TURP
( TransUretral Reseksi Prostat )<o:p></o:p></span></h4>
<div class="MsoNormal" style="margin-left: 0.25in; text-align: justify;">
<span lang="SV"> TURP
adalah suatu operasi pengangkatan jaringan prostat lewat uretra menggunakan
resektroskop, dimana resektroskop merupakan endoskop dengan tabung 10-3-F untuk
pembedahan uretra yang dilengkapi dengan alat pemotong dan counter yang
disambungkan dengan arus listrik. Tindakan ini memerlukan pembiusan umum maupun
spinal dan merupakan tindakan invasive yang masih dianggap aman dan tingkat
morbiditas minimal.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.25in; text-align: justify;">
<span lang="SV"> TURP merupakan operasi tertutup tanpa insisi
serta tidak mempunyai efek merugikan terhadap potensi kesembuhan. Operasi ini
dilakukan pada prostat yang mengalami pembesaran antara 30-60 gram, kemudian
dilakukan reseksi. Cairan irigasi digunakan secara terus-menerus dengan cairan
isotonis selama prosedur. Setelah dilakukan reseksi, penyembuhan terjadi dengan
granulasi dan reepitelisasi uretra pars prostatika (Anonim,FK UI,1995).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0.25in; text-align: justify;">
<span lang="SV"> Setelah dilakukan TURP, dipasang kateter Foley
tiga saluran no. 24 yang dilengkapi balon 30 ml, untuk memperlancar pembuangan
gumpalan darah dari kandung kemih. Irigasi kanding kemih yang konstan dilakukan
setelah 24 jam bila tidak keluar bekuan darah lagi. Kemudian kateter dibilas
tiap 4 jam sampai cairan jernih. Kateter dingkat setelah 3-5 hari setelah
operasi dan pasien harus sudah dapat berkemih dengan lancar.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;"> TURP masih merupakan standar emas.
Indikasi TURP ialah gejala-gejala dari sedang sampai berat, volume prostat
kurang dari 60 gram dan pasien cukup sehat untuk menjalani operasi. Komplikasi
TURP jangka pendek adalah perdarahan, infeksi, hiponatremia atau retensio oleh
karena bekuan darah. Sedangkan komplikasi jangka panjang adalah striktura
uretra, ejakulasi retrograd (50-90%), impotensi (4-40%). Karena pembedahan
tidak mengobati penyebab BPH, maka biasanya penyakit ini akan timbul kembali
8-10 tahun kemudian.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
<br /></div>
<div class="MsoBodyTextIndent3" style="margin-left: 0in; text-align: justify;">
<b><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">g. Komplikasi<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
<b><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">
</span></b><span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Komplikasi yang dapat terjadi adalah :<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">- perdarahan,
<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">- pembentukan
bekuan, <o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">- obstruksi
kateter <o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">- serta
disfungsi seksual tergantung dari jenis pembedahan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
<span lang="SV" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: SV;">Komplikasi yang lain yaitu perubahan anatomis pada
uretra posterior menyebabkan ejakulasi retrogard. <o:p></o:p></span></div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 60pt; text-align: center;">
<b><span lang="SV">ASUHAN KEPERAWATAN.<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="margin-left: 24pt; text-align: justify;">
<b><span lang="SV">Diagnosa keperawatan<o:p></o:p></span></b></div>
<div class="MsoBodyTextIndent" style="margin-left: 39.7pt; text-align: justify; text-indent: 17pt;">
<span lang="SV"> Diagnosa keperawatan yang dapat muncul pada
pasien BPH dengan menggunakan diagnosa NANDA antara lain adalah<b>:<o:p></o:p></b></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; text-align: justify; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="SV">1)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV">Nyeri akut
berhubungan dengan kerusakan jaringan <o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; text-align: justify; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="SV">2)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV">Resiko infeksi berhubungan dengan
pertahanan primer yang tidak adekuat.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; text-align: justify; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="SV">3)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV">Cemas berhubungan dengan perubahan status
kesehatan.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; text-align: justify; text-indent: -19.85pt;">
<!--[if !supportLists]--><span lang="SV">4)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span lang="SV">Kurang pengetahuan berhubungan dengan
keterbatasan pemahaman tentang proses penyakit. <o:p></o:p></span></div>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-83149492396778134862013-01-03T02:08:00.000-08:002013-01-03T02:08:29.130-08:00Benign Prostatic Hyperplasia<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="Section1">
<div class="MsoNormal" style="text-align: center;">
<b>Benign Prostatic Hyperplasia<o:p></o:p></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><br /></b></div>
<div class="MsoNormal" style="text-align: justify;">
Benign Prostatic Hyperplasia adalah pembesaran jinak
kelenjar prostat, disebabkan oleh karena hiperplasia beberapa atau semua
komponen prostat meliputi jaringan kelenjar/jaringan fibromuskuler yang
menyebabkan penyumbatan uretra pars prostatika (Lab/UPF Ilmu Bedah RSUD Dr
Soetomo, 1994 : 193).</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="text-align: justify;">
Etiologi/Penyebabnya</div>
<div class="MsoNormal" style="text-align: justify;">
Penyebab yang pasti dari terjadinya<b> </b>Benign Prostatic
Hyperplasia sampai sekarang belum diketahui secara pasti, tetapi hanya 2 faktor
yang mempengaruhi terjadinya Benign Prostatic Hyperplasia yaitu <u>testis</u>
dan <u>usia lanjut</u>.</div>
<div class="MsoNormal" style="text-align: justify;">
Karena etiologi yang
belum jelas maka melahirkan beberapa hipotesa yang diduga timbulnya Benign
Prostatic Hyperplasia antara lain :<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Hipotesis Dihidrotestosteron (DHT)</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Peningkatan 5 alfa reduktase dan
reseptor androgen akan menyebabkan epitel dan stroma dari kelenjar
prostatmengalami hiperplasia.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Ketidak seimbangan estrogen – testoteron</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Dengan meningkatnya usia pada
pria terjadi peningkatan hormon Estrogen dan penurunan testosteron sedangkan
estradiol tetap. yang dapat menyebabkan terjadinya hyperplasia stroma.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Interaksi stroma - epitel </div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Peningkatan epidermal gorwth
faktor atau fibroblas gorwth faktor dan penurunan transforming gorwth faktor
beta menyebabkan hiperplasia stroma dan epitel.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Penurunan sel yang mati</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Estrogen yang meningkat
menyebabkan peningkatan lama hidup stroma dan epitel dari kelenjar prostat.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Teori stem cell</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Sel stem yang meningkat mengakibatkan
proliferasi sel transit.</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
(Roger Kirby, 1994 : 38).</div>
<div class="MsoSubtitle" style="text-align: justify;">
Anatomi Dan Fisiologi
Prostat<o:p></o:p></div>
<div class="MsoNormal" style="text-align: justify;">
Kelenjar prostat terletak di bawah kandung kemih dan
mengelilingi / mengitari uretra posterior dan disebelah proximalnya berhubungan
dengan buli-buli, sedangkan bagian distalnya kelenjar prostat ini menempel pada
diafragma urogenital yang sering disebut sebagai otot dasar panggul. Kelenjar
ini pada laki-laki dewasa kurang lebih sebesar buah kemiri atau jeruk nipis.
Ukuran, panjangnya sekitar 4 - 6 cm, lebar 3 - 4 cm, dan tebalnya kurang lebih
2 - 3 cm. Beratnya sekitar 20 gram.</div>
<a name='more'></a><br />
<div class="MsoNormal" style="text-align: justify;">
Prostat terdiri dari : </div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Jaringan Kelenjar <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> 50
- 70 %</div>
<div class="MsoNormal" style="margin-left: 21.85pt; mso-list: l8 level1 lfo5; tab-stops: list 21.85pt; text-indent: -21.85pt;">
</div>
<div style="text-align: justify;">
<span style="font-family: Symbol; text-indent: -21.85pt;">·</span><span style="font-size: 7pt; text-indent: -21.85pt;"> </span></div>
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<tbody>
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<div class="shape" style="padding: 4.35pt 7.95pt 4.35pt 7.95pt;" v:shape="_x0000_s1027">
<div class="MsoNormal">
30 - 50
%</div>
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</tr>
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<span style="text-indent: -21.85pt;">Jaringan</span><span style="font-size: 10pt; text-indent: -21.85pt;"> </span><span style="text-indent: -21.85pt;">Stroma (penyangga)</span></div>
<br />
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kapsul/Musculer </div>
<div class="MsoNormal" style="text-align: justify;">
Kelenjar prostat menghasilkan cairan yang banyak mengandung
enzym yang berfungsi untuk pengenceran sperma setelah mengalami koagulasi
(penggumpalan) di dalam testis yang membawa sel-sel sperma. Pada waktu orgasme
otot-otot di sekitar prostat akan bekerja memeras cairan prostat keluar melalui
uretra. Sel – sel sperma yang dibuat di dalam testis akan ikut keluar melalui
uretra. Jumlah cairan yang dihasilkan meliputi 10 – 30 % dari ejakulasi.
Kelainan pada prostat yang dapat mengganggu proses reproduksi adalah keradangan
(prostatitis). Kelainan yang lain sepeti pertumbuhan yang abnormal (tumor) baik
jinak maupun ganas, tidak memegang peranan penting pada proses reproduksi
tetapi lebih berperanan pada terjadinya gangguan aliran kencing. Kelainanyang
disebut belakangan ini manifestasinya biasanya pada laki-laki usia lanjut.</div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<b>Patofisiologi<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
Sejalan dengan pertambahan umur,
kelenjar prostat akan mengalami hiperplasia, jika prostat membesar akan meluas
ke atas (bladder), di dalam mempersempit saluran uretra prostatica dan
menyumbat aliran urine. Keadaan ini dapat meningkatkan tekanan intravesikal.
Sebagai kompensasi terhadap tahanan uretra prostatika, maka otot detrusor dan
buli-buli berkontraksi lebih kuat untuk dapat memompa urine keluar. Kontraksi
yang terus-menerus menyebabkan perubahan anatomi dari buli-buli berupa :
Hipertropi otot detrusor, trabekulasi, terbentuknya selula, sekula dan
difertikel buli-buli. Perubahan struktur pada buli-buli dirasakan klien sebagai
keluhan pada saluran kencing bagian bawah atau Lower Urinary Tract Symptom/LUTS
(Basuki, 2000 : 76).</div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
Pada fase-fase awal dari Prostat
Hyperplasia, kompensasi oleh muskulus destrusor berhasil dengan sempurna.
Artinya pola dan kualitas dari miksi tidak banyak berubah. Pada fase ini
disebut Sebagai Prostat Hyperplasia Kompensata. Lama kelamaan kemampuan
kompensasi menjadi berkurang dan pola serta kualitas miksi berubah, kekuatan
serta lamanya kontraksi dari muskulus destrusor menjadi tidak adekuat sehingga
tersisalah urine di dalam buli-buli saat proses miksi berakhir seringkali
Prostat Hyperplasia menambah kompensasi ini dengan jalan meningkatkan tekanan
intra abdominal (mengejan) sehingga tidak jarang disertai timbulnya hernia dan
haemorhoid puncak dari kegagalan kompensasi adalah tidak berhasilnya melakukan
ekspulsi urine dan terjadinya retensi urine, keadaan ini disebut sebagai
Prostat Hyperplasia Dekompensata. Fase Dekompensasi yang masih akut menimbulkan
rasa nyeri dan dalam beberapa hari menjadi kronis dan terjadilah inkontinensia
urine secara berkala akan mengalir sendiri tanpa dapat dikendalikan, sedangkan
buli-buli tetap penuh. Ini terjadi oleh karena buli-buli tidak sanggup
menampung atau dilatasi lagi. Puncak dari kegagalan kompensasi adalah ketidak
mampuan otot detrusor memompa urine dan menjadi retensi urine. Retensi urine
yang kronis dapat mengakibatkan kemunduran fungsi ginjal (Sunaryo, H. 1999 :
11)</div>
</div>
<u><div style="text-align: justify;">
<span style="font-family: 'Times New Roman', serif; line-height: 32px;"><br /></span></div>
</u>
<div class="Section2">
<div class="MsoNormal" style="line-height: 200%; margin-left: 66.0pt;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 371px; margin-top: 11px; position: absolute; text-align: justify; width: 62px; z-index: 251652096;"><img height="69" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1043" width="62" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1045"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 66px; left: 0px; margin-left: 135px; margin-top: 11px; position: absolute; text-align: justify; width: 55px; z-index: 251654144;"><img height="66" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1045" width="55" /></span><!--[endif]--><u></u></div>
<div style="text-align: justify;">
<u><u style="line-height: 200%;">TESTIS</u><span style="line-height: 200%;"> </span><u style="line-height: 200%;">USIA
LANJUT</u></u></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
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<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 266px; margin-top: 21px; position: absolute; text-align: justify; width: 12px; z-index: 251651072;"><img height="39" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1042" width="12" /></span><!--[endif]--></div>
<div style="text-align: justify;">
<span style="line-height: 200%;">PADA FASE AWAL PROSTAT HYPERPLASIA</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
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id="_x0000_s1041" style='position:absolute;left:0;text-align:left;z-index:251650048'
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</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 266px; margin-top: 32px; position: absolute; text-align: justify; width: 12px; z-index: 251650048;"><img height="39" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1041" width="12" /></span><!--[endif]--></div>
<div style="text-align: justify;">
<span style="line-height: 200%;">POLA DAN KUALITAS MIKSI BERUBAH</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
KONTRAKSI
MUSKULUS DESTRUSSOR</div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 66px; left: 0px; margin-left: 335px; margin-top: 12px; position: absolute; text-align: justify; width: 55px; z-index: 251655168;"><img height="66" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1046" width="55" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1044"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 171px; margin-top: 12px; position: absolute; text-align: justify; width: 62px; z-index: 251653120;"><img height="69" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1044" width="62" /></span><!--[endif]--></div>
<div style="text-align: justify;">
<span style="line-height: 200%;">TIDAK ADEKUAT (LEMAH)</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 1in; text-align: justify;">
RETENSIO URINE
TOTAL RESIDUAL
URINE</div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 1.0in;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 83px; margin-top: 13px; position: absolute; text-align: justify; width: 62px; z-index: 251640832;"><img height="69" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image007.gif" v:shapes="_x0000_s1032" width="62" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1034"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 75px; left: 0px; margin-left: 450px; margin-top: 1px; position: absolute; text-align: justify; width: 12px; z-index: 251642880;"><img height="75" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image008.gif" v:shapes="_x0000_s1034" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1033"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 267px; left: 0px; margin-left: 170px; margin-top: 13px; position: absolute; text-align: justify; width: 12px; z-index: 251639808;"><img height="267" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image010.gif" v:shapes="_x0000_s1031" width="12" /></span><!--[endif]--></div>
<div style="text-align: justify;">
<span style="line-height: 200%;">(FASE DEKOMPENSASI)</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<!--[if gte vml 1]><v:shape id="_x0000_s1028"
type="#_x0000_t202" style='position:absolute;left:0;text-align:left;
margin-left:0;margin-top:13.85pt;width:126pt;height:63pt;z-index:251636736'
strokecolor="white"/><v:shape id="_x0000_s1030" type="#_x0000_t202" style='position:absolute;
left:0;text-align:left;margin-left:282pt;margin-top:13.85pt;width:126pt;
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<v:textbox>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center'>
<span
style='color:black'>KOMPENSASI MENINGKATKAN TEKANAN INTRA ABDOMINAL<o:p></o:p></span></p>
<p class=MsoNormal align=center style='text-align:center'>
<span
style='color:black'><o:p> </o:p></span></p>
<p class=MsoNormal align=center style='text-align:center'>
<span
style='color:black'><o:p> </o:p></span></p>
<p class=MsoBodyText>
HERNIA, HAEMOROID</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
</v:shape><v:line id="_x0000_s1035" style='position:absolute;left:0;
text-align:left;z-index:251643904' from="342pt,78.65pt" to="342pt,105.65pt">
<v:stroke endarrow="block"/>
</v:line><v:shape id="_x0000_s1036" type="#_x0000_t202" style='position:absolute;
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<v:textbox style='mso-next-textbox:#_x0000_s1036'>
<![if !mso]>
<table cellpadding=0 cellspacing=0 width="100%">
<tr>
<td><![endif]>
<div>
<p class=MsoNormal align=center style='text-align:center;line-height:200%'>
REFLUKS
VESIKA URETRAL</p>
<p class=MsoNormal align=center style='text-align:center;line-height:200%'>
<o:p> </o:p></p>
<p class=MsoNormal align=center style='text-align:center;line-height:200%'>
DILATASI
URETER (HYDRO URETER)</p>
<p class=MsoNormal align=center style='text-align:center;line-height:200%'>
<o:p> </o:p></p>
<p class=MsoNormal align=center style='text-align:center;line-height:200%'>
PALVIO
KALIKS GINJAL (HYDRONEFROTIK)</p>
<p class=MsoNormal align=center style='text-align:center;line-height:200%'>
<o:p> </o:p></p>
<p class=MsoNormal align=center style='text-align:center;line-height:200%'>
KERUSAKAN
GINJAL</p>
<p class=MsoNormal align=center style='text-align:center;line-height:200%'>
<o:p> </o:p></p>
<p class=MsoNormal align=center style='text-align:center;line-height:200%'>
GAGAL
GINJAL</p>
</div>
<![if !mso]></td>
</tr>
</table>
<![endif]></v:textbox>
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</v:line><v:line id="_x0000_s1040" style='position:absolute;left:0;
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</v:shape><![endif]--><!--[if !vml]--><span style="height: 574px; left: -1px; mso-ignore: vglayout; position: relative; top: 17px; width: 550px; z-index: 251636736;">
<table cellpadding="0" cellspacing="0" style="text-align: left;">
<tbody>
<tr>
<td height="0" width="0"></td>
<td width="174"></td>
<td width="10"></td>
<td width="182"></td>
<td width="10"></td>
<td width="174"></td>
</tr>
<tr>
<td height="90"></td>
<td bgcolor="white" height="90" style="background: white; border: .75pt solid white; vertical-align: top;" width="174"><!--[endif]--><!--[if !mso]--><span style="left: 0pt; mso-ignore: vglayout; position: absolute; z-index: 251636736;">
<table cellpadding="0" cellspacing="0" style="width: 100%px;">
<tbody>
<tr>
<td><!--[endif]-->
<div class="shape" style="padding: 4.35pt 7.95pt 4.35pt 7.95pt;" v:shape="_x0000_s1028">
<div class="MsoNormal" style="text-align: center;">
NYERI</div>
<div class="MsoNormal" style="text-align: center;">
OLEH TEKANAN
TEKANAN INTRA VESIKA URINARIA</div>
</div>
<!--[if !mso]--></td>
</tr>
</tbody></table>
</span><!--[endif]--><!--[if !mso & !vml]--> <!--[endif]--><!--[if !vml]--></td>
<td></td>
<td bgcolor="white" height="198" rowspan="3" style="background: white; border: .75pt solid white; vertical-align: top;" width="182"><!--[endif]--><!--[if !mso]--><span style="left: 0pt; mso-ignore: vglayout; position: absolute; z-index: 251637760;">
<table cellpadding="0" cellspacing="0" style="width: 100%px;">
<tbody>
<tr>
<td><!--[endif]-->
<div class="shape" style="padding: 4.35pt 7.95pt 4.35pt 7.95pt;" v:shape="_x0000_s1029">
<div class="MsoNormal" style="text-align: center;">
INKONTINENSIA PARADOKSA OVERFLOW INCONTINENSIA (TEKANAN
INTRA VASKULER URINARIA DARI PADA TEKANAN SPINKTER BERSIFAT KRONIS)<o:p></o:p></div>
</div>
<!--[if !mso]--></td>
</tr>
</tbody></table>
</span><!--[endif]--><!--[if !mso & !vml]--> <!--[endif]--><!--[if !vml]--></td>
<td></td>
<td rowspan="2" style="text-align: left;" valign="top"><img height="162" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1030 _x0000_s1035" width="174" /></td>
</tr>
<tr>
<td height="72"></td>
</tr>
<tr>
<td height="36"></td>
</tr>
<tr>
<td height="17"></td>
</tr>
<tr>
<td height="342"></td>
<td colspan="3" style="text-align: left;" valign="top"><img height="342" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1036 _x0000_s1037 _x0000_s1038 _x0000_s1039 _x0000_s1040" width="366" /></td>
</tr>
</tbody></table>
</span><!--[endif]--><o:p></o:p></div>
<div style="text-align: justify;">
<span style="line-height: 200%;"> </span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
Proses Miksi</div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
Fase pengisian</div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
Pves : <
20 cm H<sub>2</sub>O</div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 0.5in;">
Pup :
60 – 100 cm H<sub>2</sub>O</div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
Fase ekspulsi :<o:p></o:p></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
Isi
blader 200 – 300 ml</div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 274px; margin-top: 30px; position: absolute; text-align: justify; width: 12px; z-index: 251656192;"><img height="39" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1047" width="12" /></span><!--[endif]--></div>
<div style="text-align: justify;">
<span style="line-height: 200%;">Mulai terangsang ingin kencing</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
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<div style="text-align: justify;">
<span style="line-height: 200%;">Reseptor Strecth</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
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<div style="text-align: justify;">
<span style="line-height: 200%;">Syaraf Otonom PS S2 - 4</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
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from="210pt,19.05pt" to="210pt,46.05pt">
<v:stroke endarrow="block"/>
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<div style="text-align: justify;">
<span style="line-height: 200%;">Tonus Bladder 60 – 120 cm H2O (ingin
kencing)</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
Up
membuka, sp. Eks masih menutup</div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 60pt; text-align: center;">
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<div style="text-align: justify;">
<span style="line-height: 200%;">BPH</span><span style="line-height: 200%;"> </span><span style="line-height: 200%;">P
up meningkat</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
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id="_x0000_s1051" style='position:absolute;left:0;text-align:left;z-index:251660288'
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</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 274px; margin-top: 33px; position: absolute; text-align: justify; width: 12px; z-index: 251660288;"><img height="39" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1051" width="12" /></span><!--[endif]--></div>
<div style="text-align: justify;">
<span style="line-height: 200%;">Kontraksi Detrusor meningkat</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
Hipertropi</div>
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
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id="_x0000_s1053" style='position:absolute;left:0;text-align:left;z-index:251662336'
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<table cellpadding="0" cellspacing="0" style="text-align: left;">
<tbody>
<tr>
<td height="13" width="156"></td>
<td width="53"></td>
<td width="142"></td>
<td width="61"></td>
</tr>
<tr>
<td height="31"></td>
<td style="text-align: left;" valign="top"><img height="31" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image014.gif" v:shapes="_x0000_s1054" width="53" /></td>
<td></td>
<td style="text-align: left;" valign="top"><img height="31" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image015.gif" v:shapes="_x0000_s1053" width="61" /></td>
</tr>
</tbody></table>
<!--[endif]--><o:p></o:p></div>
<div style="text-align: justify;">
<span style="line-height: 200%;"> </span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: 30.0pt;">
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id="_x0000_s1056" style='position:absolute;left:0;text-align:left;z-index:251665408'
from="324pt,22.25pt" to="324pt,49.25pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 426px; margin-top: 29px; position: absolute; text-align: justify; width: 12px; z-index: 251665408;"><img height="39" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1056" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1055"
style='position:absolute;left:0;text-align:left;z-index:251664384' from="66pt,22.25pt"
to="66pt,49.25pt">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 39px; left: 0px; margin-left: 82px; margin-top: 29px; position: absolute; text-align: justify; width: 12px; z-index: 251664384;"><img height="39" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1055" width="12" /></span><!--[endif]--></div>
<div style="text-align: justify;">
<span style="line-height: 200%;">P Ves > P up</span><span style="line-height: 200%;"> </span><span style="line-height: 200%;">P
Ves < P up</span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
Fase Kompensata Fase
Decompensata</div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
Kualitas miksi masih baik Retensio
Urine</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b>Gejala Benign Prostatic
Hyperplasia <o:p></o:p></b></div>
<div class="MsoNormal" style="text-align: justify;">
Gejala klinis yang ditimbulkan oleh
Benign Prostatic Hyperplasia disebut sebagai Syndroma Prostatisme. Syndroma
Prostatisme dibagi menjadi dua yaitu :</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Gejala Obstruktif yaitu :</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Hesitansi yaitu memulai kencing yang lama dan
seringkali disertai dengan mengejan yang disebabkan oleh karena otot destrussor
buli-buli memerlukan waktu beberapa lama meningkatkan tekanan intravesikal guna
mengatasi adanya tekanan dalam uretra prostatika.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Intermitency yaitu terputus-putusnya aliran kencing
yang disebabkan karena ketidakmampuan otot destrussor dalam pempertahankan
tekanan intra vesika sampai berakhirnya miksi.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Terminal dribling yaitu menetesnya urine pada akhir
kencing.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Pancaran lemah : kelemahan kekuatan dan kaliber
pancaran destrussor memerlukan waktu untuk dapat melampaui tekanan di uretra.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt;">
</span><!--[endif]-->Rasa tidak puas setelah berakhirnya buang air kecil dan
terasa belum puas.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Gejala Iritasi yaitu :</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Urgency yaitu perasaan ingin buang air kecil yang sulit
ditahan.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Frekuensi yaitu penderita miksi lebih sering dari
biasanya dapat terjadi pada malam hari (Nocturia) dan pada siang hari.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Disuria yaitu nyeri pada waktu kencing.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b>Derajat Benigne Prostat Hyperplasia <o:p></o:p></b></div>
<div class="MsoNormal" style="text-align: justify;">
Benign Prostatic Hyperplasia terbagi dalam 4 derajat sesuai
dengan gangguan klinisnya :</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Derajat satu, keluhan prostatisme ditemukan penonjolan
prostat 1 – 2 cm, sisa urine kurang 50 cc, pancaran lemah, necturia, berat <u>+</u>
20 gram.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Derajat dua, keluhan miksi terasa panas, sakit,
disuria, nucturia bertambah berat, panas badan tinggi (menggigil), nyeri daerah
pinggang, prostat lebih menonjol, batas atas masih teraba, sisa urine 50 – 100
cc dan beratnya <u>+</u> 20 – 40 gram.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Derajat tiga, gangguan lebih berat dari derajat dua,
batas sudah tak teraba, sisa urine lebih 100 cc, penonjolan prostat 3 – 4 cm,
dan beratnya 40 gram.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Derajat empat, inkontinensia, prostat lebih menonjol
dari 4 cm, ada penyulit keginjal seperti gagal ginjal, hydroneprosis.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="text-align: justify;">
Pengkajian Pre operatif
Benigne Prostat Hyperplasia </div>
<div class="MsoNormal" style="margin-left: 0.5in; text-align: justify;">
<b>Riwayat Keperawatan<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Suspect BPH <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> umur > 60 tahun</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Pola urinari : frekuensi, nocturia, disuria.</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Gejala obstruksi leher buli-buli : prostatisme
(Hesitansi, pancaran, melemah, intermitensi, terminal dribbling, terasa ada
sisa) Jika frekuensi dan noctoria tak disertai gejala pembatasan aliran non
Obstruktive seperti infeksi.</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->BPH <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> hematuri</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.45pt; text-align: justify;">
<b>Pemahaman klien tentang
kejadian<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Ahli bedah bertanggung jawab, untuk menjelaskan sifat
operasi, semua pilihan alternatif, hasil yang diperkirakan dan kemungkinan
komplikasi yang dapat terjadi. Ahli bedah mendapatkan dua consent (ijin) satu
untuk prosedur bedah dan satu untuk anestesi. Perawat bertanggung jawab untuk
menentukan pemahaman klien tentang informasi, lalu memberitahu ahli bedah
apakah diperlukan informasi lebih banyak (informed consent).</div>
<div class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;">
<b>Kondisi akut dan kronis</b> :</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Untuk mengkompensasi pengaruh trauma bedah dan
anestesi, tubuh manusia membutuhkan fungsi pernafasan, sirkulasi, jantung,
ginjal, hepar dan hematopoetik yang optimal. Setiap kondisi yang mengganggu
fungsi sistem ini (misalnya: DM, gagal jantung kongestif, PPOM. Anemia,
sirosuis, gagal ginjal) dapat mempengaruhi pemulihan. Disamping itu faktor
lain, misalnya usia lanjut, kegemukan dan penyalahgunaan obat / alkohol membuat
klien lebih rentan terhadap komplikasi.</div>
<div class="MsoNormal" style="margin-left: 0.5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.45pt; text-align: justify;">
<b>Pengalaman bedah sebelumnya<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Perawat mengajukan pertanyaan spesifik pada klien
tentang pengalaman pembedahan masa lalu. Informasi yang didapatkandigunakan
untuk meningkatkan kenyamanan (fisik dan psikologis) untuk mencegah komplikasi
serius.</div>
<div class="MsoNormal" style="margin-left: 35.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.45pt; text-align: justify;">
<b>Status Nutrisi<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 53.45pt; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Status nutrisi klien praoperatif secara langsung
mempengaruhi responnya pada trauma pembedahan dan anestesi. Setelah terjadi
luka besar, baik karena trauma atau bedah, tubuh harus membentuk dan
memperbaiki jaringan serta melindungi diri dari infeksi. Untuk membantu proses
ini, klien harus meningkatkan masukan protein dan karbohidrat dengan cukup
untuk mencegah keseimbangan nitrogen negatif, hipoalbuminemia, dan penurunan
berat badan. Status nutrisi merupakan akibat masukan tidak adekuat,
mempengaruhi metabolik atau meningkatkan kebutuhan metabolik.</div>
<div class="MsoNormal" style="margin-left: 35.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.45pt; text-align: justify;">
<b>Status cairan dan elektrolit<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 53.45pt; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Klien dengan gangguan keseimbangan cairan dan elektolit
cenderung mengalami shock, hipotensi, hipoksia, dan disritmia, baik pada
intraoperatif dan pascaoperatif. Fluktuasi valume cairan merupakan akibat dari
penurunan masukan cairan atau kehilangan cairan abnormal.</div>
<div class="MsoNormal" style="margin-left: 35.45pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 35.45pt; text-align: justify;">
<b>Status emosi.<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 53.45pt; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Respon klien, keluarga dan orang terdekat pada tindakan
pembedahan yang direncanakan tergantung pada pengalaman masa lalu, strategi
koping, signifikan pembedahan dan sistem pendukung.</div>
<div class="MsoNormal" style="margin-left: 53.45pt; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Kebanyakan klien dengan pembedahan mengalami ancietas
dan ketakutan yang disebabkan penatalaksanaan tindakan operasi, nyeri, dan
immobilitas.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><b>1.<span style="font-size: 7pt; font-weight: normal;">
</span></b><!--[endif]--><b>Pemeriksaan Fisik<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Perhatian khusus pada abdomen ; Defisiensi
nutrisi, edema, pruritus, echymosis menunjukkan renal insufisiensi dari
obstruksi yang lama.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Distensi kandung kemih</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Inspeksi : Penonjolan pada daerah supra pubik <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
retensi urine</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Palpasi : Akan terasa adanya ballotement dan ini
akan menimbulkan pasien ingin buang air kecil <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> retensi urine</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Perkusi : Redup <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> residual urine</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pemeriksaan penis : uretra kemungkinan adanya
penyebab lain misalnya stenose meatus, striktur uretra, batu uretra/femosis.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pemeriksaan Rectal Toucher (Colok Dubur) <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
posisi knee chest</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify;">
Syarat : buli-buli
kosong/dikosongkan</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify;">
Tujuan : Menentukan
konsistensi prostat</div>
<div class="MsoNormal" style="margin-left: 2in; text-align: justify;">
Menentukan besar prostat</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><b>2.<span style="font-size: 7pt; font-weight: normal;">
</span></b><!--[endif]--><b>Pemeriksaan Radiologi<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Pada Pemeriksaan Radiologi
ditujukan untuk</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Menentukan volume Benign Prostatic Hyperplasia</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Menentukan derajat disfungsi buli-buli dan volume
residual urine</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Mencari ada tidaknya kelainan baik yang berhubungan
dengan Benign Prostatic Hyperplasia atau tidak</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify;">
<b>Beberapa Pemeriksaan
Radiologi<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]--><b>Intra Vena Pyelografi ( IVP </b>) : Gambaran
trabekulasi buli, residual urine post miksi, dipertikel buli.</div>
<div class="MsoNormal" style="margin-left: 42pt; text-align: justify;">
Indikasi : disertai hematuria, gejala iritatif menonjol disertai
urolithiasis</div>
<div class="MsoNormal" style="margin-left: 42pt; text-align: justify;">
Tanda BPH : Impresi prostat, hockey stick ureter </div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]--><b>BOF</b> : Untuk mengetahui adanya kelainan pada
renal</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]--><b>Retrografi dan Voiding Cystouretrografi</b> : untuk
melihat ada tidaknya refluk vesiko ureter/striktur uretra.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]--><b>USG</b> : Untuk menentukan volume urine, volume
residual urine dan menilai pembesaran prostat jinak/ganas</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><b>3.<span style="font-size: 7pt; font-weight: normal;">
</span></b><!--[endif]--><b>Pemeriksaan Endoskopi.<o:p></o:p></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><b>4.<span style="font-size: 7pt; font-weight: normal;">
</span></b><!--[endif]--><b>Pemeriksaan Uroflowmetri<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Berperan penting dalam diagnosa
dan evaluasi klien dengan obstruksi leher buli-buli</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Q max : > 15 ml/detik <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> non obstruksi</div>
<div class="MsoNormal" style="margin-left: 0.5in; text-align: justify; text-indent: 0.5in;">
10 - 15 ml/detik <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
border line</div>
<div class="MsoNormal" style="margin-left: 60pt; text-align: justify; text-indent: 12pt;">
< 10
ml/detik <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
obstruktif</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><b>5.<span style="font-size: 7pt; font-weight: normal;">
</span></b><!--[endif]--><b>Pemeriksaan Laborat <o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Urinalisis (test glukosa, bekuan darah, UL, DL,
RFT, LFT, Elektrolit, Na,/K, Protein/Albumin, pH dan Urine Kultur)</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Jika infeksi:pH urine alkalin,
spesimen terhadap Sel Darah Putih, Sel Darah Merah atau PUS.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->RFT <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> evaluasi fungsi renal</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Serum Acid Phosphatase <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> Prostat Malignancy.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify;">
Trauma bedah yang direncanakan,
menimbulkan rentang respon fisiologis dan psikologis pada klien, tergantung
pada individu dan pengalaman masa lalu yang unik, pola koping, kekuatan dan
keterbatasan. Kebanyakan klien dan keluarganya memandang setiap tindakan bedah
merupakan peristiwa besar dan mereka bereaksi dengan takut dan ansietas pada
tingkat tertentu.</div>
<div class="MsoBodyTextIndent" style="margin-left: 28.35pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b>Pengertian
Keperawatan Pre operatif<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify;">
Keperawatan Perioperatif adalah
istilah yang digunakan untuk menggambarkan tanggung jawab keperawatan yang
berhubungan dengan fase-fase preoperatif, intraoperatif, pemulihan
pascaanestesi dan pascabedah.</div>
<div class="MsoNormal" style="margin-left: 21.3pt; text-align: justify;">
Sepanjang periode perioperatif,
perawat menerapkan proses keperawatan untuk mengidentifikasi fungsi positip,
perubahan fungsi, dan potensial perubahan fungsi pada klien. Adapun tanggung
jawab keperawatan untuk masing-masing fase berfokus pada masalah kesehatan
spesifik aktual atau resiko.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b>Fokus Asuhan
Keperawatan Pada periode Pre operatif<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Fase Preoperatif</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Pengkajian Preoperatif</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Penyuluhan Preoperatif</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Persiapan untuk pindah ke ruang operasi</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Dukungan orang terdekat</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Fase Intraoperatif</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Keamanan lingkungan</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Kontrol Asepsis</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Pemantauan fisiologis</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Dukungan psikologis (prainduksi)</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt;">
</span><!--[endif]-->Pemindahan ke ruang pemulihan pascaanestesi</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Fase Pemulihan Pascaanestesi</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Pemantauan fisiologis (jantung, pernafasan, sirkulasi,
ginjal dan neurologis)</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Dukungan psikologis</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Keamanan lingkungan </div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Tindakan kenyamanan</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt;">
</span><!--[endif]-->Stabilitas untuk pindah ke unit atau bangsal</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Fase Pascaoperatif</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Pemantauan fisiologis</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Dukungan psikologis Tindakan kenyamanan</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Dukungan orang terdekat</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Keseimbangan fisiologis (nutrisi, cairan dan eliminasi)</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt;">
</span><!--[endif]-->Mobilisasi</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->f.<span style="font-size: 7pt;">
</span><!--[endif]-->Penyembuhan luka</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->g.<span style="font-size: 7pt;">
</span><!--[endif]-->Penyuluhan pulang.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="text-align: justify;">
Diagnosa Keperawatan Pre
Operasi</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Gangguan pemenuhan kebutuhan eliminasi (retensio urine)
baik akut maupun kronis berhubungan dengan obstruksi akibat pembesaran
prostat/dekompresi otot detrussor ditandai dengan urine menetes, sering buang
air kecil, buang air kecil sedikit-sedikit tidak bisa mengosongkan kandung
kencing secara total, distensi kandung kencing.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Gangguan rasa nyaman (nyeri) berhubungan dengan iritasi
mukosa/distensi kandung kencing/kolik renal/infeksi saluran kencing ditandai
dengan keluhan nyeri spasme kandung kemih, perubahan tonus otot, merintih
kesakitan.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Cemas berhubungan dengan rencana pembedahan dan
kehilangan status kesehatan serta penurunan kemampuan sexual ditandai dengan
peningkatan tensi, ungkapan rasa takut</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Dysfungsi sexual berhubungan dengan obstrusi
perkemihan.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Kurang pengetahuan tentang sifat penyakit, tujuan
tindakan yang diprogramkan dan pemeriksaan diagnostik berhubungan dengan
kurangnya informasi /terbatasnya informasi/informasi yang keliru ditandai
dengan pasien sering bertanya, perintah yang tidak dituruti dan perkembangan
infeksi tidak dapat dicegah.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt;">
</span><!--[endif]-->Gangguan pola tidur berhubungan dengan sering miksi
pada malam hari</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->7.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko injury dan resiko infeksi berhubungan dengan
obstruksi perkemihan</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->8.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko tinggi terhadap infeksi berhubungan dengan
pemasangan Dower Cateter yang lama</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="text-align: justify;">
Diagnosa Keperawatan
Post Operasi</div>
<div class="MsoSubtitle" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Terjadinya perdarahan berhubungan dengan tindakan
bedah (reseksi).<o:p></o:p></div>
<div class="MsoSubtitle" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Gangguan rasa nyaman (nyeri) berhubungan dengan terputusnya kontinuitas
jaringan akibat reseksi<o:p></o:p></div>
<div class="MsoSubtitle" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Cemas berhubungan dengan proses penyakitnya yang masih dapat kambuh
lagi.<o:p></o:p></div>
<div class="MsoSubtitle" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko terjadinya retensi urine berhubungan dengan obstruksi saluran
kateter oleh bekuan darah/klot.<o:p></o:p></div>
<div class="MsoSubtitle" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko terjadinya kelebihan cairan dalam tubuh (Syndroma TUR)
berhubungan dengan adanya penyerapan cairan irigasi yang berlebihan.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: justify;">
<b>Perencanaan/Penatalaksanaan<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 66pt; text-align: justify; text-indent: -42pt;">
Tujuan: klien
tidak akan mengalami berbagai komplikasi dari pengobatan retensi Urine.</div>
<div class="MsoNormal" style="margin-left: 42pt; text-align: justify; text-indent: -42pt;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b>Intervensi:<o:p></o:p></b></div>
<div class="MsoNormal" style="text-align: justify;">
A Non
Pembedahan</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Memperkecil gejala obstruksi <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> hal-hal yang menyebabkan
pelepasan cairan prostat.</div>
<h5 style="text-align: justify;">
<!--[if !supportLists]-->1)<span style="font-size: 7pt; font-weight: normal;">
</span><!--[endif]-->Prostatic massage</h5>
<h5 style="text-align: justify;">
<!--[if !supportLists]-->2)<span style="font-size: 7pt; font-weight: normal;">
</span><!--[endif]-->Frekuensi coitus meningkat</h5>
<h5 style="text-align: justify;">
<!--[if !supportLists]-->3)<span style="font-size: 7pt; font-weight: normal;">
</span><!--[endif]-->Masturbasi</h5>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Menghindari minum banyak dalam waktu singkat,
menghindari alkohol dan diuretic mencegah oven distensi kandung kemih akibat
tonus otot detrussor menurun.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Menghindari obat-obat penyebab retensi urine seperti : anticholinergic,
anti histamin, decongestan.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]-->Observasi Watchfull Waiting</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify;">
Yaitu pengawasan berkala/follow –
up tiap 3 – 6 bulan kemudian setiap tahun tergantung keadaan klien</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify;">
Indikasi : BPH dengan IPPS Ringan</div>
<div class="MsoNormal" style="margin-left: 120pt; text-align: justify;">
Baseline data normal</div>
<div class="MsoNormal" style="margin-left: 120pt; text-align: justify;">
Flowmetri non obstruksi</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->5.<span style="font-size: 7pt;">
</span><!--[endif]-->Terapi medikamentosa pada Benigne Prostat Hyperplasia</div>
<div class="MsoNormal" style="margin-left: 42pt; text-align: justify;">
Terapi ini diindikasikan pada
Benigne Prostat Hyperplasia dengan keluhan ringan, sedang dan berat tanpa
disertai penyulit serta indikasi pembedahan, tetapi masih terdapat kontra
indikasi atau belum “well motivated”. Obat yang digunakan berasal dari
Fitoterapi, Golongan Supressor Androgen dan Golongan Alfa Bloker.</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Fito Terapi</div>
<div class="MsoNormal" style="margin-left: 87.3pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;">
</span><!--[endif]-->Hypoxis rosperi (rumput)</div>
<div class="MsoNormal" style="margin-left: 87.3pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;">
</span><!--[endif]-->Serenoa repens (palem)</div>
<div class="MsoNormal" style="margin-left: 87.3pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;">
</span><!--[endif]-->Curcubita pepo (waluh )</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Pemberian obat Golongan Supressor Androgen/anti
androgen :</div>
<div class="MsoNormal" style="margin-left: 87.3pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->a)<span style="font-size: 7pt;">
</span><!--[endif]-->Inhibitor 5 alfa reduktase</div>
<div class="MsoNormal" style="margin-left: 87.3pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->b)<span style="font-size: 7pt;">
</span><!--[endif]-->Anti androgen</div>
<div class="MsoNormal" style="margin-left: 87.3pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->c)<span style="font-size: 7pt;">
</span><!--[endif]-->Analog LHRH</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Pemberian obat Golongan Alfa Bloker/obat penurun
tekanan diuretra-prostatika : Prazosin, Alfulosin, Doxazonsin, Terazosin</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->6.<span style="font-size: 7pt;">
</span><!--[endif]-->Bila terjadi retensi urine</div>
<div class="MsoNormal" style="margin-left: 66pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Kateterisasi <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> Intermiten</div>
<div class="MsoNormal" style="margin-left: 2in; text-align: justify;">
Indwelling</div>
<div class="MsoNormal" style="margin-left: 66pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Dilakukan pungsi blass</div>
<div class="MsoNormal" style="margin-left: 66pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Dilakukan cystostomy</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->7.<span style="font-size: 7pt;">
</span><!--[endif]-->Prostetron (Trans Uretral Microwave Thermoterapy/TUMT)</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
B. Pembedahan</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Trans Uretral Reseksi Prostat : 90 - 95 %</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Open Prostatectomy : 5
- 10 %</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify;">
BPH yang besar (50 - 100 gram) <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
Tidak habis direseksi dalam 1 jam.</div>
<div class="MsoNormal" style="margin-left: 48pt; text-align: justify;">
Disertai Batu Buli Buli Besar
(>2,5cm), multiple. Fasilitas TUR tak ada.</div>
<div class="MsoSubtitle" style="margin-left: 24pt; text-align: justify;">
Mortalitas Pembedahan BPH<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
0
- 1 % KAUSA
: Infark Miokatd</div>
<div class="MsoNormal" style="margin-left: 1.75in; text-align: justify;">
Septikemia dengan Syok</div>
<div class="MsoNormal" style="margin-left: 1.75in; text-align: justify;">
Perdarahan Massive</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Kepuasan Klien : 66 –
95 %</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Indikasi Pembedahan BPH</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Retensi urine akut</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Retensi urine kronis</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Residual urine lebih dari 100 ml</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->BPH dengan penyulit</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Hydroneprosis</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Terbentuknya Batu Buli</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Infeksi Saluran Kencing Berulang</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Hematuri berat/berulang</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Hernia/hemoroid</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Menurunnya Kualitas Hidup</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Retensio Urine</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Gangguan Fungsi Ginjal</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Terapi medikamentosa tak berhasil</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Sindroma prostatisme yang progresif</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Flow metri yang menunjukkan pola obstruktif</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Flow. Max kurang dari 10 ml</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kurve berbentuk datar</div>
<div class="MsoNormal" style="margin-left: 65.5pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Waktu miksi memanjang</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Kontra Indikasi</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->IMA</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->CVA akut</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Tujuan :<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Mengurangi gejala yang disertai dengan obstruksi
leher buli-buli</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Memperbaiki kualitas hidup.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><b>1)<span style="font-size: 7pt; font-weight: normal;">
</span></b><!--[endif]--><b>Trans Uretral Reseksi Prostat </b><span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> <b>90
- 95 % <o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Dilakukan bila pembesaran pada
lobus medial.</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Keuntungan :</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Lebih aman pada klien yang mengalami resiko
tinggi pembedahan</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Tak perlu insisi pembedahan</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Hospitalisasi dan penyebuhan pendek</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Kerugian :</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Jaringan prostat dapat tumbuh kembali</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kemungkinan trauma urethra <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
strictura urethra.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><b>2)<span style="font-size: 7pt; font-weight: normal;">
</span></b><!--[endif]--><b>Retropubic Atau Extravesical Prostatectomy<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
<span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> Prostat terlalu besar
tetapi tak ada masalah kandung kemih.</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><b>3)<span style="font-size: 7pt; font-weight: normal;">
</span></b><!--[endif]--><b>Perianal Prostatectomy<o:p></o:p></b></div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pembesaran prostat disertai batu buli-buli</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Mengobati abces prostat yang tak respon terhadap
terapi conservatif</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Memperbaiki komplikasi : laserasi kapsul prostat</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]--><b>4)<span style="font-size: 7pt; font-weight: normal;">
</span></b><!--[endif]--><b>Suprapubic Atau Tranvesical Prostatectomy<o:p></o:p></b></div>
</div>
<b><div style="text-align: justify;">
<span style="font-family: 'Times New Roman', serif; text-transform: uppercase;"><br /></span></div>
</b>
<div class="Section3">
<div class="MsoSubtitle" style="text-align: justify;">
Periode PRE OPERATIF CARE</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Mengkaji kecemasan klien,
mengoreksi miskonsepsi tentang pembedahan dan memberikan informasi yang akurat
pada klien</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Type pembedahan</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Jenis anesthesi <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> TUR – P, general / spina
anesthesi</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Cateter : folly cateter, Continuous Bladder
Irigation (CBI).</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Persiapan orerasi lainnya yaitu :</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pemeriksaan lab. Lengkap : DL, UL, RFT, LFT, pH,
Gula darah, Elektrolit</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pemeriksaan EKG</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pemeriksaan Radiologi : BOF, IVP, USG, APG.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pemeriksaan Uroflowmetri <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> Bagi penderita yang tidak
memakai kateter.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pemasangan infus dan puasa</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pencukuran rambut pubis dan lavemen.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Pemberian Anti Biotik</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Surat Persetujuan Operasi (Informed Concern).</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="text-align: justify;">
Periode Intra Operatif CARE</div>
<div class="MsoNormal" style="text-align: justify;">
Pengelolaan Keamanan:</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Jaminan penghitungan kasa, jarum, instrumen dan alat
lain, cocok untuk pemakaian.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Mengatur posisi pasien</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Posisi fungsional</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Membuka daerah untuk operasi</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Mempertahankan posisi selama prosedur.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Memasang alat grounding</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Menyiapkan bantuan fisik</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
Pemantauan fisiologis </div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Mengkalkulasi pengaruh terhadap pasien akibat
kekurangan cairan</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Membandingkan data normal dan abnormal dari
cardiopulmonal.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Melaporkan perubahan-perubahan tanda-tanda vital (suhu,
nadi, tekanan darah dan RR.)</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
Pemantauan psikologi sebelum induksi dan bila pasien sadar</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Menyiapkan bantuan emosional</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Melanjutkan observasi status emosional</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Mengkomunikasikan status emosional pasien kepada
anggota tim.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
Manajemen Keperawatan</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Menyelamatkan keselamatan fisik pasien.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Mempertahankan aseptis pada lingkungan yang terkendali</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Mengelola dengan efektif sumber daya manusia.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
Anggota Tim Fase intraoperatif</div>
<div class="MsoNormal" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;"> </span><!--[endif]-->Tim
bedah utama steril</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Ahli bedah utama</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]--> Asisten ahli
bedah</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Perawat instrumentator.</div>
<div class="MsoNormal" style="margin-left: 0.5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;"> </span><!--[endif]-->Tim
anestesi:</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Ahli anestesi atau pelaksana anestesi</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Circulating nurse</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt;">
</span><!--[endif]-->Lain-lain (tehnisi, ahli aptologi dll.)</div>
<div class="MsoNormal" style="text-align: justify;">
Tugas perawat instrumentator</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Persiapan pengadaan bahan-bahan dan alat steril yang
diperlukan untuk operasi.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Membantu ahli bedah dan asisten bedah waktu melakukan
prosedur</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Pendidikan bagi staf baru yang berkualifikasi bedah</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Membantu jumlah kebutuhan jarum, pisau bedah, kasa atau
instrumen yang diperlukan untuk prosedur, menurut jumlah yang biasa digunakan.
Untuk pelaksanaan kegiatan yang efektif perawat instrumen harus memiliki
pengetahuan tehnik aseptik yang baik, ketrampilan tangan dan ketangkasan,
stamina fisik, tahan terhadap berbagai desakan, sangat menghayati kecermatan
dan memperhitungkan prilaku yang menuntaskan asuhan pasien yang optimal.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
Tugas Perawat Circulating</div>
<div class="MsoNormal" style="text-align: justify;">
Perawat keliling memegang peranan dalam keseluruhan
pengelolaan ruang operasi, perawat ini dipercaya untuk koordinasi semua
aktivitas di dalam ruangan dan harus mengelola asuhan keperawatan yang
diperluikan pasien.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="text-align: justify;">
Periode Pemulihan Pasca Anestesi</div>
<div class="MsoNormal" style="text-align: justify;">
Trauma bedah dan anestesi mengganggu semua fungsi utama
sistem tubuh, tetapi kebanyakan klien mempunyai kemampuan kompensasi untuk
memulihkan homeostasis. Namun klien tertentu berisiko lebih tinggi untuk
mengalami kompensasi tak efektif terhadap efek merugikan dari pembedahan dan
anestesi pada jantung, sirkulasi, pernafasan dan fungsi lain. </div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
Secara Umum Diagnosa Keperawatan yang muncul pada fase
/periode pemulihan pasca anrestesi adalah :</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko terhadap aspirasi yang berhubungan dengan
samnolen dan peningkatan sekresi sekunder terhadap intubasi.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Ansietas yang berhubungan dengan nyeri sekunder
terhadap trauma pada jaringan dan syaraf.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko terhadap cedera yang berhubungan dengan samnolen
sekunder terhadap anestesia</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Resiko terhadap hipotermia yang berhubungan dengan
pemaparan pada suhu ruang operasi yang dingin.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
Kriteria umum syarat pasien dipindahkan dari ruang pemulihan
pasca anestesi ke unit perawatan adalah sbb. :</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->a.<span style="font-size: 7pt;">
</span><!--[endif]-->Kemampuan memutar kepala </div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->b.<span style="font-size: 7pt;">
</span><!--[endif]-->Ekstubasi dengan jalan nafas bersih.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->c.<span style="font-size: 7pt;">
</span><!--[endif]-->Sadar, mudah terbangun.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->d.<span style="font-size: 7pt;">
</span><!--[endif]-->Tanda-tanda vital stabil</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->e.<span style="font-size: 7pt;">
</span><!--[endif]-->Balutan kering dan utuh</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->f.<span style="font-size: 7pt;">
</span><!--[endif]-->Haluaran urine sedikitnya 30 ml/jam.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->g.<span style="font-size: 7pt;">
</span><!--[endif]-->Drain, selang , jalur intravena paten dan berfungsi.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->h.<span style="font-size: 7pt;">
</span><!--[endif]-->Persetujuan ahli anestesi untuk pindah ke ruangan.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoSubtitle" style="text-align: justify;">
Periode POST OPERATIF CARE</div>
<div class="MsoNormal" style="text-align: justify;">
Post operatif care pada dasarnya sama seperti pasien lainnya
yaitu monitoring terhadap respirasi, sirkulasi dan kesadaran pasien :</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Airway : Bebaskan jalan fafas</div>
<div class="MsoNormal" style="margin-left: 84pt; text-align: justify;">
Posisi kepala ekstensi</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Breathing : Memberikan O2
sesuai dengan kebutuhan</div>
<div class="MsoNormal" style="margin-left: 84pt; text-align: justify;">
Observasi pernafasan</div>
<div class="MsoBodyTextIndent3" style="text-align: justify;">
Cirkulasi : mengukur tensi, nadi, suhu tubuh,
pernafasan, kesadaran dan produksi urine pada fase awal (6jam) paska operasi
harus dimonitor setiap jam dan harus dicatat.</div>
<div class="MsoNormal" style="margin-left: 84pt; text-align: justify;">
Bila pada fase awal stabil,
monitor/interval bisa 3 jam sekali</div>
<div class="MsoNormal" style="margin-left: 84pt; text-align: justify;">
Bila tensi turun, nadi meningkat
(kecil), produksi urine merah pekat harus waspada terjadinya perdarahan <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
segera cek Hb dan lapor dokter.</div>
<div class="MsoNormal" style="margin-left: 84pt; text-align: justify;">
Tensi meningkat dan nadi menurun
(bradikardi), kadar natrium menurun, gelisah atau delir harus waspada terjadinya
syndroma TUR <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
segera lapor dokter.</div>
<div class="MsoNormal" style="margin-left: 84pt; text-align: justify;">
Bila produksi urine tidak keluar
(menurun) dicari penyebabnya apakah kateter buntu oleh bekuan darah <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
terjadi retensi urine dalam buli-buli <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> lapor dokter, spoling
dengan PZ tetesan tergantung dari warna urine yang keluar dari Urobag. Bila
urine sudah jernih tetesan spoling hanya maintennens/dilepas dan bila produksi
urine masih merah spoling diteruskan sampai urine jernih.</div>
<div class="MsoNormal" style="margin-left: 84pt; text-align: justify;">
Bila perlu Analisa Gas Darah </div>
<div class="MsoNormal" style="margin-left: 84pt; text-align: justify;">
Apakah terjadi kepucatan,
kebiruan.</div>
<div class="MsoNormal" style="margin-left: 84pt; text-align: justify;">
Cek lab : Hb, RFT, Na/K dan
kultur urine.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Pemberian Anti Biotika</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Antibiotika profilaksis, diberikan bila hasil
kultur urine sebelum operasi steril. Antibiotik hanya diberikan 1 X pre operasi
<u>+</u> 3 – 4 jam sebelum operasi.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Antibiotik terapeutik, diberikanpada pasien
memakai dower kateter dari hasil kultur urine positif. Lama pemberian <u>+</u>
2 minggu, mula-mula diberikan parenteral diteruskan peroral. Setiap melepas
kateter harus diberikan antibiotik profilaksis untuk mencegah septicemia.</div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Perawatan Kateter</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Kateter uretra yang dipasang pada
pasca operasi prostat yaitu folley kateter 3 lubang (treeway catheter) ukuran
24 Fr.</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Ketiga lubang tersebut gunanya :</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->untuk mengisibalon, antara 30 – 40 ml cairan</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->untuk melakukan irigasi/spoling</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->untuk keluarnya cairan (urine dan cairan spoling).</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Setelah 6 jam pertama sampai 24
jam kateter tadi biasanya ditraksi dengan merekatkan ke salah satu paha pasien
dengan tarikan berat beban antara 2 – 5 kg. Paha ini tidak boleh fleksi selama
traksi masih diperlukan.</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Paling lambat pagi harinya traksi
harus dilepas dan fiksasi kateter dipindahkan ke paha bagian proximal/ke arah
inguinal agar tidak terjadi penekanan pada uretra bagian penosskrotal. Guna dari
traksi adalah untuk mencegah perdarahan dari prostat yang diambil mengalir di
dalam buli-buli, membeku dan menyumbat pada kateter.</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Bila terlambat melepas kateter
traksi, dikemudian hari terjadi stenosis leher buli-buli karena mengalami
ischemia.</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Tujuan pemberian spoling/irigasi
:</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Agar jalannya cairan dalam kateter tetap lancar.</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Mencegah pembuntuan karena bekuan darah menyumbat
kateter</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Cairan yang digunakan spoling H<sub>2</sub>O / PZ</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Kecepatan irigasi tergantung dari
warna urine, bila urine merah spoling dipercepat dan warna urine harus sering
dilihat. Mobilisasi duduk dan berjalan urine tetap jernih, maka spoling dapat
dihentikan dan pipa spoling dilepas.</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Kateter dilepas pada hari kelima.
Setelah kateter dilepas maka harus diperhatikan miksi penderita. Bisa atau
tudak, bila bisa berapa jumlahnya harus diukur dan dicatat atau dilakukan
uroflowmetri.</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Sebab-sebab terjadinya retensio
urine lagi setelah kateter dilepas :</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Terbentuknya bekuan darah</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Pengerokan prostat kurang bersih (pada TUR) sehingga
masih terdapat obstruksi.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.8pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->A.<span style="font-size: 7pt;"> </span><!--[endif]-->TUR
– P</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Setelah TUR – P klien dipasang
tree way folley cateter dengan retensi balon 30 – 40 ml. Kateter di tarik untuk
membantu hemostasis</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Intruksikan klien untuk tidak
mencoba mengosongkan bladder Otot bladder kontraksi <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> nyeri spasme</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
CBI (Continuous Bladder
Irigation) dengan normal salin <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> mencegah obstruksi atau komplikasi lain CBI – P. Folley
cateter diangkat 2 – 3 hari berikutnya</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Ketika kateter diangkat timbul
keluhan : frekuensi, dribbling, kebocoran <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> normal</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Post TUR – P : urine bercampur
bekuan darah, tissue debris <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> meningkat <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> intake cairan minimal 3000 ml/hari <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
membantu menurunkan disuria dan menjaga urine tetap jernih.</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 21.8pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]-->B.<span style="font-size: 7pt;"> </span><!--[endif]-->OPEN
PROSTATECTOMY</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Resiko post operative bleeding
pada 24 jam pertama oleh karena bladder spsme atau pergerakan</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Monitor out put urine tiap 2 jam
dan tanda vital tiap 4 jam</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Arterial bleeding <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
urine kemerahan (saos) + clotting</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Venous bleeding <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
urine seperti anggur <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> traction kateter</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Vetropubic prostatectomy</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Observasi : drainage purulent,
demam, nyeri meningkat <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span> deep wound infection, pelvic abcess</div>
<div class="MsoNormal" style="margin-left: 24pt; text-align: justify;">
Suprapubic prostatectomy</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Perlu Continuous Bladder Irigation via
suprapubic <span style="font-family: Symbol; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">®</span>
klien diinstruksikan tetap tidur sampai Continuous Bladder Irigation dihentikan</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: justify; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Kateter uretra diangkat hari 3 – 4 post op</div>
<div class="MsoNormal" style="margin-left: 43.65pt; text-align: left; text-indent: -21.8pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]-->Setelah kateter diangkat, kateter supra pubic di
clamp dan klien disuruh miksi dan dicek residual urine, jika residual urine ±
75 ml, kateter diangkat</div>
<div class="MsoNormal" style="text-align: left;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b>EVALUASI<o:p></o:p></b></div>
<div class="MsoNormal" style="text-align: justify;">
Kreteria yang diharapkan terhadap diagnosis yang berhubungan
dengan obstruksi urinari adalah :</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt;">
</span><!--[endif]-->Mengatasi obstruksi urine tanpa infeksi atau komplikasi
yang permanen</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt;">
</span><!--[endif]-->Tidak mengalami tekanan atau nyeri berkepanjangan</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt;">
</span><!--[endif]-->Mengungkapkan penurunan atau tak adanya kecemasan
tentang retensio urine.</div>
<div class="MsoNormal" style="margin-left: 21.85pt; text-align: justify; text-indent: -21.85pt;">
<!--[if !supportLists]-->4.<span style="font-size: 7pt;">
</span><!--[endif]--> Menunjukan
tingkat fungsi sexual kembali sebagaimana sebelumnya.</div>
</div>
<div style="text-align: justify;">
<span style="font-family: 'Times New Roman', serif;"><br /></span></div>
<div class="MsoNormal" style="text-align: center;">
<b>DAFTAR PUSTAKA<o:p></o:p></b></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Carpenito,
Linda Jual. (1995). <b>Rencana Asuhan & Dokumentasi Keperawatan</b>
(terjemahan). PT EGC. Jakarta.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Djanalaeoni
H. (1977). <b>Aseptik dan Antiseptik</b>. Volume 6. Ropanasuri.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Doenges,
et al. (2000). <b>Rencana Asuhan Keperawatan</b> (terjemahan). PT EGC. Jakarta.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Engram,
Barbara. (1998). <b>Rencana Asuhan Keperawatan</b><b> Medikal Bedah. </b>Volume I
(terjemahan). PT EGC. Jakarta.</div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Hardjowijoto S. <b>Pemeriksaan Sistoskopi</b>.
Seksi/Program Studi Urologi Unair.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Hardjowijoto S. (1999) .<b>Benigna Prostatic Hyperplasia</b>. Airlangga University Press. Surabaya<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Long, Barbara C. (1996). <b>Perawatan Medikal Bedah</b>. Volume I. (terjemahan).Yayasan Ikatan
Alumni Pendidikan Keperawatan Pajajaran. Bandung.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Puruhito. (1989). <b>Tata Kerja Kamar Operasi</b>.
Surabaya.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Soeparman.
(1990). <b>Ilmu Penyakit Dalam. </b>Jilid II. FKUI. Jakarta.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Soesanto Wibowo, Puruhito, Setiono Basuki. <b>Pedoman Teknik Operasi.</b><o:p></o:p></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 0.75in; text-align: justify; text-indent: -0.75in;">
Sumartono, M., Gardjito, W., Hardjowijoto, S.
(1983). <b>Reseksi Transuretral Pada
Hyperplasia Benigna dari Kelenjar Prostat</b>. Bagian ilmu bedah Fakultas Kedokteran Universitas Airlangga. <o:p></o:p></div>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-63996302684463058912012-12-19T21:49:00.000-08:002012-12-19T21:49:27.541-08:00DENGAN GAGAL NAFAS (BANTUAN VENTILASI MEKANIK)<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div align="center" class="MsoNormal" style="text-align: center;">
LAPORAN PENDAHULUAN
ASUHAN KEPERAWATAN <span lang="IN">KLIEN <o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="IN">DENGAN GAGAL NAFAS<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="IN"> (BANTUAN
VENTILASI MEKANIK)<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<h2>
<span lang="IN">Pengertian</span></h2>
<div class="MsoNormal">
<span lang="IN">Kegagalan
pernafasan adalah pertukaran gas yang tidak adekuat sehingga terjadi hipoksia,
hiperkapnia (peningkatan konsentrasi karbon dioksida arteri), dan asidosis.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Ventilator adalah
suatu alat yang digunakan untuk membantu sebagian atau seluruh proses ventilasi
untuk mempetahankan oksigenasi.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<h2>
<span lang="IN">Penyebab gagal nafas</span></h2>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="IN">Penyebab sentral<o:p></o:p></span></li>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal"><span lang="IN">Trauma kepala : contusio cerebri<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Radang otak : encephalitis<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Gangguan vaskuler : perdarahan otak
, infark otak<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Obat-obatan : narkotika, anestesi<o:p></o:p></span></li>
</ol>
<li class="MsoNormal"><span lang="IN">Penyebab perifer<o:p></o:p></span></li>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal"><span lang="IN">Kelainan neuromuskuler : GBS,
tetanus, trauma cervical, muscle relaxans<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Kelainan jalan nafas : obstruksi
jalan nafas, asma bronchiale<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Kelainan di paru : edema paru, atelektasis,
ARDS<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Kelainan tulang iga/thoraks: fraktur
costae, pneumo thorax, haematothoraks<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Kelainan jantung : kegagalan jantung
kiri<o:p></o:p></span></li>
</ol>
</ol>
<h2>
<span lang="IN">Patofisiologi</span></h2>
<div class="MsoNormal" style="text-indent: .5in;">
<span lang="IN">Pada pernafasan spontan inspirasi terjadi karena diafragma dan otot
intercostalis berkontraksi, rongga dada mengembang dan terjadi tekanan negatif
sehingga aliran udara masuk ke paru, sedangkan fase ekspirasi berjalan secara
pasif .<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Pada pernafasan
dengan ventilasi mekanik, ventilator mengirimkan udara dengan memompakan ke
paru pasien, sehingga tekanan selama inspirasi adalah positif dan menyebabkan
tekanan intra thorakal meningkat. Pada akhir inspirasi tekanan dalam rongga
thoraks paling positif. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<a name='more'></a><br />
<div align="center" class="MsoNormal" style="text-align: center;">
<span lang="IN">Ventilator<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
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<tbody>
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<td height="5" width="282"></td>
</tr>
<tr>
<td></td>
<td><img height="27" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1026" width="12" /></td>
</tr>
</tbody></table>
<!--[endif]--><span lang="IN"> </span></div>
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<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-right: -45.0pt;">
<!--[if gte vml 1]><v:line
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o:allowincell="f">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; margin-left: 282px; margin-top: 16px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251646464;"><img height="27" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1027" width="12" /></span><!--[endif]--><span lang="IN">
Tekanan positif inspirasi<o:p></o:p></span></div>
<div class="MsoHeader">
<br /></div>
<div class="MsoHeader" style="margin-right: -.25in; tab-stops: .5in;">
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to="45pt,39.05pt" o:allowincell="f"/><![endif]--><!--[if !vml]--><span style="height: 38px; margin-left: 59px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251650560;"><img height="38" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1031" width="2" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1030"
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o:allowincell="f"/><![endif]--><!--[if !vml]--><span style="height: 2px; margin-left: 59px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 158px; z-index: 251649536;"><img height="2" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1030" width="158" /></span><!--[endif]--><span lang="IN"> Darah
ke jantung suplai ke otak vol tidal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 171.0pt;">
<span lang="IN"> Terhambat kurang tinggi<o:p></o:p></span></div>
<div class="MsoNormal">
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<v:stroke endarrow="block"/>
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="2" width="282"></td>
<td width="12"></td>
<td width="120"></td>
<td width="12"></td>
<td width="132"></td>
<td width="12"></td>
</tr>
<tr>
<td height="27"></td>
<td align="left" valign="top"><img height="27" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1028" width="12" /></td>
<td></td>
<td align="left" valign="top"><img height="27" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1044" width="12" /></td>
<td></td>
<td align="left" valign="top"><img height="27" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1046" width="12" /></td>
</tr>
</tbody></table>
<!--[endif]--><span lang="IN"> </span></div>
<br clear="ALL" />
<div class="MsoNormal">
<span lang="IN">Darah ke atrium
kiri Venous return
b(-)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-right: -.25in;">
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<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 27px; margin-left: 282px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251648512;"><img height="27" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1029" width="12" /></span><!--[endif]--><span lang="IN"> Berkurang
TIK meningkat
resiko <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-right: -.25in;">
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o:allowincell="f">
<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 63px; margin-left: 54px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251652608;"><img height="63" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1033" width="12" /></span><!--[endif]--><span lang="IN">
pneumotorak<o:p></o:p></span></div>
<div class="MsoNormal">
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<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; margin-left: 70px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 135px; z-index: 251653632;"><img height="12" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image007.gif" v:shapes="_x0000_s1034" width="135" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1032"
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o:allowincell="f"/><![endif]--><!--[if !vml]--><span style="height: 2px; margin-left: 59px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251651584;"><img height="2" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image008.gif" v:shapes="_x0000_s1032" width="2" /></span><!--[endif]--><span lang="IN">
cardiac output menurun<o:p></o:p></span></div>
<div class="MsoNormal">
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<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; margin-left: 383px; margin-top: 1px; mso-ignore: vglayout; position: absolute; width: 51px; z-index: 251659776;"><img height="12" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image009.gif" v:shapes="_x0000_s1040" width="51" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1038"
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o:allowincell="f"/><![endif]--><!--[if !vml]--><span style="height: 14px; margin-left: 287px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251657728;"><img height="14" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image010.gif" v:shapes="_x0000_s1038" width="2" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1037"
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o:allowincell="f"/><![endif]--><!--[if !vml]--><span style="height: 2px; margin-left: 287px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251656704;"><img height="2" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image008.gif" v:shapes="_x0000_s1037" width="2" /></span><!--[endif]--><span lang="IN">
Hipotensi Ggn
perfusi jaringan<o:p></o:p></span></div>
<div class="MsoNormal">
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<v:stroke endarrow="block"/>
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to="378pt,27.65pt" o:allowincell="f"/><v:line id="_x0000_s1051" style='position:absolute;
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="0"></td>
<td width="27"></td>
<td width="177"></td>
<td width="26"></td>
</tr>
<tr>
<td height="5"></td>
<td align="left" rowspan="2" valign="top"><img height="12" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1039" width="27" /></td>
</tr>
<tr>
<td height="7"></td>
<td></td>
<td align="left" rowspan="2" valign="top"><img height="38" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1047 _x0000_s1051" width="26" /></td>
</tr>
<tr>
<td height="31"></td>
</tr>
</tbody></table>
</span></span><!--[endif]--><span lang="IN"> </span></div>
<br clear="ALL" />
<div class="MsoNormal">
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<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; margin-left: 503px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 27px; z-index: 251670016;"><img height="12" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1050" width="27" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1036"
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<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 15px; margin-left: 234px; margin-top: 5px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251655680;"><img height="15" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image014.gif" v:shapes="_x0000_s1036" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1035"
style='position:absolute;z-index:251654656;mso-position-horizontal:absolute;
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mso-position-vertical-relative:text' from="126pt,4.85pt" to="180pt,4.85pt"
o:allowincell="f"/><![endif]--><!--[if !vml]--><span style="height: 2px; margin-left: 167px; margin-top: 5px; mso-ignore: vglayout; position: absolute; width: 74px; z-index: 251654656;"><img height="2" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image015.gif" v:shapes="_x0000_s1035" width="74" /></span><!--[endif]--><span lang="IN">Kompresi mikro vaskuler
Kecemasan<o:p></o:p></span></div>
<div class="MsoHeader">
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o:allowincell="f"/><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251668992;"><span style="height: 14px; left: 503px; position: absolute; top: -1px; width: 2px;"><img height="14" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image010.gif" v:shapes="_x0000_s1049" width="2" /></span></span><!--[endif]--><!--[if gte vml 1]><v:line
id="_x0000_s1048" style='position:absolute;z-index:251667968;
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to="378pt,9.05pt" o:allowincell="f"/><![endif]--><!--[if !vml]--><span style="height: 2px; margin-left: 491px; margin-top: 11px; mso-ignore: vglayout; position: absolute; width: 14px; z-index: 251667968;"><img height="2" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image016.gif" v:shapes="_x0000_s1048" width="14" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1041"
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<v:stroke endarrow="block"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; margin-left: 335px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 39px; z-index: 251660800;"><img height="12" src="file:///C:/DOCUME~1/ADMINI~1/LOCALS~1/Temp/msohtmlclip1/01/clip_image017.gif" v:shapes="_x0000_s1041" width="39" /></span><!--[endif]--><span lang="IN">
Suplai darah ke paru b(-)
Ggn oksigenasi<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<h2>
<span lang="IN">Pemeriksaan Fisik</span><span lang="IN" style="font-weight: normal; mso-bidi-font-weight: bold;"><o:p></o:p></span></h2>
<div class="MsoNormal">
<span lang="IN">( Menurut
pengumpulan data dasar oleh Doengoes)<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l4 level1 lfo5; tab-stops: list .25in; text-indent: -.5in;">
<!--[if !supportLists]--><span lang="IN">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Sirkulasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN">Tanda : Takikardia, irama ireguler<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN">S3S4/Irama gallop <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN">Daerah PMI bergeser ke daerah mediastinal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN">Hamman’s sign (bynui udara beriringan dengan denyut jantung menandakan
udara di mediastinum)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN">TD : hipertensi/hipotensi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l4 level1 lfo5; tab-stops: list .25in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Nyeri/Kenyamanan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent2">
<span lang="IN">Gejala : nyeri pada satu sisi, nyeri tajam saat napas
dalam, dapat menjalar ke leher, bahu dan
abdomen, serangan tiba-tiba saat batuk</span></div>
<div class="MsoHeader">
<span lang="IN"> Tanda :
Melindungi bagian nyeri, perilaku distraksi, ekspresi meringis<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l4 level1 lfo5; tab-stops: list .25in; text-indent: -.5in;">
<!--[if !supportLists]--><span lang="IN">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Pernapasan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -45.0pt;">
<span lang="IN">Gejala
: riwayat trauma dada, penyakit
paru kronis, inflamasi paru , keganasan, “lapar udara”, batuk<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -45.0pt;">
<span lang="IN">Tanda :
takipnea, peningkatan kerja pernapasan, penggunaan otot asesori,
penurunan bunyi napas, penurunan fremitus vokal, perkusi : hiperesonan di atas
area berisi udara (pneumotorak), dullnes di area berisi cairan (hemotorak);
perkusi : pergerakan dada tidak seimbang, reduksi ekskursi thorak. Kulit :
cyanosis, pucat, krepitasi sub kutan; mental: cemas, gelisah, bingung, stupor<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l4 level1 lfo5; tab-stops: list .25in; text-indent: -.5in;">
<!--[if !supportLists]--><span lang="IN">4.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Keamanan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN">Gejala : riwayat terjadi fraktur,
keganasan paru, riwayat radiasi/kemoterapi<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">5. Penyuluhan/pembelajaran<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN"> Gejala : riwayat faktor resiko keluarga
dengan tuberkulosis, kanker <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -45.0pt;">
<span lang="IN"> <o:p></o:p></span></div>
<h2>
<span lang="IN">Pemeriksaan Diagnostik</span></h2>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">- Hb : dibawah 12 gr %<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">- Analisa gas
darah : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo2; tab-stops: list .75in; text-indent: -81.0pt;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="IN">pH dibawah 7,35 atau di atas 7,45<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo2; tab-stops: list .75in; text-indent: -81.0pt;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="IN">paO2 di bawah 80 atau di atas 100 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo2; tab-stops: list .75in; text-indent: -81.0pt;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="IN">pCO2 di bawah 35 atau di atas 45 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo2; tab-stops: list .75in; text-indent: -81.0pt;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span lang="IN">BE di bawah -2 atau di atas +2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo2; tab-stops: list 9.0pt; text-indent: -1.0in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Saturasi
O2 kurang dari 90 %<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo2; tab-stops: list 9.0pt; text-indent: -1.0in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Ro” :
terdapat gambaran akumulasi udara/cairan , dapat terlihat perpindahan letak
mediastinum<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<h2>
<span lang="IN">Diagnosa Keperawatan</span></h2>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Diagnosa
Keperawatan yang mungkin muncul pada klien dengan pernafasan ventilator mekanik
adalah :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN">1.Ketidak efektifan bersihan jalan nafas berhubungan dengan peningkatan
produksi sekret<o:p></o:p></span></div>
<ol start="2" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="IN">Gangguan pertukaran gas berhubungan
dengan sekresi tertahan, proses
penyakit<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Ketidakefektifan pola nafas
berhubungandengan kelelahan, pengesetan ventilator yang tidak tepat,
obstruksi selang ETT<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Cemas berhubungan dengan penyakti
kritis, takut terhadap kematian<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Gangguan komunikasi verbal
berhubungan dengan pemasangan selang ETT<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Resiko tinggi komplikasi infeksi
saluran nafas berhubungan dengan pemasangan selang ETT<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Resiko tinggi sedera berhubungan
dengan penggunaan ventilasi mekanik, selang ETT, ansietas, stress<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Nyeri berhubungan dengan penggunaan
ventilasi mekanik, letak selang ETT<o:p></o:p></span></li>
</ol>
<div class="MsoNormal">
<br /></div>
<h2>
<span lang="IN">Rencana Keperawatan</span></h2>
<div class="MsoNormal">
<br /></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="IN">Ketidak efektifan bersihan jalan
nafas berhubungan dengan peningkatan produksi sekret<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoBodyTextIndent2">
<span lang="IN">Tujuan : Klien akan memperlihatkan
kemampuan meningkatkan dan mempertahankan keefektifan jalan nafas</span></div>
<div class="MsoBodyTextIndent2">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN">Kriteria hasil :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo2; tab-stops: list 1.0in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Bunyi
nafas bersih<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo2; tab-stops: list 1.0in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Ronchi
(-)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo2; tab-stops: list 1.0in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Tracheal
tube bebas sumbatan<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
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<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">Intervensi<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">Rasional<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">1.Auskultasi
bunyi nafas tiap 2-4 jam atau bila diperlukan<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">2.Lakukan
penghisapan bila terdengar ronchi dengan cara :<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">a.Jelaskan pada
klien tentang tujuan dari tindakan penghisapan<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">b.Berikan
oksigenasi dengan O2 100 % sebelum dilakukan penghisapan, minimal 4 – 5 x pernafasan<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">c.Perhatikan
teknik aseptik, gunakan sarung tangan steril, kateter penghisap steril<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">d.Masukkan
kateter ke dalam selang ETT dalam keadaan tidak menghisap, lama penghisapan
tidak lebih 10 detik<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">e.Atur tekana
penghisap tidak lebih 100-120 mmHg <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">f.Lakukan
oksigenasi lagi dengan O2 100% sebelum melakukan penghisapan berikutnya<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">g.Lakukan
penghisapan berulang-ulang sampai suara nafas bersih<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">3.Pertahankan
suhu humidifier tetap hangat ( 35 – 37,8 C)<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">Mengevaluasi
keefektifan bersihan jalan nafas<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Meningkatkan
pengertian sehingga memudahkan klien berpartisipasi<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Memberi
cadangan oksigen untuk menghindari hypoxia<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Mencegah
infeksi nosokomial<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Aspirasi lama
dapat menyebabkan hypoksiakarena tindakan penghisapan akan mengeluarkan
sekret dan oksigen<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Tekana negatif
yang berlebihan dapat merusak mukosa jalan nafas<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Memberikan
cadangan oksigen dalam paru<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Menjamin
kefektifan jalan nafas<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Membantu
mengencerkan sekret<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l3 level1 lfo3; tab-stops: list .25in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Gangguan
pertukaran gas berhubungan dengan sekresi tertahan,proses penyakit, pengesetan
ventilator yang tidak tepat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN">Tujuan : Klien akan memperlihatkan kemampuan pertukaran gas yang kembali
normal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in;">
<span lang="IN">Kriteria hasil :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo2; tab-stops: list 1.0in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Hasil
analisa gas darah normal :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo2; tab-stops: list 117.0pt; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">PH
(7,35 – 7,45)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo2; tab-stops: list 117.0pt; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">PO2
(80 – 100 mmHg)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo2; tab-stops: list 117.0pt; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">PCO2
( 35 – 45 mmHg)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 117.0pt; mso-list: l2 level3 lfo2; tab-stops: list 117.0pt; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN" style="font-family: Wingdings; mso-ansi-language: IN; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">BE (
-2 - +2)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1.0in; mso-list: l2 level2 lfo2; tab-stops: list 1.0in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="IN">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="IN">Tidak
cyanosis<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">Intervensi<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">Rasional<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">1.Cek analisa
gas darah setiap 10 –30 mnt setelah perubahan setting ventilator<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">2.Monitor hasil
analisa gas darah atau oksimetri selama periode penyapihan<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">3.Pertahankan
jalan nafas bebas dari sekresi<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">4.Monitpr tanda
dan gejala hipoksia<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">Evaluasi
keefektifan setting ventilator yang diberikan<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Evaluasi
kemampuan bernafas klien<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Sekresi
menghambat kelancaran udara nafas<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Deteksi dini
adanya kelainan<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<ol start="3" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="IN">Ketidakefektifan pola nafas
berhubungan dengan kelelahan, pengesetan ventilator yang tidak tepat,
peningkatan sekresi, obstruksi ETT<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Tujuan : Klien
akan mempertahankan pola nafas yang efektif<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Kriteria hasil : <o:p></o:p></span></div>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal"><span lang="IN">Nafas sesuai dengan irama ventilator<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Volume nafas adekuat<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN">Alarm tidak berbunyi<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="IN"> </span></li>
</ol>
<div class="MsoNormal">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">Intervensi<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">Rasional<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">1.Lakukan
pemeriksaan ventilator tiap 1-2 jam <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">2.Evaluasi
semua alarm dan tentukan penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">3.Pertahankan
alat resusitasi manual (bag & mask) pada posisi tempat tidur sepanjang
waktu<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">4.Monitor
slang/cubbing ventilator dari terlepas, terlipat, bocor atau tersumbat<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">5.Evaluasi
tekanan atau kebocoran balon cuff<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">6.Masukkan
penahan gigi (pada pemasangan ETT lewat oral)<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">7.Amankan slang
ETT dengan fiksasi yang baik<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">8.Monitor suara
nafas dan pergerakan ada secara teratur<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 221.4pt;" valign="top" width="295">
<div class="MsoNormal">
<span lang="IN">Deteksi dini
adanya kelainan atau gangguan fungsi ventilator<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Bunyi alarm
menunjukkan adanya gangguan fungsi ventilator<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Mempermudah
melakukan pertolongan bila sewaktu-waktu ada gangguan fungsi ventilator<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Mencegah
berkurangnya aliran udara nafas<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Mencegah
berkurangnya aliran udara nafas<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Mencegah
tergigitnya slang ETT<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="IN">Mencegah
terlepasnya.tercabutnya slang ETT<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="IN">Evaluasi
keefektifan pola nafas<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h1 style="text-indent: -.75in;">
<span lang="IN">Daftar Pustaka</span></h1>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-right: -27.0pt;">
Carpenito, Lynda Juall (2000), <i>Buku saku Diagnosa Keperawatan</i>, Edisi 8, EGC, Jakarta</div>
<div class="MsoNormal" style="margin-right: -27.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-right: -27.0pt;">
Corwin, Elizabeth J, (2001<i>), Buku saku Patofisiologi</i>, Edisi bahasa
Indonesia, EGC, Jakarta</div>
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<br /></div>
<div class="MsoNormal" style="margin-right: -27.0pt;">
Doengoes, E. Marilyn (1989), <i>Nursing Care Plans,</i> Second Edition, FA
Davis, Philadelphia</div>
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<br /></div>
<div class="MsoBodyTextIndent">
<span lang="IN">Suprihatin, Titin (2000), <i>Bahan Kuliah Keperawatan Gawat Darurat PSIK
Angkatan I,</i> Universitas Airlangga, Surabaya</span></div>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-60872076004699853702012-12-19T21:41:00.000-08:002012-12-19T21:41:14.871-08:00KONSEP LANSIA LANJUT USIA (GERONTIK)<div dir="ltr" style="text-align: left;" trbidi="on">
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<b>KONSEP LANSIA</b></div>
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<b>LANJUT USIA (GERONTIK)</b></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> Batasan Lansia<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Menurut Organisasi Kesehatan Dunia ,lanjut usia
dikelompokkan menjadi:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Usia pertengahan (<i>middle
age</i>), ialah kelompok usia 45 sampai 59 tahun.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Lanjut usia (<i>elderly</i>)
: antara 60 dan 74 tahun.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Lanjut usia tua (<i>old</i>)
: antara 75 dan 90 tahun<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">d.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Usia sangat tua (<i>very
old</i>) : diatas 90 tahun<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> Permasalahan
Pada Lanjut Usia</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 21.3pt; tab-stops: 63.8pt; text-align: justify; text-indent: 28.35pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berbagai permasalahan yang
berkaitan dengan pencapaian kesejahteraan lanjut usia antara lain (Setiabudhi,1999: 40 - 42):<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Permasalahan Umum :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Makin besarnya jumlah lansia yang berada di bawah
garis kemiskinan.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Makin melemahnya nilai kekerabatan sehingga anggota
keluarga yang berusia lanjut kurang diperhatikan, dihargai dan dihormati.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Lahirnya kelompok masyarakat industri.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Masih rendahnya kuantitas dan kualitas tenaga profesional
pelayanan lanjut usia.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Belum membudaya dan melembaganya kegiatan pembinaan
kesejahteraan lansia.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Permasalahan khusus :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berlangsungnya proses menua yang berakibat timbulnya
masalah baik fisik, mental maupun sosial.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berkurangnya integrasi sosial lanjut usia.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Rendahnya produktivitas kerja lansia.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Banyaknya lansia yang miskin, telantar dan cacat.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berubahnya nilai sosial masyarakat yang mengarah pada
tatanan masyarakat individualistik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Adanya dampak negatif dari proses pembangunan yang
dapat mengganggu kesehatan fisik lansia.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori Proses Menua</span></b></div>
<a name='more'></a><b><o:p></o:p></b><br />
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori-Teori
Biologi<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori
Genetik dan Mutasi</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> (<i>Somatic
Mutatie Theory</i>)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Menurut teori ini menua telah terprogram secara genetik untuk
spesies-spesies tertentu. Menua terjadi sebagai akibat dari perubahan biokimia
yang diprogram oleh molekul-molekul/DNA dan setiap sel pada saatnya akan
mengalami mutasi. Sebagai contoh yang khas adalah mutasi dari sel-sel kelamin.
(terjadi penurunan kemampuan fungsional sel).<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">"<b>Pemakaian
dan Rusak</b>" kelebihan usaha dan stres menyebabkan sel-sel tubuh lelah
(terpakai).<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Reaksi dari
kekebalan sendiri</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> (<i>Auto Immune
Theory</i>)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Di dalam proses metabolisme tubuh, suatu saat diproduksi
suatu zat khusus. <st1:city w:st="on"><st1:place w:st="on">Ada</st1:place></st1:city>
jaringan tubuh tertentu yang tidak tahan terhadap zat tersebut sehingga
jaringan tubuh menjadi lemah dan sakit.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori "<b>Immunologi
Slow Virus</b>" (<i>Immunology Slow
Virus Theory</i>)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Sistem immun menjadi efektif dengan bertambahnya usia dan
masuknya virus ke dalam tubuh dapat menyebabkan kerusakan organ tubuh.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> <b>Stres</b><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Menua terjadi akibat hilangnya sel-sel yang biasa digunakan
tubuh. Regenerasi jaringan tidak dapat mempertahankan kestabilan lingkungan
internal, kelebihan usaha dan stres menyebabkan sel-sel tubuh lelah terpakai.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori
Radikal</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> <b>Bebas</b><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Radikal bebas dapat terbentuk di alam bebas, tidak stabilnya
radikal bebas (kelompok atom) mengakibatkan oksidasi oksigen bahan-bahan
organik seperti karbohidrat dan protein. Radikal ini menyebabkan sel-sel tidak
dapat regenerasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">7.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori
Rantai</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> <b>Silang</b><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Sel-sel yang tua atau usang, reaksi kimianya menyebabkan ikatan
yang kuat, khususnya jaringan kolagen. Ikatan ini menyebabkan kurangnya
elastis, kekacauan, dan hilangnya fungsi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">8.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori</span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> <b>Program</b><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Kemampuan organisme untuk menetapkan jumlah sel yang membelah
setelah sel-sel tersebut mati.<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori
Kejiwaan Sosial<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Aktivitas atau Kegiatan (<i>Activity Theory</i>)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Ketentuan akan meningkatnya pada penurunan jumlah
kegiatan secara langsung. Teori ini menyatakan bahwa pada <i>lanjut usia</i> yang sukses adalah mereka yang aktif dan ikut banyak
dalam kegiatan sosial.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Ukuran
optimum</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> (pola hidup) dilanjutkan pada cara hidup dari <i>lanjut usia.</i><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Mempertahankan hubungan antara sistem sosial dan
individu agar tetap stabil dari usia pertengahan ke <i>lnjut usia.</i><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Kepribadian berlanjut (<i>Continuity Theory</i>)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Dasar kepribadian atau tingkah laku
tidak berubah pada <i>lanjut usia</i>. Teori
ini merupakan gabungan dari teori di atas. Pada teori ini menyatakan bahwa
perubahan yang terjadi pada seseorang yang <i>lanjut
usia</i> sangat dipengaruhi oleh tipe <i>personality</i>
yang dimilikinya.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori Pembebasan (<i>Disengagement
Theory</i>)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori ini menyatakan bahwa dengan
bertambahnya usia, seseorang secara berangsur-angsur mulai melepaskan diri dari
kehidupan sosialnya atau menarik diri dari pergaulan sekitarnya. Keadaan ini
mengakibatkan interaksi sosial <i>lanjut
usia</i> menurun, baik secara kualitas maupun kuantitas sehingga sering terjadi
kehilangan ganda (<i>Triple Loos</i>), yakni
:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Kehilangan peran (<i>Loos
of Role</i>)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Hambatan kontak sosial (<i>Restraction of Contact and Relation Ships</i>)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berkurangnya komitmen (<i>Reduced commitment to Social Mores and Values</i>)<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Faktor-faktor yang mempengaruhi ketuaan<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Faktor-faktor yang mempengaruhi ketuaan adalah (Nugroho,
2000:19):<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">s<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Hereditas =
ketuaan genetik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">s<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Nutrisi =
makanan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">s<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Status
kesehatan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">s<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pengalaman
hidup<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">s<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Lingkungan<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Perubahan-perubahan yang terjadi pada lansia<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Perubahan-perubahan Fisik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Meliputi perubahan dari tingkat sel sampai ke semua sistem
organ tubuh diantaranya sistem pernafasan, pendengaran, penglihatan, kardio
vaskuler, sistem pengaturan temperatur tubuh, sistem respirasi, muskuloskletal,
gastrointestinal, genitourinaria, endokrin dan integumen<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Perubahan-perubahan
mental<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Faktor-faktor yang mempengaruhi perubahan mental<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pertama-tama perubahan fisik, khususnya organ perasa<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Kesehatan umum<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Tingkat pendidikan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Keturunan (<i>Hereditas</i>)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Lingkungan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gangguan saraf panca indera, timbul kebutaan dan
ketulian<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gangguan gizi akibat kehilakngan jabatan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Rangkaian dari kehilangan, yaitu kehilangan hubungan
dengan teman-teman dan <i>family</i><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Hilangnya kekuatan dan ketegapan fisik : perubahan
terhadap gambaran diri, perubahan konsep diri.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Perkembangan
Spiritual<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Agama atau kepercayaan makin terintegrasi dalam
kehidupannya (Maslow, 1970).<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">¨<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Lansia makin matur dalam kehidupan keagamaannya, hal
ini terlihat dalam berfikir dan bertindak dalam sehari-hari. (Murray dan
Zentner, 1970).<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Penyakit yang sering dijumpai pada lansia<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Menurut
"<i>The national Old People's Welfare
Council"<o:p></o:p></i></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Di Inggris mengemukakan bahwa penyakit atau gangguan
umum pada <i>lanjut usia</i> ada 12 macam,
yakni (Nugroho, 2000: 42):<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi mental<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gangguan pendengaran<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Bronkitis kronis<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gangguan pada tungkai / sikap berjalan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gangguan pada koksa / sendi panggul<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Anemia<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">7.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Demensia<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<br /></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Konsep Depresi<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> Definisi<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi adalah suatu kelainan alam
perasaan berupa hilangnya minat atau kesenangan dalam aktivitas-aktivitas yang
biasa dan pada waktu yang lampau (Townsend,1998:179). Rentang respon emosi
individu dapat berfluktuasi dalam rentang respon emosi dari adaptif sampai
maladaptif. Respon depresi merupakan emosi yang mal adaptif (Keliat,1996:2).<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> Jenis-Jenis
Depresi<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Penggolongan depresi dapat dibedakan
(Wilkinson,1995:18 - 26):<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Menurut gejalanya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi neurotik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi neurotik biasanya terjadi setelah mengalami peristiwa
yang menyedihkan tetapi yang jauh lebih berat daripada biasanya. Penderitanya
seringkali dipenuhi trauma emosional yang mendahului penyakit misalnya
kehilangan orang yang dicintai, pekerjaan, milik berharga, atau seorang
kekasih. Orang yang menderita depresi neurotik bisa merasa gelisah, cemas dan
sekaligus merasa depresi. Mereka menderita hipokondria atau ketakutan yang
abnormal seperti agrofobia tetapi mereka tidak menderita delusi atau
halusinasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi psikotik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Secara tegas istilah 'psikotik' harus dipakai untuk penyakit
depresi yang berkaitan dengan delusi dan halusinasi atau keduanya.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Psikosis depresi manik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi manik biasanya merupakan penyakit yang kambuh kembali
disertai gangguan suasana hati yang berat. Orang yang mengalami gangguan ini
menunjukkan gabungan depresi dan rasa cemas tetapi kadang-kadang hal ini dapat
diganti dengan perasaan gembira, gairah, dan aktivitas secara berlebihan
gambaran ini disebut 'mania'.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pemisahan diantara keduanya<o:p></o:p></span></div>
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<st1:place w:st="on"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Para</span></st1:place><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> dokter
membedakan antara depresi neurotik dan psikotik tidak hanya berdasarkan gejala
lain yang ada dan seberapa terganggunya perilaku orang tersebut.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Menurut Penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi reaktif<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pada depresi reaktif, gejalanya diperkirakan akibat stres
luar seperti kehilangan seseorang atau kehilangan pekerjaan.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi endogenus<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pada depresi endogenous, gejalanya terjadi tanpa dipengaruhi
oleh faktor lain.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi primer dan sekunder<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Tujuan penggolongan ini adalah untuk memisahkan depresi yang
disebabkan penyakit fisik atau psiatrik atau kecanduan obat atau alkohol
(depresi 'sekunder') dengan depresi yang tidak mempunyai penyebab-penyebab ini
(depresi 'primer'). Penggolongan ini lebih banyak digunakan untuk penelitian
tujuan perawatan.<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Menurut arah penyakit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi tersembunyi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Diagnosa depresi tersembunyi (atau atipikal) kadang-kadang
dibuat bilamana depresi dianggap
mendasari gangguan fisik dan mental yang tidak dapat diterangkan, misalnya rasa
sakit yang lama tanpa sebab yang nyata atau hipokondria atau sebaliknya
perilaku yang tidak dapat diterangkan seperti wanita lanjut usia yang suka
mengutil.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berduka<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Proses kesedihan itu wajar dan merupakan reaksi yang
diperlukan terhadap suatu kehilangan. Proses ini membuat orang yang kehilangan
itu mampu menerima kenyataan tersebut, mengalami rasa sakit akibat kesedihan
yang menimpa, menderita putusnya hubungan dengan orang yang dicintai dan
penyesuaian kembali.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi pascalahir<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Banyak wanita kadang-kadang mengalami periode gangguan
emosional dalam 10 hari pertama setelah melahirkan bayi ketika emosi mereka
masih labil dan mereka merasa sedih dan suka menangis. Seringkali hal itu
berlangsung selama satu atau dua hari kemudian berlalu.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Depresi dan manula<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Usia tua merupakan saat meningkatnya kerentanan terhadap
depresi. Namun, kadang-kadang depresi pada manula ditutupi oleh penyakit fisik
dan cacat tubuh seperti penglihatan atau pendengaran yang terganggu. Oleh
karena itu, sangatlah penting untuk mengingat kemungkinan terjadinya penyakit
depresi pada orang tua.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> Faktor
Predisposisi<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Terdapat 2 teori untuk menjelaskan
faktor pendukung terjadinya depresii (Townsend,1998:181 - 183):<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori Biologis<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Genetik</span></i></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">. Dari sejumlah penyelidikan yang
telah dilakukan ditemukan bahwa terdapat dukungan keterlibatan herediter dalam
penyakit depresi. Luasnya akibat pada pokoknya tampak menjadi lebih tinggi
diantara individu-individu yang memiliki hubungan keluarga dengan kelainan
tersebut daripada diantara populasi umum (<i>DSM-III-R,</i>
1987).<o:p></o:p></span></div>
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<!--[if !supportLists]--><b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></span></b><!--[endif]--><b><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Biokimia</span></i></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">.
Ketidakseimbangan elektrolit tampak memainkan peranan dalam penyakit depresif.
Suatu kesalahan hasil metabolisme dalam perubahan natrium dan kalium di dalam
neuron (Gibbons, 1960).<b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori biokimia yang lainnya menyangkut biogenik amin
norepinefrin, dopamin, dan serotinin. Tingkatan zat-zat kimia ini mengalami
defisiensi dalam individu dengan penyakit depresif (Janowsky et al, 1988).<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori Psikososial<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Psikoanalisa</span></i></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">. Teori ini (Klein, 1934)
melibatkan suatu ketidakpuasan dalam hubungan awal ibu-bayi sebagai suatu
predisposisi untuk penyakit depresif. Kebutuhan bayi tidak terpenuhi, suatu
kondisi yang digambarkan sebagai suatu kehilangan. Respons berduka belum
terpecahkan, dan kemarahan dan permusuhan ditunjukkan kepada diri sendiri. Ego
tetap lemah, sementara superego meluas dan menjadi menghukum.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Kognitif</span></i></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">. Ahli teori-teori ini (Beck et al,
1979) yakin bahwa penyakit depresif terjadi sebagai suatu hasil dari kelainan
kognitif. Kelainan proses pikir membantu perkembangan evaluasi diri individu.
Persepsi merupakan ketidakadekuatan dan ketidakberhargaan. Pandangan untuk masa
depan merupakan suatu kepesimisan keputusasaan.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori Pembelajaran</span></i></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">. Teori ini
(seligman, 1973) mengemukakan bahwa penyakit depresif dipengaruhi oleh
keyakinan individu bahwa ada kurang kontrol atau situasi-situasi kehidupannya.
Ini dianggap bahwa keyakinan ini muncul dari pengalaman-pengalaman yang
mengakibatkan kegagalan (baik yang dirasakan atau yang nyata). Setelah sejumlah
kegagalan, individu merasa tidak berdaya untuk berhasil dalam usaha-usaha yang
keras, dan oleh karena itu berhenti mencoba. Pembelajaran ketidakberdayaan ini
digambarkan sebagai suatu predisposisi untuk penyakit depresif.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">d.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><b><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teori Kehilangan Objek</span></i></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">. Teori ini
(Bowly, 1973) menyatakan bahwa penyakit depresif terjadi jika pribadi tersebut
terpisah dari atau ditolak orang terdekat selama 6 bulan pertama kehidupan.
Proses ikatan diputuskan, dan anak menarik diri dari orang lain dan lingkungan.<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Faktor Pencetus<o:p></o:p></span></b></div>
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<st1:city w:st="on"><st1:place w:st="on"><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Ada</span></st1:place></st1:city><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> empat sumber utama stresor yang
dapat mencetuskan gangguan alam perasaan (Sundeen,Stuart,1998:260):<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Kehilangan
keterikatan,</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> yang nyata atau yang dibayangkan, termasuk kehilangan cinta,
seseorang, fungsi fisik, kedudukan, atau harga diri. Karena elemen aktual dan
simbolik melibatkan konsep kehilangan, maka persepsi pasien merupakan hal yang
sangat penting.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Peristiwa
besar dalam kehidupan</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> sering dilaporkan sebagai pendahulu episode depresi
dan mempunyai dampak terhadap masalah-masalah yang dihadapi sekarang dan
kemampuan menyelesaikan masalah.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Peran dan
ketegangan peran</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> telah dilaporkan mempengaruhi perkembangan depresi,
terutama pada wanita.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Perubahan
fisiologik</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> diakibatkan oleh obat-obatan atau berbagai penyakit fisik,
seperti infeksi, neoplasma, dan gangguan keseimbangan metabolik, dapat mencetuskan
gangguan alam perasaan.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pengelolaan Depresi Pada Usia Lanjut </span></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">(FKUI,2000:60
- 76)<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Hal-hal yang perlu diperhatikan pada usia lanjut :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Obat-obatan <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Beberapa jenis obat seperti digoksin, L-dopa, steroid,
penyekat beta dan anti hipertensi lainnya, pemberian benzodiazepin jangka
panjang, fenobarbiton, dan pemakaian neuroleptik jangka lama dapat
mengakibatkan depresi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Neurobiologik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Perubahan neuroendokrinologik seperti hormon, neurotransmiter
(serotonin, dopamin, dll) menyebabkan usia lanjut rentan terhadap depresi.
Depresi pada usia lanjut dapat diakibatkan oleh proses neurodegeneratif,
misalnya depresi sebagai gejala dari demensia.<o:p></o:p></span></div>
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<br /></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Psikososial<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Kepribadian pasien sebelum sakit turut berperan dalam
manifestasi gejala depresi, misalnya orang yang pencemas semasa mudanya ketika
mengalami depresi di usia lanjut memperlihatkan gambaran depresi neurotik yang
menyolok.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Dukungan sosial yang buruk, kapasitas membina
keakraban yang lemah juga berperan dalam
terjadinya depresi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berbagai peristiwa kehidupan seperti kematian
pasangan, problem keuangan yang berat, pindah rumah, peringatan peristiwa
sedih, anak yang cacat menanjak dewasa, dan sebagainya lebih sering terjadi
pada pasien-pasien usia lanjut dengan depresi dibandingkan dengan usia lanjut
yang sehat.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gambaran Klinis Depresi Pada Usia Lanjut<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Seorang usia lanjut yang mengalami
depresi kebanyakan menyangkal adanya <i>mood</i>
depresi. Yang terlihat adalah gejala hilangnya tenaga (loyo), hilangnya rasa
senang, tidak bisa tidur atau keluhan rasa sakit dan nyeri. Menurut Brodaty
(1991) gejala yang sering tampil adalah ansietas (kecemasan), preokupasi gejala
fisik, perlambatan motorik, kelelahan, mencela diri sendiri, pikiran bunuh diri
dan insomnia.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gambaran klinik depresi pada pasien
berusia lanjut (dibandingkan dengan pasien yang lebih muda), adalah mereka
lebih banyak menonjolkan gejala somatiknya disamping mengeluh tentang gangguan
memori, dan umumnya cenderung meminimalkan atau menyangkal <i>mood</i> depresinya. Hal lain yang tidak menguntungkan adalah pasien
usia lanjut umumnya kurang mau mencari bantuan psikiater karena tak dapat
menerima penjelasan yang bersifat psikologis untuk gangguan depresi yang mereka
alami.<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Diagnosis Depresi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gangguan depresi dibedakan dalam
depresi ringan, sedang dan berat sesuai dengan banyak dan beratnya gejala serta
dampaknya terhadap fungsi kehidupan seseorang. Menurut ICD 10, pada gangguan
depresi ada 3 gejala utama yaitu :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Mood terdepresi (suasana perasaan hati murung /
sedih),<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Hilang minat atau gairah,<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Hilang tenaga dan mudah lelah, yang disertai dengan
gejala lain seperti :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; mso-list: l23 level1 lfo18; tab-stops: 92.15pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Konsentrasi
menurun,<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; mso-list: l23 level1 lfo18; tab-stops: 92.15pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Harga diri
menurun,<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; mso-list: l23 level1 lfo18; tab-stops: 92.15pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Perasaan
bersalah,<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; mso-list: l23 level1 lfo18; tab-stops: 92.15pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pesimis
memandang masa depan,<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; mso-list: l23 level1 lfo18; tab-stops: 92.15pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Ide bunuh
diri atau menyakiti diri sendiri,<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; mso-list: l23 level1 lfo18; tab-stops: 92.15pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pola tidur
berubah,<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; mso-list: l23 level1 lfo18; tab-stops: 92.15pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Nafsu makan
menurun.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Tabel 2.1Pedoman Berat Ringannya Depresi<o:p></o:p></span></div>
<div align="center">
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 58.15pt;" valign="top" width="78">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Depresi<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 48.15pt;" valign="top" width="64">
<div align="center" class="MsoNormal" style="tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gejala<o:p></o:p></span></div>
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<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Utama<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 63.8pt;" valign="top" width="85">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gejala lain<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 63.75pt;" valign="top" width="85">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Fungsi<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 88.6pt;" valign="top" width="118">
<div align="center" class="MsoNormal" style="margin-top: 6.0pt; tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keterangan<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 58.15pt;" valign="top" width="78">
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: justify;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Ringan<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 48.15pt;" valign="top" width="64">
<div align="center" class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 63.8pt;" valign="top" width="85">
<div align="center" class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 63.75pt;" valign="top" width="85">
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: justify;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Baik<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 88.6pt;" valign="top" width="118">
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: justify;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Distress <u>+</u><o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 58.15pt;" valign="top" width="78">
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: justify;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Sedang<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 48.15pt;" valign="top" width="64">
<div align="center" class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 63.8pt;" valign="top" width="85">
<div align="center" class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3 atau 4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 63.75pt;" valign="top" width="85">
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: justify;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Terganggu<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 88.6pt;" valign="top" width="118">
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berlangsung minimal 2 minggu<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 58.15pt;" valign="top" width="78">
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: justify;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Berat<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 48.15pt;" valign="top" width="64">
<div align="center" class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 63.8pt;" valign="top" width="85">
<div align="center" class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: center;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 63.75pt;" valign="top" width="85">
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: justify;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Terganggu berat<o:p></o:p></span></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 88.6pt;" valign="top" width="118">
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: justify;">
<span style="font-family: "Arial Narrow","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Intensitas gejala sangat berat<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
</div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> Sumber:Bagian Ilmu Penyakit
Dalam FKUI,2000 <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: justify;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; tab-stops: 63.8pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 63.8pt; mso-list: l12 level1 lfo15; tab-stops: 63.8pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pemeriksaan pasien Depresi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 63.8pt; tab-stops: 63.8pt; text-align: justify; text-indent: 28.35pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Salah satu langkah awal yang
penting dalam penatalaksanaan depresi adalah mendeteksi atau mengidentifikasi.
Sampai saat ini belum ada suatu konsensus atau prosedur khusus untuk penapisan
/ skrining depresi pada populasi usia lanjut. Salah satu instrumen yang dapat
membantu adalah <i>Geriatric Depression
Scale </i>(GDS) yang terdiri atas 30 pertanyaan yang harus dijawab oleh pasien
sendiri. GDS ini dapat dimampatkan menjadi hanya 15 pertanyaan saja.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 63.8pt; tab-stops: 63.8pt; text-align: justify; text-indent: 28.35pt;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Bilamana ditemukan tanda-tanda yang
mengarah pada depresi, harus dilakukan lagi pemeriksaan yang lebih rinci
sebagai berikut :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Riwayat klinik / anamnesis<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; mso-list: l19 level1 lfo20; tab-stops: 92.15pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">riwayat keluarga<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; mso-list: l19 level1 lfo20; tab-stops: 92.15pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">gangguan psikiatri yang lampau<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; mso-list: l19 level1 lfo20; tab-stops: 92.15pt; text-align: justify; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">kepribadian<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">d.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">riwayat sosial<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">e.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">ide / percobaan bunuh diri<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">f.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">gangguan-gangguan somatik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">g.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">perkembangan gejala-gejala depresi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pemeriksaan Fisik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pemeriksaan fisik pada pasien depresi sangat penting karena
gejala-gejala depresi sering disertai dengan penyakit fisik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pemeriksaan kognitif<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Penilaian Mini Mental State Examination (MMSE) pada usia
lanjut yang menunjukkan gejala depresi bermanfaat dalam tindak lanjut
penatalaksanaan pasien. Perbaikan pada MMSE setelah dilakukan terapi terhadap
depresi, menunjukkan bahwa pasien dengan depresi mengalami masalah konsentrasi
dan memori yang mempengaruhi fungsi kognitifnya.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pemeriksaan status mental<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Penampilan dan perilaku<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Mood</span></i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"> / suasana
perasaan hati<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pembicaraan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Isi pikiran<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gejala ansietas<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Gejala hipokondriakal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Pemeriksaan lainnya<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 78.0pt; tab-stops: 78.0pt; text-align: justify;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Mengingat pasien usia lanjut rentan terhadap gangguan
metabolik sekunder akibat penyakit depresi yang berat, seperti tidak adekuatnya
asupan cairan, maka perlu dipertimbangkan pemeriksaan sebagai berikut :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">ureum dan elektrolit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">darah lengkap dan hitung jenis<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Vitamin B12 dan Folat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Tes fungsi Tiroid<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Foto dada<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Lain-lain : serum sifilis,Electro Cardio Graphy (
ECG),Electro Encephalo Graphy ( EEG), CT-<i>scan</i>
dst.<o:p></o:p></span></div>
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<br /></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Prognosis<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Prognosis depresi pada usia lanjut
tidaklah berbeda dengan prognosis pada usia yang lebih muda. Umumnya pasien
akan sembuh dan tetap dapat berfungsi dengan baik jika depresi diobati dan
ditatalaksana dengan baik. Hasil terapi yang kurang baik tampaknya berhubungan
dengan episode awal yang parah dan adanya komorbiditas dengan penyakit kronik.<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Penatalaksanaan Depresi Pada usia Lanjut<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Terapi fisik<o:p></o:p></span></div>
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<!--[if !supportLists]--><b><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; font-style: normal; font-weight: normal; line-height: normal;">
</span></span></i></b><!--[endif]--><b><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Obat<o:p></o:p></span></i></b></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Secara umum, semua obat antidepresan sama efektivitasnya.
Pemilihan jenis antidepresan ditentukan oleh pengalaman klinikus dan pengenalan
terhadap berbagai jenis antidepresan. Biasanya pengobatan dimulai dengan dosis
separuh dosis dewasa, lalu dinaikkan perlahan-lahan sampai ada perbaikan
gejala.<o:p></o:p></span></div>
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<!--[if !supportLists]--><b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></span></b><!--[endif]--><b><i><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Terapi
Elektrokonvulsif (ECT)</span></i></b><b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 92.15pt; tab-stops: 92.15pt; text-align: justify;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Untuk pasien depresi yang tidak bisa makan dan minum, berniat
bunuh diri atau retardasi hebat maka ECT merupakan pilihan terapi yang efektif
dan aman. ECT diberikan 1- 2 kali seminggu pada pasien rawat nginap, unilateral
untuk mengurangi <i>confusion/memory
problem.</i> Terapi ECT diberikan sampai ada perbaikan <i>mood</i> (sekitar 5 - 10 kali), dilanjutkan dengan anti depresan untuk
mencegah kekambuhan.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Terapi Psikologik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Psikoterapi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Psikoterapi individual maupun kelompok paling efektif jika
dilakukan bersama-sama dengan pemberian antidepresan. Baik pendekatan
psikodinamik maupun kognitif <i>behaviour</i>
sama keberhasilannya. Meskipun mekanisme psikoterapi tidak sepenuhnya
dimengerti, namun kecocokan antara pasien dan terapis dalam proses terapeutik
akan meredakan gejala dan membuat pasien lebih nyaman, lebih mampu mengatasi
persoalannya serta lebih percaya diri.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Terapi kognitif<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Terapi kognitif - perilaku bertujuan mengubah pola pikir
pasien yang selalu negatif (persepsi diri, masa depan, dunia, diri tak berguna,
tak mampu dan sebagainya) ke arah pola pikir yang netral atau positif. Ternyata
pasien usia lanjut dengan depresi dapat menerima metode ini meskipun penjelasan
harus diberikan secara singkat dan terfokus. Melalui latihan-latihan,
tugas-tugas dan aktivitas tertentu terapi kognitif bertujuan mengubah perilaku
dan pola pikir.<o:p></o:p></span></div>
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<br /></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Terapi keluarga<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Problem keluarga dapat berperan dalam perkembangan penyakit
depresi, sehingga dukungan terhadap keluarga pasien sangat penting. Proses
penuaan mengubah dinamika keluarga, ada perubahan posisi dari dominan menjadi
dependen pada orang usia lanjut. Tujuan terapi terhadap keluarga pasien yang
depresi adalah untuk meredakan perasaan frustasi dan putus asa, mengubah dan
memperbaiki sikap / struktur dalam keluarga yang menghambat proses penyembuhan
pasien.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">d.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Penanganan Ansietas (Relaksasi)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Teknik yang umum dipergunakan adalah program relaksasi
progresif baik secara langsung dengan instruktur (psikolog atau terapis
okupasional) atau melalui <i>tape recorder.</i>
Teknik ini dapat dilakukan dalam praktek umum sehari-hari. Untuk menguasai
teknik ini diperlukan kursus singkat terapi relaksasi.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Dukungan Keluarga dalam Kaitannya dengan Depresi Pada
Lansia<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Keluarga memainkan suatu peranan
yang signifikan dalam kehidupan pada hampir semua orang lanjut usia (lansia).
Ketika keluarga tidak menjadi bagian kehidupan seseorang yang telah lansia,
umumnya menyebabkan orang tersebut tidak mempunyai tempat tinggal, atau ada
masalah-masalah yang telah berlangsung lama dan keterasingan. Sebaliknya,
kepercayaan yang umum, ketika orang lansia akan membutuhkan bantuan keluarga
menyediakan sekurang-kurangnya 80% dukungan / bantuan. Dibandingkan dengan
"kenyamanan di hari tua", keluarga saat ini menyediakan kepedulian
yang lebih luas selama periode waktu yang lama (Schmall, Pratt, 1993).<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Walaupun anak yang telah dewasa
adalah suatu sumber utama yang memberi bantuan terhadap orangtua yang lansia,
beberapa trend demografi dan sosial mempunyai akibat / impak yang signifikan
pada kemampuan anggota keluarga dalam menyediakan dukungan. Hal ini tidak
berarti bahwa keluarga bertanggung jawab atas timbulnya depresi pada seseorang
namun sudah jelas bahwa banyak masalah depresi berkisar di seputar kesulitan
dalam cara anggota keluarga saling berkomunikasi dan saling berhubungan.<o:p></o:p></span></div>
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Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-77234710657882975652012-12-19T21:20:00.002-08:002012-12-19T21:20:32.428-08:00TONSILITIS<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">TONSILITIS</span></b></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">A. PENGERTIAN<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Tonsilitis adalah suatu inflamasi (peradangan) pada
tonsil. <o:p></o:p></span></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">B. PENYEBAB<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Penyebab radang akut ini ialah kuman golongan
streptokokus B hemolytikus, streptokokus viridans dan streptokokus pyogenes,
yang merupakan penyebab pada 50% pada kasus. Sisanya disebabkan oleh infeksi
virus yaitu adenovirus, ECHO, virus influenza, serta herpes. Cara infeksinya
ialah oleh percikan ludah (droplet infeksi).<b><o:p></o:p></b></span></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">C. TANDA DAN GEJALA</span></b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;"><o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Gejala yang sering ditemukan adalah suhu tubuh naik
sampai mencapai 40 derajat celsius, rasa lesu, rasa nyeri di sendi, odimofagi,
tidak nafsu makan, rasa nyeri di telinga (<i>otalgia</i>),
karena nyeri alih <i>(referred pain</i>) melalui
nervus glosofaringeus (N IX). <o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Pada pemeriksaan tampak faring hiperemis, tonsil
membengkak, hiperemis, terlihat detritus berbentuk folikel, lakuna atau
beberapa membran.<o:p></o:p></span></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">D. PATOFISIOLOGI<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Mula-mula terjadi infiltrasi pada lapisan epitel. Bila
epitel terkikis, maka jaringan limfoid superfisial mengadakan reaksi, terdapat
pembendungan radang dengan infiltrasi leukosit polimorfonuklear. Proses ini
secara klinis tampak pada kriptur tonsil yang berisi bercak kuning yang disebut
detritus. Detritus merupakan kumpulan leukosit, bakteri dan epitel yang
terlepas. Suatu tonsilitis akut dengan detritus, yang jelas disebut tonsilitis
folikularis. Bila bercak-bercak detritus itu berdekatan menjadi satu, maka
terjadi tonsilitis lakunaris. Bercak detritus yang melebar itu dapat lebih
lebar lagi, sehingga terbentuk membran semu (psedomembran). <o:p></o:p></span></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">E. PEMERIKSAAN PENUNJANG<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Dilakukan pemeriksaan fisik menyeluruh, dan pengumpulan
riwayat kesehatan yang cermat untuk menyingkirkan kondisi sistemik atau kondisi
yang berkaitan. Usap tonsilar dikultur untuk menentukan adanya infeksi bakteri.<o:p></o:p></span></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">F. PENATALAKSANAAN MEDIS<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Terapi pada tonsilitis akut adalah antibiotik atau
sulfonamida, antipiretik dan obat kumur atau obat isap yang mengandung
desinfektan. Tonsilektomi bisanya dilakukan jika pengobatan medis tidak
menunjukkan hasil, dan terdapat abses hipertrofi atau tonsilar berat yang
menyumbat faring, membuat kesulitan menelan dan membahayakan jalan napas.
Terapi antibiotik yang sesuai diresepkan untuk pasien yang menjalani
tonsilektomi. Terapi antibiotik yang paling umum adalah penisilin oral, yang
diminum selama 10 hari. Amoksilin dan eritromisin merupakan alternatif.<o:p></o:p></span></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">G. POTENSIAL KOMPLIKASI<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">1. Perdarahan<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">2. Abses peritonsilar<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">3. Abses parafaring<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">4. Toksemia<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">5. Septikemia<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">6. Otitis media akut<o:p></o:p></span></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">BAB II<o:p></o:p></span></b></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">STANDAR ASUHAN KEPERAWATAN PADA PASIEN TONSILITIS<o:p></o:p></span></b></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">A. PENGKAJIAN<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Riwayat kesehatan pasien yang lengkap yang menunjukkan
kemungkinan tanda dan gejala sakit kepala, sakit tenggorok dan nyeri sekitar
mata dan pada kedua sisi hidung, kesulitan menelan, batuk, suara serak, demam,
hidung tersumbat dan rasa tidak nyaman umum dan keletihan. Menetapkan kapan
gejala mulai timbul, apa yang menjadi pencetusnya, apa jika ada yang dapat
menghilangkan atau meringankan gejala tersebut, dan apa yang memperburuk gejala
tersebut juga identifikasi setiap riwayat alergi atau adanya penyakit yang
timbul bersamaan. Tonsil diinspeksi terhadap temuan abnormal seperti warna
kemerahan, asimetris atau adanya drainase, ulserasi atau pembesaran.<o:p></o:p></span></div>
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<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">B. MASALAH YANG LAZIM MUNCUL<o:p></o:p></span></b></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">1. Prabedah<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">a. Nyeri akut</span><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; font-variant: small-caps; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-family: Arial;"> </span><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-family: Arial;">b.d engan injuri fisik: kerusakan jaringan</span><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; font-variant: small-caps; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-family: Arial;"><o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">b. Gangguan
menelan</span><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-family: Arial;"><o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">2. Pasca bedah<o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">a. Nyeri akut </span><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-family: Arial;">b.d engan injuri fisik: kerusakan jaringan</span><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;"><o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">b. Risiko infeksi </span><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: DE; mso-bidi-font-family: Arial;">b.d kerusakan jaringan</span><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;"><o:p></o:p></span></div>
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<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">c. PK: perdarahan<o:p></o:p></span></div>
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<span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">No<o:p></o:p></span></div>
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<span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Diagnosa Keperawatan<o:p></o:p></span></div>
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<span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Rencana Keperawatan<o:p></o:p></span></div>
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<span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Tujuan Tindakan<o:p></o:p></span></div>
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<span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Rencana Tindakan<o:p></o:p></span></div>
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<div class="MsoNormal" style="text-align: justify;">
<span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">1<o:p></o:p></span></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 311.8pt;" valign="top" width="416">
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<span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Nyeri akut b.d engan injuri fisik: kerusakan jaringan<o:p></o:p></span></div>
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<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; line-height: 150%; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Definisi : <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Sensori yang tidak menyenangkan dan
pengalaman emosional yang muncul secara aktual atau potensial kerusakan
jaringan atau menggambarkan adanya kerusakan (Asosiasi Studi Nyeri
Internasional): serangan mendadak atau pelan intensitasnya dari ringan sampai
berat yang dapat diantisipasi dengan akhir yang dapat diprediksi dan dengan
durasi kurang dari 6 bulan.<o:p></o:p></span></div>
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<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Batasan karakteristik : <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Laporan secara verbal atau non verbal <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Fakta dari observasi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Posisi antalgic untuk menghindari nyeri <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Gerakan melindungi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Tingkah laku berhati-hati<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Muka topeng <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Gangguan tidur (mata sayu, tampak capek, sulit atau
gerakan kacau, menyeringai)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Terfokus pada diri sendiri <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Fokus menyempit (penurunan persepsi waktu,
kerusakan proses berpikir, penurunan interaksi dengan orang dan lingkungan) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Tingkah laku distraksi, contoh : jalan-jalan,
menemui orang lain dan/atau aktivitas, aktivitas berulang-ulang)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Respon autonom (seperti diaphoresis, perubahan
tekanan darah, perubahan nafas, nadi dan dilatasi pupil)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Perubahan autonomic dalam tonus otot (mungkin dalam
rentang dari lemah ke kaku) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Tingkah laku ekspresif (contoh : gelisah, merintih,
menangis, waspada, iritabel, nafas panjang/berkeluh kesah) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 24.6pt; text-align: justify; text-indent: -6.0pt;">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">- Perubahan dalam nafsu makan dan minum<o:p></o:p></span></div>
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<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Faktor yang berhubungan : <o:p></o:p></span></div>
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<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Agen injuri (biologi, kimia, fisik,
psikologis)</span><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;"><o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 170.6pt;" valign="top" width="227">
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">NOC :<o:p></o:p></span></div>
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<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Pain Level, Pain Control, Comfort Level<o:p></o:p></span></div>
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<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Pain : Disruptive Effects <o:p></o:p></span></div>
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<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kriteria Hasil :<o:p></o:p></span></div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal" style="mso-list: l11 level1 lfo3; tab-stops: list .5in; text-align: justify;"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Menggunakan skala nyeri untuk mengidentifikasi
tingkat nyeri<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l11 level1 lfo3; tab-stops: list .5in; text-align: justify;"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Melaporkan bahwa nyeri berkurang dengan
menggunakan manajemen nyeri.<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l11 level1 lfo3; tab-stops: list .5in; text-align: justify;"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Melaporkan kebutuhan tidur dan istirahat
tercukupi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l11 level1 lfo3; tab-stops: list .5in; text-align: justify;"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Mampu menggunakan metode non farmakologi untuk
mengurangi nyeri<o:p></o:p></span></li>
</ul>
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<br /></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 170.6pt;" valign="top" width="227">
<div class="MsoBodyTextIndent2" style="margin-left: .5in; mso-list: l2 level1 lfo4; tab-stops: list .5in;">
<!--[if !supportLists]--><span style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Arial Narrow"; mso-fareast-font-family: "Arial Narrow";">1.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><i><span style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Manajemen nyeri :<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Definisi</span></b><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;"> : mengurangi nyeri dan menurunkan tingkat nyeri yang dirasakan
pasien.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Intervensi</span></b><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;"> :<o:p></o:p></span></div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Lakukan
pengkajian nyeri secara komprehensif termasuk lokasi, karakteristik,
durasi, frekuensi, kualitas dan faktor presipitasi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Observasi
reaksi nonverbal dari ketidaknyamanan<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Gunakan
teknik komunikasi terapeutik untuk mengetahui pengalaman nyeri pasien<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Kaji kultur yang mempengaruhi respon nyeri<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Evaluasi
pengalaman nyeri masa lampau<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Evaluasi
bersama pasien dan tim kesehatan lain tentang ketidakefektifan kontrol
nyeri masa lampau<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Bantu pasien dan keluarga untuk mencari dan menemukan dukungan<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Kontrol lingkungan yang dapat mempengaruhi nyeri seperti suhu
ruangan, pencahayaan dan kebisingan<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Kurangi
faktor presipitasi nyeri<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Pilih
dan lakukan penanganan nyeri (farmakologi, non farmakologi dan inter
personal)<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Kaji tipe dan sumber nyeri untuk menentukan intervensi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Ajarkan
tentang teknik non farmakologi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Berikan
analgetik untuk mengurangi nyeri<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Evaluasi
keefektifan kontrol nyeri<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Tingkatkan
istirahat<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Kolaborasikan
dengan dokter jika ada keluhan dan tindakan nyeri tidak berhasil<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Monitor penerimaan pasien tentang manajemen nyeri<o:p></o:p></span></li>
</ul>
<div class="MsoBodyTextIndent2">
<br /></div>
<ol start="2" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="mso-list: l2 level1 lfo4; tab-stops: list .5in; text-align: justify;"><i><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Medication administration<o:p></o:p></span></i></li>
</ol>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Definisi </span></b><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">: penggunaan agen farmakologi untuk menghentikan atau mengurangi
nyeri.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Intervensi</span></b><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;"> :<o:p></o:p></span></div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal" style="mso-list: l7 level1 lfo6; tab-stops: list .5in; text-align: justify;"><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Tentukan lokasi, karakteristik, kualitas, dan derajat nyeri sebelum
pemberian obat<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l7 level1 lfo6; tab-stops: list .5in; text-align: justify;"><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Cek instruksi dokter tentang jenis obat, dosis, dan frekuensi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l7 level1 lfo6; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Cek
riwayat alergi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l7 level1 lfo6; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Pilih
analgesik yang diperlukan atau kombinasi dari analgesik ketika pemberian
lebih dari satu <o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l7 level1 lfo6; tab-stops: list .5in; text-align: justify;"><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Tentukan pilihan analgesik tergantung tipe dan beratnya nyeri<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l7 level1 lfo6; tab-stops: list .5in; text-align: justify;"><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Tentukan analgesik pilihan, rute pemberian, dan dosis optimal<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l7 level1 lfo6; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Pilih
rute pemberian secara IV, IM untuk pengobatan nyeri secara teratur<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l7 level1 lfo6; tab-stops: list .5in; text-align: justify;"><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Monitor
vital sign sebelum dan sesudah pemberian analgesik pertama kali<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l7 level1 lfo6; tab-stops: list .5in; text-align: justify;"><span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Berikan analgesik tepat waktu terutama saat nyeri hebat<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l7 level1 lfo6; tab-stops: list .5in; text-align: justify;"><span lang="PT-BR" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: PT-BR; mso-bidi-font-family: Arial;">Evaluasi efektivitas analgesik, tanda dan gejala
(efek samping)<o:p></o:p></span></li>
</ul>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="DE" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: DE; mso-bidi-font-family: Arial;">Resiko Infeksi b.d kerusakan jaringan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Definisi : Peningkatan resiko masuknya
organisme patogen<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Faktor-faktor resiko : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Prosedur Infasif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Ketidakcukupan pengetahuan untuk menghindari paparan patogen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Trauma <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kerusakan jaringan dan peningkatan paparan lingkungan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Ruptur membran amnion<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Agen farmasi (imunosupresan)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Malnutrisi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Peningkatan paparan lingkungan patogen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Imonusupresi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Ketidakadekuatan imum buatan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Tidak adekuat pertahanan sekunder (penurunan Hb, Leukopenia, penekanan
respon inflamasi)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Tidak adekuat pertahanan tubuh primer (kulit tidak utuh, trauma
jaringan, penurunan kerja silia, cairan tubuh statis, perubahan sekresi pH,
perubahan peristaltik)<o:p></o:p></span></div>
<div class="MsoNormal" style="tab-stops: -5.4pt; text-align: justify;">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;"> -
Nyeri kronis<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">NOC :<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Immune Status<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Knowledge : Infection
Control<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Risk Control<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kriteria Hasil :<o:p></o:p></span></div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Klien bebas dari
tanda dan gejala infeksi<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Menunjukkan kemampuan
untuk mencegah timbulnya infeksi<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Jumlah sel darah
putih dalam batas normal<o:p></o:p></span></li>
</ul>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Menunjukkan perilaku hidup
sehat (menjaga kebersihan) seperti mencuci tangan, perawatan mulut, dan
lain-lain.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">1. Infection Control<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="FR" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: FR; mso-bidi-font-family: Arial;">Definisi</span></b><span lang="FR" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: FR; mso-bidi-font-family: Arial;"> :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="FR" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: FR; mso-bidi-font-family: Arial;">Meminimalkan mendapatkan infeksi dan trasmisi agen
infeksi<o:p></o:p></span></div>
<div class="MsoNormal" style="tab-stops: 80.0pt; text-align: justify;">
<b><span lang="FR" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: FR; mso-bidi-font-family: Arial;">Intervensi</span></b><span lang="FR" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: FR; mso-bidi-font-family: Arial;"> : <o:p></o:p></span></div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="FR" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: FR; mso-bidi-font-family: Arial;">Bersihkan lingkungan setelah dipakai pasien lain<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="FR" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: FR; mso-bidi-font-family: Arial;">Pertahankan teknik isolasi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="FR" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: FR; mso-bidi-font-family: Arial;">Batasi pengunjung bila perlu<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Instruksikan pada pengunjung untuk mencuci tangan saat berkunjung dan
setelah berkunjung meninggalkan pasien<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Gunakan sabun antimikrobia untuk cuci tangan<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Cuci tangan setiap sebelum dan sesudah tindakan kperawtan<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Gunakan baju, sarung tangan sebagai alat pelindung<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Pertahankan lingkungan aseptik selama pemasangan alat<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Ganti letak IV perifer dan line central dan dressing sesuai dengan
petunjuk umum<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Gunakan kateter intermiten untuk menurunkan infeksi kandung kencing <o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Tingktkan intake nutrisi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l5 level1 lfo8; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Berikan terapi antibiotik bila perlu<o:p></o:p></span></li>
</ul>
<div class="MsoNormal" style="text-align: justify;">
<i><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">2. Infection Protection<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Deinisi</span></b><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;"> :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Pencegahan dan deteksi dini infeksi pada pasien yang
beresiko<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Intervensi</span></b><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;"> :<o:p></o:p></span></div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Monitor tanda dan gejala infeksi sistenikmdan lokal<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Monitor hitung granulosit, WBC<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Monitor kerentanan terhadap infeksi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Batasi pengunjung<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Saring pengunjung terhadap penyakit menular<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Partahankan teknik aspesis pada pasien yang beresiko<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Pertahankan teknik isolasi k/p<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Berikan perawatan kuliat pada area epidema<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Inspeksi kulit dan membran mukosa terhadap kemerahan, panas, drainase<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Ispeksi kondisi luka / insisi bedah<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Ambil kultur<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Dorong masukkan nutrisi yang cukup<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Dorong masukan cairan<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Dorong istirahat<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Monitor perubahan tingkat energi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Dorong peningkatan mobilitas dan latihan<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Dorong batuk dan napas dalam<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Instruksikan pasien untuk minum antibiotik sesuai resep<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Ajarkan pasien dan keluarga tanda dan gejala infeksi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Ajarkan cara menghindari infeksi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Batasi buah segar, sayuran dan merica pada pasien nertipenia<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Jauhkan bunag dan tanaman dari lingkungan pasien<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Berikan ruangan pribadi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Yakinkan keamanan air dengan hiperklorinasi dan pemanasan<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Laporkan kecurigaan infeksi<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l10 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span lang="NL" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NL; mso-bidi-font-family: Arial;">Laporkan kultur positif<o:p></o:p></span></li>
</ul>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">3<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Gangguan menelan<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Definisi : <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Fungsi tubuh yang tidak normal dalam mekanisme
menelan berkaitan dengan gangguan fungsi dalam mulut, paryng, atau struktur
esophagus.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Batasan karakteristik : <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kerusakan pada tahap
pharyng : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Perubahan pada posisi kepala <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Tidak adekuatnya elevasi laryng <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Makan tidak masuk <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Demam yang tidak jelas <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Keterlambatan menelan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kambuhnya infeksi paru <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Cegukan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Reflux ke hidung <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Tercekik, batuk terus menerus atau tersumbat <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Multiple swallows<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Ketidaknormalan pada tahap pharyngeal<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kerusakan pada tahap
esophageal : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Heart burn atau nyeri epigastrik <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Nafas berbau asam <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Ketidakstabilan sekitar waktu makan yang tidak dapat dijelaskan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Muntah di bantal <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Tersedak saat menelan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Muntahan isi lambung atau WET BURPS <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Bruxism <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Batuk malam hari atau terbangun <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Observasi kesulitan menelan (misal : tertahannya makanan di rongga
mulut, batuk/tercekik)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kepala hiperoklusi, menunduk selalu atau sesudah makan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Ketidaknormalan phase esophageal dalam proses menelan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">ODYNOPHAGIA<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Menolak makan/konsumsi sedikit <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Mengeluh ketika menelan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Hematemesis <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Muntah <o:p></o:p></span></div>
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<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kerusakan pada tahap oral
: <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kurangnya/keterbatasan gerak lidah untuk membentuk bolus <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kelemahan dalam menghisap atau tidak efisien dalam proses menyusu<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Bibir menutup tidak sempurna <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Makanan terdorong keluar mulut <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Pembentukan bolus yang terlambat <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Makanan jatuh dari mulut <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Bolus yang masuk sempurna <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Ketidakmampuan membersihkan rongga mulut <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Lama mengunyah dengan <span style="display: none; mso-hide: all;">ang tidak
dapat dijelaskan enelan berkaitan dengan gangguan fungsi dalam mulut, paryng,
atau struktur esoph</span>konsumsi sedikit <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Reflek hidung <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Batuk, tercekik, tersumbat sebelum menelan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Ketidaknormalan dalam fase oral <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">PLACENEAL DEGLUTITION<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kurang pengunyahan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Menumpuk dalam rongga mulut bagian samping<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.6pt; text-align: justify;">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Siallorhea atau ngiller<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;"> <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Faktor yang berhubungan : <o:p></o:p></span></div>
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<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Defisit Kongenital : <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Anomali jalan nafas bagian atas <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kegagalan perkembangan atau Protein Energy Malnutrisi (PEM) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kondisi dengan hypotoni (kekuatan tonus yang rendah) yang signifikan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Gangguan respirasi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Riwayat NGT <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Masalah berhubungan dengan perilaku makan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Perilaku merusak diri <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kelemahan neuromuskular (misal : Penurunan atau tidak adanya reflek
menelan, penurunan kekuatan atau kesalahan dalam mengunyah, kesalahan
perseptual, paralisis otot muka) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Obstruksi mekanis (misal : oedema, trachesotomi, tumor)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Penyakit jantung bawaan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kelemahan syaraf kranial <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Masalah neurologi : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Anomali jalan nafas bagian atas <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l6 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="NO-BOK" style="font-size: 10.0pt; mso-ansi-language: NO-BOK;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Ketidaknormalan laring <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify; text-indent: 36.6pt;">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Akalasia<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">NOC :<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Swallowing Status<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Kriteria Hasil :<o:p></o:p></span></div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Menunjukkan kemampuan
menelan dengan efektif tanpa tersedak atau batuk<o:p></o:p></span></li>
<li class="MsoNormal"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Pasien terhindar dari
aspirasi (misalnya paru-paru bersih, suhu dalam batas normal)<o:p></o:p></span></li>
</ul>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<i><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Aspiration Precaution<o:p></o:p></span></i></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Definisi: Mencegah atau meminimalkan faktor
risiko pasiko pasien mengalami aspirasi<o:p></o:p></span></div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal" style="mso-list: l12 level1 lfo11; tab-stops: list .5in; text-align: justify;"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Monitor tingkatkesadaran, refleks batuk dan kemampuan mengunyah<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l12 level1 lfo11; tab-stops: list .5in; text-align: justify;"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Monitor status paru<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l12 level1 lfo11; tab-stops: list .5in; text-align: justify;"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Pelihara jalan napas<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l12 level1 lfo11; tab-stops: list .5in; text-align: justify;"><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">Makan dalam jumlah cukup<o:p></o:p></span></li>
</ul>
<div class="MsoNormal">
<span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;">4<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: IN; mso-bidi-font-family: Arial;">PK: perdarahan</span><span lang="NO-BOK" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: Arial;"><o:p></o:p></span></div>
<div class="MsoBodyText">
<span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-ansi-language: IN; mso-bidi-font-family: Arial;">Setelah dilakukan asuhan
keperawatan selama....x24 jam perawat dapat meminimalkan perdarahan dan
mencegah komplikasi dengan kriteria :<o:p></o:p></span></div>
<div class="MsoBodyText" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo12; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-size: 10.0pt;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">tidak
terjadi perdarahan<o:p></o:p></span></div>
<div class="MsoBodyText" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo12; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-size: 10.0pt;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">vital sign
normal<o:p></o:p></span></div>
<div class="MsoBodyText" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo12; tab-stops: list .5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-size: 10.0pt;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">Anemis (-)<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 22.65pt; mso-list: l3 level1 lfo13; tab-stops: list 22.65pt; text-align: justify; text-indent: -18.7pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Arial Narrow"; mso-bidi-font-style: italic; mso-fareast-font-family: "Arial Narrow";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-style: italic;">Monitor keadaan umum pasien<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 42.1pt; mso-list: l3 level1 lfo13; tab-stops: list 22.65pt; text-align: justify; text-indent: -38.15pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Arial Narrow"; mso-bidi-font-style: italic; mso-fareast-font-family: "Arial Narrow";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-style: italic;">Monitor tanda-tanda vital<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 22.65pt; mso-list: l3 level1 lfo13; tab-stops: list 22.65pt; text-align: justify; text-indent: -18.7pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Arial Narrow"; mso-bidi-font-style: italic; mso-fareast-font-family: "Arial Narrow";">c.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-style: italic;">Monitor jumlah perdarahan pasien <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 42.1pt; mso-list: l3 level1 lfo13; tab-stops: list 22.65pt; text-align: justify; text-indent: -38.15pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Arial Narrow"; mso-bidi-font-style: italic; mso-fareast-font-family: "Arial Narrow";">d.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-style: italic;">Kaji kondisi luka post operasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 42.1pt; mso-list: l3 level1 lfo13; tab-stops: list 22.65pt; text-align: justify; text-indent: -38.15pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Arial Narrow"; mso-bidi-font-style: italic; mso-fareast-font-family: "Arial Narrow";">e.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-style: italic;">Awasi jika terjadi anemi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 22.65pt; mso-list: l3 level1 lfo13; tab-stops: list 22.65pt; text-align: justify; text-indent: -18.7pt;">
<!--[if !supportLists]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Arial Narrow"; mso-fareast-font-family: "Arial Narrow";">f.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial; mso-bidi-font-style: italic;">Kolaborasi dengan dokter mengenai masalah yang terjadi berhubungan
perdarahan : pemberian tranfusi, medicasi dll</span><i><span lang="EN-GB" style="font-family: "Arial Narrow","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: Arial;">.<o:p></o:p></span></i></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">DAFTAR PUSTAKA<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo1; tab-stops: list .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Brunner
dan Suddarth, 2000, <i>Keperawatan
Medikal Bedah</i>, edisi 1, Penerbit Buku Kedokteran EGC, Jakarta.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo1; tab-stops: list .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Johnson
M, 2000, <i>Nursing Outcomes
Clasifications (NOC)</i>, Second editions, Mosby Inc, Iowa.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo1; tab-stops: list .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">McCloskey.
J.C, 1996, <i>Nursing Interventions
Clasifications (NIC</i>), Second editions, Mosby Inc, Iowa.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo1; tab-stops: list .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN; mso-bidi-font-weight: bold;">Linda Jual Carpenito, 2001, <i>Buku Saku Diagnosa Keperawatan</i>,
edisi 6 EGC, Jakarta.</span><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;"> <o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo1; tab-stops: list .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">NANDA,
2001, <i>Nursing Diagnosis: Defenitions
and Clasificatiion 2001-2002</i>, Philadelphia.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l9 level1 lfo1; tab-stops: list .5in; text-align: justify;"><span lang="IN" style="font-family: "Arial Narrow","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-ansi-language: IN;">Soepardi
E.A, Iskandar N, 2000, <i>Buku Ajar
Ilmu Kesehatan Telinga Hidung Tenggorok</i>, edisi 4, Balai Penerbit FKUI,
Jakarta.<o:p></o:p></span></li>
</ol>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-56895495887095738852012-12-19T21:14:00.004-08:002012-12-19T21:14:54.960-08:00RETARDASI MENTAL<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="MsoNormal" style="line-height: 150%; text-align: center;">
<b>RETARDASI MENTAL</b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><br /></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>A. PENGERTIAN<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Retaldasi mental
adalah suatu gangguan heterogen yang terdiri dari gangguan fungsi dibawah
rata-rata dan gangguan dalam ketrampilan adaptif yang ditemukan sebelum orang
berusia 18 tahun (Mansjoer,2001)</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Retardasi mental
adalah fungsi intelektual di bawah rata-rata yang muncul beramaan dengan
kurangnya perilaku adatif, awitannya sebelum usia 18 tahun (Wong,2003).</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Retaldasi mental
mempunyai gambaran khusus, yaitu: (Varcarlois,1999)</div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo1; tab-stops: list .5in; text-align: justify;">Fungsi intelektual di bawah rata-rata (IQ 70 atau
lebih rendah)</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo1; tab-stops: list .5in; text-align: justify;">Defisit atau kerusakan fungsi adatif</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l2 level1 lfo1; tab-stops: list .5in; text-align: justify;">Terjadi sebelum usia 18 tahun </li>
</ol>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Retardasi mental
dapat didefinisikan sebagai keterbatasan dalam kecerdasan yang mengganggu
adaptasi normal terhadap lingkungan. Hal ini bermanifestasi dengan perkembangan
yang abnormal dan berkaitan dengan kesukaan belajar dan adaptasi social (Sacharin et al,1999)</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>B. ETIOLOGI<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Faktor penyabab
retardasi mental adalah:</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
1.Penyebab
prenatal</div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">Penyakit kromosom (Trisomi 21 / sindrom down, sindrom
fragile-X)</li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Hal
ini mencakup jumlah terbesar dari penyebab genetic dan paling sering adalah
trisomi yang melibatkan kromosom tambahan. Misalnya 47 dibandingkan keadaan
normal sebesar 46. Misalnya trisomi 17-18 (sindrom E), trisomi 13-15 (sindrom
D). Kehilangan parsial atau lengkap dari lengan pendek kromosom 5 juga
diketahui sebagai sindrom “ Cri duchat” Kelainan kromosom seks, seperti sindrom
klinefelter (XXY), sindrom Turner dan sebagai mosaic, dapat juga berkaitan
dengan retardasi mental.</div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">Gangguan sindrom</li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Cacat
ditransmisikan melalui gen, sebagai besar diantaranya adalah cacat resesif
terkait seks, misalnya sindrom Lowe (sindrom Okuloserebrorenal) dan sindrom
Hunter.</div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">Irradiasi</li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Terutama
pada kandungan dengan umur kehamilan 2-6 minggu. Pengaruh irradiasi pada janin
pada kehamilan muda dapat berupa perubahan mutasi baru pada kromosom atau
merusak janin secara langsung, sehingga terjadi malformasi pada bayi yang
dilahirkan.</div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">Gangguan metabolisme sejak lahir (Feniketonuria)</li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Gangguan
metabolic seperti feniketonuria, galaktosemia, penyakit Tay-Sachs juga
disebabkan oleh gangguan autosomal fesesif.</div>
<a name='more'></a><br />
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Feniketonuria
yaitu gangguan metabolic yang menyebabkan tubuh tidak mampu mengubah
phenialanin menjadi tryrosin, Karena adanya defisiensi enzyme hidrolase.
Kelainan ini diturunkan melalui gan resesif.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Gaklaktosemia
yaitu gangguan metabolisme hydratarang yang jarang ditemukan dan yang terdapat
pada masa permulaan bayi, dimana tubuh tak mampu untuk menggunakan galaktose
yang masuk.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Tay-sachs
disease yaitu suatu gangguan metabolisme lemak, dimana tubuh tidak bisa
mengubah zat-zat pralipoid menjadi lipoid yang diperlukan oleh sel-sel otak.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
2. Penyebab
perinatal</div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">Masalah intrauteri seperti abrupsio plasenta</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">Malnutrisi in utero dan toksin juga dapat menyebabkan
retardasi mental.</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">Diabetes maternal</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">Kelahiran maternal</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo2; tab-stops: list .5in; text-align: justify;">Kondisi neonatal (meningitis dan perdarahan
intracranial)</li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Komplikasi
perinatal seperti presentasi bokong, perdarahan, persalinan kuman tinggi dan
asfiksia neonatorum dapat meningkatkan resiko retardasi mental akibat kerusakan
jaringan otak.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
3. Penyebab
pascanatal</div>
<ul style="margin-top: 0in;" type="square">
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo6; tab-stops: list .5in; text-align: justify;">Kondisi-kondisi yang terjadi karena cedera kepala </li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo6; tab-stops: list .5in; text-align: justify;">Infeksi</li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Infeksi
yang disebabkan virus rubella dan sitomegalo virus juga telah diidentifikasi
sebagai penyebab retardasi mental. Virus ini dapat melintasi barier plasenta
dan mengganggu perkembangan normal jaringan fetus.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Infeksi
pasca natal oleh virus dan bakteri, keracunan oleh bahan seperti timah dan
cedera kepala berat kesemuanya dapat menyebabkan retardasi mental. Malnutrisi
mempunyai efek utama pada perkembangan otak da retardasi mental dapat timbul
jika terjadi kelaparan.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
4. Gangguan
degeratif</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
5. Demielinisasi</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>C. KLASIFIKASI<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;">
Hampir
semua penulis sepakat, bahwa untuk menetukan derajat defek dari RM, dipakai
patokan hasil atau nilai I.Q pada seorang anak. Tentu saja setelah hasil
tersebut dapat ditentukan kesesuainnya dengan keadaan-keadaan yang lain.
Patokan ini gunanya untuk menentukan langkah-langkah lebih lanjut dalam hal
penanganan anak-anak tersebut.<b><o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Keadaan debil I.Q: 50-70</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Keadaan embisil I.Q:
25-50</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Keadaan idiot I.Q: kurang dari 25</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>I.<i> </i>Retardasi
mental ringan (mampu didik mampu latih)<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;">
Kelompok
ini merupakan kelompok terbesar dari RM. Kira-kira 80% individu dengan
retardasi mental ini dapat memperkembangkan ketrampilan sosial dan komunikasi
dalam masa prasekolah. RM dalam kelompok ini terdapat perkembangan motorik dan
bicara, tetapi anak tidak mampu memelihara dirinya sendiri. Anak memerlukan
perawatan dan pengawasan yang lengkap.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>II. Retardasi mental sedang (tidak mampu
didik mampu latih)<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;">
Kelompok
ini kira-kira 12% dari seluruh penderita RM. Mereka dapat berbicara atau
belajar berkomunikasi selama masa prasekolah, akan tetapi kesadaran mereka
tentang norma sosial sangat buruk. Secara parsial individu dapat mendukung diri
sendiri dibawah pengawasan yang lengkap. Anak mampu untuk mengembangkan
proteksi diri dan mampu untuk menerima kecakapan dengan pengendalian lingkungan
yang berguna sampai tingkat minimal dalam lingkungan yang terkendali.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>III. Retardasi mental berat (tidak mampu
didik tidak mampu latih)<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;">
Kelompok
ini kira-kira 7 %. Selama periode prasekolah jelas ada perkembangan motorik
yang buruk dan kemampuan bicara yang minimal. Mereka hanya mampu
memperkembangkan sedikit atau tidak sama sekali pembicaraan komunikatif. Anak
mampu memelihara diri sendiri dalam pekerjaan yang tidak terlatih atau setengah
terlatih. Anak memerlukan bimbingan dan pedoman ketika berada dalam stres
sosial dan ekonomi yang ringan.</div>
<h2 style="line-height: 150%;">
<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">IV. Retardasi mental yang sangat berat<o:p></o:p></span></b></h2>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .5in;">
Kelompok
ini kira-kira 1% dari seluruh penderita RM. Menunjukkan kapasitas yang minimal
dalam fungsi sensorimotormereka membutuhkan suatu lingkungan yang sangat
teratur, selalu perlu bantuan dan supervisi. Kemampuan perawatan diri yang
sangat terbatas di dalam suatu lingkungan yang sangat teratur dan harus
disertai bantuan dan supervisi yang terus menerus.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>D. MANIFESTASI KLINIS<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .25in;">
Pada dasarnya RM merupakan gangguan yang menyangkut sseluruh fungsi yang
ada pada manusia yaitu fungsi fisik, fungsi psikologis dan fungsi sosial.
Gejala klinis pada RM:</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo3; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->1.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->perkembangan biologik yang terhambat</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo3; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->2.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->kemampuan adaptasi sosial yang terhambat</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l5 level1 lfo3; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->3.<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->perkembangan proses berfkir yang mengalami kegagalan</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Piaget
memberikan gambaran tentang perkembangan kognitif ini melalui urutan-urutan:</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->fase sensori motor (0-2 th)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->fase pra operasional (2-6 th)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->fase operasional konkrit (6-12 th)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->fase operational formal (>12 th)</div>
<div class="MsoBodyText2" style="line-height: 150%;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">Menurut Piaget, apabila
seseorang mampu mencapai taraf perkembangan kognitif sampai fase operasional
formal secara sempurna, maka kemampuan berfikirnya telah mencapai taraf
perkembangan proses berfikir orang dewasa yang normal. Pada anak RM, biasanya
perkembangan kognitif hanya mencapai taraf pra operasional.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>E. PEMERIKSAAN PENUNJANG<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
1. Uji
intelegensi standar</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
2. Uji
perkembangan, seperti Denver II</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
3. Pengukuran
fungsi adatif</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>F. KOMPLIKASI</b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
1. Serebral
palsi</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
2. gangguan
kejang</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
3. Gangguan
kejiwaan</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
4. Gangguan
konsentrasi / hiperaktif</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
5. Defisit
komunikasi</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
6. Konstipasi
(Karena penurunan motilitas usus akibat oabt-obatan antikonvulsi, kurang
mengkonsumsi makanan berserat dan cairan)</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>G. PENATALAKSANAAN<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>Terapi pada anak dengan RM meliputi 4 aspek:<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l6 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b>1.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Terapi terhadap aspek fisik<o:p></o:p></b></div>
<div class="MsoBodyText2" style="line-height: 150%;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%;">sasaran terapi
ditujukan terhadap kelainan atau gangguan fisik. Terapi ini meliputi:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
- terapi
simptomatik</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
semua
kelainan-kelainan fisik yang dapat diatasi atau ditolong dengan terapi ini,
misalnya: fenilketouria, galaktosemia, kejang-kejang dengan obat yang sesuai.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
- Koreksi
terhadap cacat</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Sering dilakukan
koreksi terhadap alat gerak, defek panca indra dan yang koreksi lain yang
berhubungan dengan kosmetik, untuk memperbaiki fungsi dan penampilan diri.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l6 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b>2.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Terapi terhadap aspek psikologik/psikiatrik<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Sasaran terapi
ditujukan terhadap kelainan atau gangguan yang berhubungan dengan emosi dan
gangguan tingkah laku serta terhadap kondisi psikologis keluarga. Terapi ini
meliputi:<b><o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->terhadap emosi dan tingkah laku penderita</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
terutama pada
penderita yang hiperaktif dapat diberikan obat-obatan golongan ansiolotik,
misalnya: diazepam, khlordiazepokside atau yang lain. Bila hal ini belum
menolong, dapat dipertimbangan pemberian anti psikotik atau neuroleptika dalam
dosis awal yang kecil dulu, secara bertahap, bila belum baik dapat dinaikkan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->terhadap kondisi psikologis keluarga</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
bantuan yang
teratur dalam periode 3 bulan sekali dapat mempertahankan kondisi psikologis
keluarga.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l6 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b>3.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Terapi terhadap aspek pendidikan<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->kelompok yang mampu didik dan mampu latih</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
dilakukan
pendidikan secara perlahan-lahan dan secara bertahap dengan memperbanyak
latihan-latihan dibandingkan dengan sekolah atau pendidikan normal lainnya</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->kelompok yang tidak mampu didik dan mampu latih</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
dilakukan
latihan-latihan, terutama latihan untuk dapat melakukan aktivitas sehari-hari,
tanpa bantuan orang lain. Misalnya: kesehatan perseorangan, kebersihan,
pekerjaan-pekerjaan kasar yang tidak memerlukan pemikiran daan bersifat rutin.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->kelompok yang tidak mampu didik dan tidak mampu latih</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
dilakukan
perawatan secara terus menerus dan pencegahan dari bahaya.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l6 level1 lfo5; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b>4.<span style="font-size: 7pt; font-weight: normal; line-height: normal;"> </span></b><!--[endif]--><b>Terapi terhadap aspek social<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Tujuan dari
terapi ini adalah mengoptimalkan kemampuan penderita dalam berm,asyarakat. Hal
ini untuk menghilangkan stigma masyarakat, bahwa anak atau orang dengan RM
tidak ada gunanya sama sekali. Dengan pemberian tugas-tugas dalam masyarakat
yang dapat dilakukan sesuai dengan kemampuan penderita akan menimbulkan
perasaan pada penderita bahwa dirinya masih diperlukan oleh orang lain,
sehingga hal ini mempertinggi rasa percaya dirinya.<b><o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .25in;">
Kadang-kadang anak dengan RM memerlukan perawatan baik di RS atau di
penti-panti pendidikan penampungan anak. Anak-anak dengan RM yang mempunyai
indikasi perawatan antara lain:</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->mempunyai kecacatan yang ganda (multiple handicap)</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->mempunyai gangguan fisik yang berat</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->penderita RM usia tua</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->penderita dengan gangguan emosi yang berat</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l4 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]-->-<span style="font-size: 7pt; line-height: normal;">
</span><!--[endif]-->anak-anak yang memerlukan pendidikan khusus yang jauh
dari jangkauan rumah</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>H.ASUHAN KEPERAWATAN<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b>1. PENGKAJIAN<o:p></o:p></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b> </b>Format
pengkajian menurut Wong (2003) adalah:</div>
<ol start="1" style="margin-top: 0in;" type="a">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo7; tab-stops: list .5in; text-align: justify;">Lakukan pengkajian fisik</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo7; tab-stops: list .5in; text-align: justify;">Lakukan pengkajian perkembangan</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo7; tab-stops: list .5in; text-align: justify;">Dapatkan riwayat keluarga, terutama mengenal
retardasi mental gangguan herediter dimana retardasi mental adalah salah
satu jenisnya yang utama.</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo7; tab-stops: list .5in; text-align: justify;">Dapatkan riwayat kesehatan untuk mendapatkan
bukti-bukti adanya trauma prenatal, perinatal, atau paskanatal atau cedera
fisik, infeksi maternal prenatal, alkoholis, konsumsi obat, nutrisi tidak
adekuat, penyimpangan lingkungan, gangguan psikiatrik, infeksi terutama
yang melibatkan otak atau suhu tubuh tinggi , abnormalitas kromosom</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo7; tab-stops: list .5in; text-align: justify;">Bantu dengan tes diagnostic klinis missal analisis
kromosom, disfungsi metabolic, radiografi, tomografi, elektroenselografi</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo7; tab-stops: list .5in; text-align: justify;">Lakukan atau Bantu dengan tse perilaku
adatif-vineland Social Maturity Scale</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo7; tab-stops: list .5in; text-align: justify;">Observasi adanya menifestasi dini retardasi mental :
tidak resposnif terhadap kontak, konrak mata buruk selama menyusu,
penurunan aktivitas, spontan, penurunan kesadaran terhadap suara atau
gerakan, peka rangsangan menyusu lamb</li>
</ol>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;">
DAFTAR PUSTAKA</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Ingram,I.M,
Timbury,G.C.,Mowbray, R.M., 1993, catatan kuliah psikiatri Edisi 6, EGC, <st1:city w:st="on">Jakarta</st1:city></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
McCloskey, J.C
dan Bulechek, Gloria.M, 1996, Nursing Intervention Classification second
edition, Mosby- Year Book, <st1:city w:st="on">St. Louis</st1:city>.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Mansjoer, Arif
dkk,2001, Kapita selekta kedokteran Edisi ketiga jilid 1, Media Aesculapius FK
UI, <st1:city w:st="on">Jakarta</st1:city>.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Nanda, 2001,
Nursing diagnoses: definition and classification 2001-2002, Philadelhia.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Sacharin,
R.M,1993, Prisisp keperawatan pediatric Edisi 2, Jakarata: EGC.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Varcarolis,
Elisabeth M.,1999, Foundation Of Psychiatric Mental Health Nursing, Saunders
Company, <st1:city w:st="on">Philadelphia</st1:city>.</div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
Wong, Donna
L.,2003, Pedoman klinis Keperawatan Pediatrik Edisi 4, EGC, <st1:city w:st="on">Jakarta</st1:city>.</div>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-15004164534744744542012-12-19T21:09:00.000-08:002012-12-19T21:09:45.952-08:00GLOMERULODEFRITIS<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: center;">
<b style="font-size: small;">GLOMERULODEFRITIS</b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoHeading7">
<!--[if !supportLists]-->A.<span style="font-size: 7pt;">
</span><!--[endif]-->Pengertian</div>
<div class="MsoNormal" style="margin-left: 27.0pt; text-align: justify; text-indent: 45.0pt;">
<span lang="EN-GB">Glomerulonefritis adalah gangguan pada ginjal yang
ditandai dengan peradangan pada kapiler glumerolus yang fungsinya sebagai
filtrasi cairan tubuh dan sisa-sisa pembuangan.</span></div>
<div class="MsoNormal" style="margin-left: 27.0pt; text-align: justify; text-indent: 45.0pt;">
<br /></div>
<div class="MsoHeading7" style="margin-left: 9.0pt; mso-list: none; tab-stops: .5in; text-indent: 0in;">
Pengertian</div>
<div class="MsoNormal" style="margin-left: 27.0pt; text-align: justify; text-indent: 45.0pt;">
<span lang="EN-GB">Glomerulonefritis adalah gangguan pada ginjal yang
ditandai dengan peradangan pada kapiler glumerolus yang fungsinya sebagai
filtrasi cairan tubuh dan sisa-sisa pembuangan.</span></div>
<div class="MsoNormal" style="margin-left: 27.0pt; text-align: justify; text-indent: 45.0pt;">
<br /></div>
<h2>
<!--[if !supportLists]--><span lang="EN-GB">B.<span style="font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]--><span lang="EN-GB">Etiologi</span></h2>
<div class="MsoNormal" style="margin-left: 27.0pt; text-align: justify; text-indent: 45.0pt;">
<span lang="EN-GB">Glomerulonefritis biasanya terjadi karena reaksi
antigen antibodi sekunder dari infeksi streptococcus yang mengenai saluran
pernafasan atas atau kulit dan seringkali pada anak-anak usia sekolah.
Laki-laki lebih tinggi dari wanita. Kuman penyebab <i>Beta Hemolitic
Streptococcus</i> yang sering adalah pharyngitis dan impetigo</span></div>
<div class="MsoNormal" style="margin-left: 27.0pt; text-align: justify; text-indent: 45.0pt;">
<span lang="EN-GB">Manifestasi klinis :</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l1 level1 lfo2; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Riwayat infeksi saluran nafas
atas atau otitis media</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l1 level1 lfo2; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Hematuria</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l1 level1 lfo2; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Proteinuria</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l1 level1 lfo2; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">4.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Edema</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l1 level1 lfo2; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">5.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Menurunnya output urin</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l1 level1 lfo2; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">6.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Renal insuffisiensi (kerja
jantung tidak sanggup mengedarkan darah</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l1 level1 lfo2; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">7.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Hipertensi</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l1 level1 lfo2; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">8.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Fatigue</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; mso-list: l1 level1 lfo2; tab-stops: list 45.0pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">9.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Mungkin demam</span></div>
<div class="MsoNormal" style="margin-left: 27.0pt; text-align: justify;">
<br /></div>
<a name='more'></a><br />
<div class="MsoHeading7" style="tab-stops: list .5in; text-align: justify;">
<!--[if !supportLists]-->C.<span style="font-size: 7pt;">
</span><!--[endif]-->Patofisiologi<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l5 level1 lfo3; tab-stops: list 45.0pt .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">1.</span><!--[endif]--><span lang="EN-GB">Suatu reaksi radang pada glomerulus dengan sebutan lekosit dan
proliferasi sel.</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l5 level1 lfo3; tab-stops: list 45.0pt .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">2.</span><!--[endif]--><span lang="EN-GB">Gangguan pada glomerulus ginjal dipertimbangkan sebagai suatu respon
imunologi yang terjadi dengan adanya perlawanan antibodi dengan mikroorganisme
yaitu streptococcus.</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l5 level1 lfo3; tab-stops: list 45.0pt .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">3.</span><!--[endif]--><span lang="EN-GB">Reaksi antigen-antibodi tersebut membentuk imun kompleks yang
menimbulkan respon peradangan yang menyebabkan kerusakan dinding kapiler dan
menjadikan lumen pembuluh darah menjadi kecil yang mana akan menurunkan
filtrasi glomerulus,insuffisiensi renal dan perubahan permeabilitas kapiler
sehingga molekul yang besar seperti protein diekskresikan dalam
urin/proteinuria.</span></div>
<div class="MsoNormal" style="margin-left: .5in; text-align: justify;">
<br /></div>
<h2>
<!--[if !supportLists]--><span lang="EN-GB">D.<span style="font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]--><span lang="EN-GB">Penatalaksanaan terapetik </span></h2>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l3 level1 lfo4; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Penatalaksanaan cairan dan
elektrolit</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l3 level1 lfo4; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Anti hipertensi<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l3 level1 lfo4; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Diuretik<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l3 level1 lfo4; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Diet rendah protein pada
fase akut<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l3 level1 lfo4; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">5.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Rendah sodium<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoHeading9" style="text-align: justify;">
Pemeriksaan Diagnostik</div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l4 level1 lfo5; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Riwayat gambaran klinis,infeksi
saluran nafas sebelumnya</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l4 level1 lfo5; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Analisa urin, peningkatan
sel darah merah (RBC)<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l4 level1 lfo5; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">BUN dan creatinin meningkat<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l4 level1 lfo5; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Menurunnya Hb dan
hematokrit karena delution<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l4 level1 lfo5; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">5.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Kultur sampel atau apusan
dari alat pernafasan untuk indentifikasi mikroorganisme<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l4 level1 lfo5; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">6.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Biopsi ginjal<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .5in; text-align: justify;">
<b><span lang="EN-GB"> <o:p></o:p></span></b></div>
<h2>
<!--[if !supportLists]--><span lang="EN-GB">E.<span style="font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]--><span lang="EN-GB">Komplikasi</span></h2>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l2 level1 lfo6; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Kerusakan ginjal</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l2 level1 lfo6; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Oliguri<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l2 level1 lfo6; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Ensefalopati hipertensi<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l2 level1 lfo6; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Protein darah rendah<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l2 level1 lfo6; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><b><span lang="EN-GB">5.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><span lang="EN-GB">Gagal ginjal akut</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l2 level1 lfo6; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB"><br /></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l2 level1 lfo6; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB"><br /></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l2 level1 lfo6; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<span lang="EN-GB"></span></div>
<h5>
BAB II</h5>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span lang="EN-GB">STANDAR
ASUHAN KEPERAWATAN<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<h1 style="margin-left: 1.25in; mso-list: l6 level2 lfo1; tab-stops: list 27.0pt 1.25in; text-indent: -.25in;">
<!--[if !supportLists]-->A.<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->PENGKAJIAN</h1>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l0 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Riwayat penyakit</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l0 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Kaji tanda-tanda kelebihan
cairan</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l0 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Pengkajian perawatan</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l0 level1 lfo2; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">4.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Bandingkan berat badan
sebelumnya</span></div>
<div class="MsoNormal" style="margin-left: .5in;">
<br /></div>
<div class="MsoHeading8">
<!--[if !supportLists]-->B.<span style="font-size: 7pt;">
</span><!--[endif]-->DIAGNOSIS KEPERAWATAN</div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l6 level3 lfo1; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">1.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Kelebihan volume cairan
berhubungan dengan perubahan mekanisme regulasi,peningkatan permeabilitas
dinding glumerolus.</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l6 level3 lfo1; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">2.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Intoleransi aktivitas
berhubungan dengan fatique</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l6 level3 lfo1; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">3.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Kerusakan integritas kulit
berhubungan dengan edema dan menurunnya tingkat aktifitas</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l6 level3 lfo1; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">4.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Ketidakseimbangan nitrisi
kurang dari kebutuhan tubuh berhubungan dengan pembatasan cairan,diit dan
hilangnya protein</span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l6 level3 lfo1; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-GB">5.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-GB">Kecemasan berhubungan dengan
kurang pengetahuan dan hospitalisasi</span></div>
<div class="MsoNormal" style="margin-left: 45.0pt; tab-stops: list 27.0pt 45.0pt; text-indent: -.25in;">
<br /></div>
<div class="MsoNormal" style="margin-left: 45.0pt; tab-stops: list 45.0pt; text-indent: -.25in;">
<br /></div>
<h4>
<span lang="EN-GB">C. RENCANA PERAWATAN</span></h4>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0in 5.4pt 0in 5.4pt;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; page-break-inside: avoid;">
<td rowspan="2" style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 28.15pt;" valign="top" width="38">
<div class="MsoNormal">
<span lang="EN-GB">NO</span></div>
</td>
<td rowspan="2" style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 116.7pt;" valign="top" width="156">
<div align="center" class="MsoNormal" style="tab-stops: list 0in; text-align: center;">
<span lang="EN-GB">Diagnosa Keperawatan</span></div>
</td>
<td colspan="2" style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 298.25pt;" valign="top" width="398">
<div align="center" class="MsoNormal" style="tab-stops: list 0in; text-align: center;">
<span lang="EN-GB">Perencanaan Keperawatan</span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1; page-break-inside: avoid;">
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 132.7pt;" valign="top" width="177">
<div class="MsoNormal">
<span lang="EN-GB">Tujuan
&Kriteria Hasil</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 165.55pt;" valign="top" width="221">
<div align="center" class="MsoNormal" style="tab-stops: list 0in; text-align: center;">
<span lang="EN-GB">Rencana Tindakan</span></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 28.15pt;" valign="top" width="38">
<div class="MsoNormal">
<span lang="EN-GB">1</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 116.7pt;" valign="top" width="156">
<div class="MsoNormal">
<span lang="EN-GB">Kelebihan
volume cairan berhubungan dengan perubahan mekanisme regulasi,peningkatan
permeabilitas dinding glomerolus</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 132.7pt;" valign="top" width="177">
<div class="MsoNormal">
<span lang="EN-GB">Keseimbangan
kompartemen cairan tubuh diintraseluler dan ekstraseluler dengan kriteria :</span></div>
<div class="MsoNormal">
<span lang="EN-GB">Edema kurang,
urin kembali jernih, protein dalam urin negatif, BUN dan creatinin dalam
batas normal,CCT dan UCT dalam batas normal</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 165.55pt;" valign="top" width="221">
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="EN-GB">Monitor abnormal serum elektrolit</span></li>
<li class="MsoNormal"><span lang="EN-GB">Monitor manifestasi ketidakseimbangan elektrolit</span></li>
<li class="MsoNormal"><span lang="EN-GB">Pertahankan kepatenan IV line</span></li>
<li class="MsoNormal"><span lang="EN-GB">Beri cairan yang tepat</span></li>
<li class="MsoNormal"><span lang="EN-GB">Pertahankan keakuratan catatan input dan output</span></li>
<li class="MsoNormal"><span lang="EN-GB">Konsul dokter untuk pemberian pengobatan elektrolit</span></li>
<li class="MsoNormal"><span lang="EN-GB">Siapkan spesimen untuk analisis lab yang tepat</span></li>
<li class="MsoNormal"><span lang="EN-GB">Pertahankan diit yang tepat</span></li>
<li class="MsoNormal"><span lang="EN-GB">Ajarkan pada pasien dan keluarga tentang tipe,penyebab,dan
pengobatan ketidakseimbangan elektrolit</span></li>
<li class="MsoNormal"><span lang="EN-GB">Monitor respon klien terhadap terapi elektrolit</span></li>
<li class="MsoNormal"><span lang="EN-GB">Siapkan klien untuk dialisis.</span></li>
</ol>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 28.15pt;" valign="top" width="38">
<div class="MsoNormal">
<span lang="EN-GB">2</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 116.7pt;" valign="top" width="156">
<div class="MsoNormal">
<span lang="EN-GB">Intoleransi
aktifitas berhubungan dengan fatique</span></div>
<div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 132.7pt;" valign="top" width="177">
<div class="MsoNormal">
<span lang="EN-GB">Kemempuan
untuk berespon terhadap kebutuhan tubuh dalam memenuhi kebutuhan dan
keinginan aktivitas sehari-hari</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 165.55pt;" valign="top" width="221">
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="EN-GB">Tentukan kebutuhan fisik pasien</span></li>
<li class="MsoNormal"><span lang="EN-GB">Tentukan persepsi klien penyebab kelemahan</span></li>
<li class="MsoNormal"><span lang="EN-GB">Mendorong pengungkapan perasaan tentang kelemahan</span></li>
<li class="MsoNormal"><span lang="EN-GB">Tentukan penyebab kelemahan</span></li>
<li class="MsoNormal"><span lang="EN-GB">Tentukan bagaimana dan seberapa banyak aktivitas yang dibutuhkan
untuk menangun daya tahan</span></li>
</ol>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<ol start="6" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="EN-GB">Monitor intake nutrisi untuk memastikan sumber energi yang
adekuat</span></li>
<li class="MsoNormal"><span lang="EN-GB">Konsul dengan ahli gizi bagaimana caranya untuk meningkatkan
intake makanan dengan energi tinggi</span></li>
<li class="MsoNormal"><span lang="EN-GB">Monitor klien untuk mengetahui peningkatan kelemahan fisik dan
emosional,pola tidur, ketidaknyamanan fisik yang dapat mengganggu fungsi
kognitif dan monitoring diri. </span></li>
<li class="MsoNormal"><span lang="EN-GB">Pembatasan aktifitas</span></li>
<li class="MsoNormal"><span lang="EN-GB">Menyusun aktifitas fisik untuk mengurangi kompetisi suplai
oksigen terhadap fungsi vital tubuh</span></li>
<li class="MsoNormal"><span lang="EN-GB">Gunakan aktif atau pasif room untuk mencegah kekakuan sendi</span></li>
<li class="MsoNormal"><span lang="EN-GB">Bantu aktifitas fisik reguler</span></li>
<li class="MsoNormal"><span lang="EN-GB">Monitor respon oksigenasi pasien</span></li>
<li class="MsoNormal"><span lang="EN-GB">Ajarkan pada klien prinsip konservasi energi</span></li>
<li class="MsoNormal"><span lang="EN-GB">Ajarkan mengorganisasi aktivitas dan management waktu untuk
mencegah kelemahan</span></li>
<li class="MsoNormal"><span lang="EN-GB">Bantu klien untuk memonitor diri terhadap perkembangan dan
menggunakan catatan intake kalori dan energi yang dibutuhkan</span></li>
</ol>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 28.15pt;" valign="top" width="38">
<div class="MsoNormal">
<span lang="EN-GB">3</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 116.7pt;" valign="top" width="156">
<div class="MsoNormal">
<span lang="EN-GB">Kerusakan
integritas kulit berhubungan dengan edema dan menurunnya tingkat aktifitas.</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 132.7pt;" valign="top" width="177">
<div class="MsoNormal">
<span lang="EN-GB">Struktur utuh
dan fungsu fisik normal dari kulir dan membran mukosa</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 165.55pt;" valign="top" width="221">
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="EN-GB">Melakukan penilaian komprehensif sirkulasi pripheral</span></li>
<li class="MsoNormal"><span lang="EN-GB">Jangan memulai pemasangan i.v line atau pemberian darah jika
mempengaruhi ekstremitas/sirkulasi</span></li>
<li class="MsoNormal"><span lang="EN-GB">Hindarkan menggunakan tekanan darah untuk menilai keefektifan
sirkulasi</span></li>
<li class="MsoNormal"><span lang="EN-GB">Hindarkan penggunaan tourniquet untuk mengefektifkan sirkulasi</span></li>
<li class="MsoNormal"><span lang="EN-GB">Pertahankan hidrasi yang adekuat untuk mencegah viskositas
darah</span></li>
<li class="MsoNormal"><span lang="EN-GB">Cegah injuri</span></li>
<li class="MsoNormal"><span lang="EN-GB">Cegah infeksi dari luka</span></li>
<li class="MsoNormal"><span lang="EN-GB">Instruksikan klien dan keluarga untuk mengetes air mandi
untuk mencegah terbakarnya kulit</span></li>
<li class="MsoNormal"><span lang="EN-GB">Instruksikan klien dan keluarga untuk merawat kuku dan kaki</span></li>
<li class="MsoNormal"><span lang="EN-GB">Monitor ekstremitas untuk menilai adanya rasa
panas,nyeri,kemerahan dll</span></li>
</ol>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 28.15pt;" valign="top" width="38">
<div class="MsoNormal">
<span lang="EN-GB">4</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 116.7pt;" valign="top" width="156">
<div class="MsoNormal">
<span lang="EN-GB">Ketidakseimbangan
nutrisi kurang dari kebutuhan tubuh berhubungan dengan pembatasan cairan,diit
dan hilangnya protein</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 132.7pt;" valign="top" width="177">
<div class="MsoNormal">
<span lang="EN-GB">Kecukupan
makanan dan cairan yangf masuk kedalam tubuh selama 24 jam.</span></div>
<div class="MsoNormal">
<span lang="EN-GB">Batasan
karakteristik :</span></div>
<div class="MsoNormal">
<span lang="EN-GB">Berat badan
20% atau lebih dibawah ideal</span></div>
<div class="MsoNormal">
<span lang="EN-GB">Membran mukosa
dan konjungtiva pucat</span></div>
<div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 165.55pt;" valign="top" width="221">
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="EN-GB">Monitor BB tiap hari</span></li>
<li class="MsoNormal"><span lang="EN-GB">Catat diaporesis</span></li>
<li class="MsoNormal"><span lang="EN-GB">Pertahankan keakuratan catatan intake dan out put</span></li>
<li class="MsoNormal"><span lang="EN-GB">Pasang kateter urine dengan tepat</span></li>
<li class="MsoNormal"><span lang="EN-GB">Monitor status hidrasi</span></li>
</ol>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
<ol start="6" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="EN-GB">Monitor hasil laboratorium yang relevan dengan retensi cairan</span></li>
<li class="MsoNormal"><span lang="EN-GB">Monitor vital sign</span></li>
<li class="MsoNormal"><span lang="EN-GB">Kaji lokasi edema</span></li>
<li class="MsoNormal"><span lang="EN-GB">Administrasi pemasangan therapi i.v line</span></li>
<li class="MsoNormal"><span lang="EN-GB">Monitor status nutrisi</span></li>
<li class="MsoNormal"><span lang="EN-GB">Pertahankan intake oral</span></li>
<li class="MsoNormal"><span lang="EN-GB">Administrasikan pemasangan NGT</span></li>
<li class="MsoNormal"><span lang="EN-GB">Instruksikan pasien untuk NPO</span></li>
<li class="MsoNormal"><span lang="EN-GB">Konsul dokter jika ada tanda-tanda gejala kelebihan cairan</span></li>
<li class="MsoNormal"><span lang="EN-GB">Administrasikan pengobatan dan diet</span></li>
</ol>
<div class="MsoNormal" style="margin-left: .25in;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 28.15pt;" valign="top" width="38">
<div class="MsoNormal">
<span lang="EN-GB">5</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 116.7pt;" valign="top" width="156">
<div class="MsoNormal">
<span lang="EN-GB">Kecemasan
berhubungan dengan kurang pengetahuan dan hospitalisasi </span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 132.7pt;" valign="top" width="177">
<div class="MsoNormal">
<span lang="EN-GB">Tindakan
profesional </span></div>
<div class="MsoNormal">
<span lang="EN-GB">Untuk
menghilangkan atau mengurangi perasaan khawatir dan marah/gelisah sebagai
akibat sumber-sumber kecemasan yang tidak teridentifikasi</span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 165.55pt;" valign="top" width="221">
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal"><span lang="EN-GB">Gunakan sentuhan untk menenangkan</span></li>
<li class="MsoNormal"><span lang="EN-GB">Nyatakan dengan jelas harapan dari perilaku klien dan
keluarga</span></li>
<li class="MsoNormal"><span lang="EN-GB">Jelaskan semua prosedur termasuk sensasi pengalaman selama
prosedur dilakukan</span></li>
<li class="MsoNormal"><span lang="EN-GB">Mencari dan mengetahui persepsi klien tentang situasi penuh
stres</span></li>
<li class="MsoNormal"><span lang="EN-GB">Pertahankan informasi faktual tentang diagnosis,perawatan,
dan pengobatan</span></li>
<li class="MsoNormal"><span lang="EN-GB">Temani klien dan keluarga untuk meningkatkan kenyamanan dan
mengurangi takut</span></li>
<li class="MsoNormal"><span lang="EN-GB">Dorong keluarga untuk memahami klien</span></li>
</ol>
</td>
</tr>
</tbody></table>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-88270651344897379932012-12-19T20:51:00.000-08:002012-12-19T20:51:06.377-08:00TUMBUH KEMBANG ANAK<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div align="center" class="MsoNormal" style="text-align: center;">
<b>TUMBUH KEMBANG ANAK<o:p></o:p></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<ol start="1" style="margin-top: 0in;" type="A">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in;">PENGERTIAN</li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Tumbuh
adalah proses bertambahnya ukuran/dimensi akibat penambahan jumlah atau ukuran
sel dan jaringan interseluler.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Kembang/perkembangan
adalah proses pematangan/maturasi fungsi
organ tubuh termasuk berkembangnya kemampuan mental intelegensia serta
perlakuan anak.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
Perkembangan
adalah bertambahnya kemampuan atau keahlian dalam struktur dan fungsi tubuh
yang lebih kompleks dalam pola yang teratur dan dapat diramalkan, sebagai hasil
dari proses pematangan. Disini menyangkut adanya proses di ferensiasi dari
sel-sel tubuh, jaringan tubuh organ-organ dan system organ yang berkembang
sedemikian rupa sehingga msing-masing dapat memenuhi fungsinya. Termasuk juga
perkembangan emosi, intelektual dan tingkah laku sebagai hasil interaksi dengan
lingkungan.</div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in;">
<br /></div>
<ol start="2" style="margin-top: 0in;" type="A">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in;">JENIS TUMBUH KEMBANG</li>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level2 lfo1; tab-stops: list 1.0in; text-align: justify;">Tumbuh kembang fisis meliputi perubahan dalam
bentuk besar dan fungsi organisme individu.</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level2 lfo1; tab-stops: list 1.0in; text-align: justify;">Tumbuh kembang intelektual berkaitan dengan
kepandaian berkomunikasi dan kemampuan menangani materi yang bersifat
abstrak dan simbolik seperti berbicara,bermain,berhitung dan membaca.</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level2 lfo1; tab-stops: list 1.0in; text-align: justify;">Tumbuh kembang social emosional bergantung
kemampuan bayi untuk membentuk ikatan batin,berkasih saying,menangani
kegelisahan akibat suatu frustasi dan mengelola rangsangan agresif.</li>
</ol>
</ol>
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<br /></div>
<ol start="3" style="margin-top: 0in;" type="A">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level1 lfo1; tab-stops: list .5in;">FAKTOR FAKTOR YANG MEMPENGARUHI TUMBUH KEMBANG</li>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level2 lfo1; tab-stops: list 1.0in;">Faktor Genetik</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level2 lfo1; tab-stops: list 1.0in;">Faktor herediter konstitusional</li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l1 level2 lfo1; tab-stops: list 1.0in;">Faktor lingkungan<a name='more'></a></li>
</ol>
</ol>
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Lingkungan ini meliputi aspek fisikobiopsikososial yang
dapat berupa :</div>
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<span style="font-family: "Times New Roman","serif";"> a.Orang
tua : hidup rukun dan harmonis,persiaan jasmani,mental,social yang matang pada
saat membina keluarga,mempunyai tingkat ekonomo/kesejahteraan yang cukup,cukup
waktu untuk memperhatikan,membimbing dan mendidik anak<o:p></o:p></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman","serif";"> b.Pelayanan
KIA dan KB yang cukup untuk perlindungan kesehatan Ibu dan Anak dengan jaringan
dan fasilitas yang memadai dalam tenaga,peralatan,anggaran dan mencakup seluruh
populasi.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman","serif";"> c.Didaerah
perkotaan m,aupun pedesaan diciptakan keadaan yang cukup baik dalam segi-segi :
kesehatan,geografis,demografis,social ekonomi.<o:p></o:p></span></div>
<div align="left" class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman","serif";"> d.Pendidikan di rumah,sekolah,
diluar sekolah dan rumah untuk pembinaan perkembangan emosi, social, moral, etika, tanggung jawab,pengetahuan, ketrampilan dan
kepribadian.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: .5in; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">D.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">TAHAP TAHAP TUMBUH KEMBANG<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";">Proses tumbuh kembang dimulai sejak sel telur
dibuahi dan akan berlangsung sampai dewasa.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";">a. Tahap
prenatal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Masa
embrio : mulai konsepsi – 8 minggu<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Masa
tengah fetus : 9 minggu – 24 minggu<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Masa
fetus lanjut : 24 minggu – lahir<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";">b. Tahap
postnatal<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Masa
neonatal : lahir – 1 bulan<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";"> Masa bayi
awal : 1 bulan – 1 tahun<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Masa
bayi lanjut : 1 tahun – 2 tahun<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";">c. Masa anak
(wanita : 2-10 tahun, laki-laki : 2-12 tahun) :<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Masa
prasekolah : 2 – 6 tahun<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Masa
sekolah : wanita 6 – 10 tahun,laki-laki 6 – 12 tahun<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: .5in;">
<span style="font-family: "Times New Roman","serif";">d. Masa
remaja (adolesen) : wanita 10-18 tahun, laki-laki 12-20 tahun<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Pra
pubertas : wanita 10-12 tahun,laki-laki 10-14 tahun<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Pubertas
: wanita 12-14 tahun,laki-laki 14-15 tahun<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Post
pubertas :wanita 14-18 tahun,laki-laki 16-20 tahun<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 51.05pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: .5in; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">E.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">SKRINING DAN PENGAWASAN TUMBUH
KEMBANG<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 45.0pt; text-indent: 20.2pt;">
<span style="font-family: "Times New Roman","serif";">Pengawasan tumbuh kembang anak
dilakukan secara kontinue dengan pencatatan yang baik dimulai sejak dalam
kandungan (Ante Natal Care) secara teratur dan pengawasan terutama anak balita.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; mso-list: l5 level1 lfo6; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Untuk pertumbuhan anak dengan
pengukuran BB dan TB menggunakan Kartu Menuju Sehat (KMS).<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; mso-list: l5 level1 lfo6; tab-stops: list 69.05pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Untuk
perkembangan anak dengan menggunakan DDST (Denver Development Screening Test).<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 45.0pt;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 45.0pt;">
<span style="font-family: "Times New Roman","serif";">Sedangkan tahap-tahap penilaian perkembangan anak
yaitu :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Anamnesis<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Skrining
gangguan perkembangan anak<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; mso-list: l2 level1 lfo7; tab-stops: list 69.05pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Evaluasi
penglihatan dan pendengaran anak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Evaluasi
bicara dan bahasa anak<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; mso-list: l2 level1 lfo7; tab-stops: list 69.05pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Pemeriksaan
fisik<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 0in;">
<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: .5in; mso-list: l1 level1 lfo1; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">F.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">TEORI PERKEMBANGAN MENURUT SIGMUND
FREUD<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";">1.Fase Oral :
0 – 1 tahun<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";"> Keuntungan
: Kepuasaan/kebahagian terletak pada mulut<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";">
Mengisap,menelan,memainkan bibir,makan,kenyang dan tidur.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";"> Kerugian :
menggigit,mengeluarkan air liur,marah,menangis jika tidak terpenuhi.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: .5in;">
<span style="font-family: "Times New Roman","serif";">2.Fase Anal :
1 – 3 tahun<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";">
Keuntungan : belajar mengontrol pengeluran BAB dan BAK,senang melakukan
sendiri<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";"> Kerugian :
jika tidak dapat melakukan dengan baik.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";">3.Fase Phalic : 3 – 6 tahun<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Dekat
dengan orang tua lawan jenis<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Bersaing
dengan orang tua sejenis<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";">4.Fase latent : 6 – 12 tahun<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Orientasi
social keluar rumah<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Pertumbuhan
intelektual dan social<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; mso-list: l0 level1 lfo8; tab-stops: list 69.05pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Banyak
teman dan punya group<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Impuls
agresivitas lebih terkontrol<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: .5in;">
<span style="font-family: "Times New Roman","serif";">5.Fase genital<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; mso-list: l9 level1 lfo9; tab-stops: list 69.05pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Pemustan
seksual pada genital<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Penentuan
identitas<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; mso-list: l9 level1 lfo9; tab-stops: list 69.05pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Belajar
tidak tergantung pada orang tua<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 65.2pt; mso-list: l9 level1 lfo9; tab-stops: list 69.05pt; text-indent: -14.15pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Bertanggung
jawab pada diri sendiri<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Intim
dengan lawan jenis.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";"> Keuntungan
: bergroup<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";"> Kerugian :
konflik diri,ambivalen.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 0in;">
<span style="font-family: "Times New Roman","serif";">ASUHAN KEPERAWATAN<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif";">A. PENGKAJIAN KEPERAWATAN<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">1.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Review kembali catatan medik
masalah kesehatan yang berkaitan dengan gangguan pada perkembangan anak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">2.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Kaji pengetahuan keluarga akan
penyakit/masalah yag berkaitan dengan gangguan tumbang anak<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 32.25pt; mso-list: l3 level1 lfo10; tab-stops: list 32.25pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">3.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Tentukan perkembangan anak sesuai
umurnya (dengan DDST)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">4.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Kaji kemampuan fungsional anak
yang meliputi kemampuannya dalam makan,mandi,berpakaian,berjalan,memecahkan
masalah dan berkomunikasi.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 32.25pt; mso-list: l3 level1 lfo10; tab-stops: list 32.25pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">5.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Kaji persepsi orang tua <st1:state w:st="on"><st1:place w:st="on">kan</st1:place></st1:state> tingkat perkembangan
anak dan pengharapan mereka terhadap anaknya.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 32.25pt; mso-list: l3 level1 lfo10; tab-stops: list 32.25pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">6.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Kaji tentang hubungan orang tua
denagan anak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">7.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Kaji sumber-sumber yang mendukung
seperti tingkat perekonomian keluarga dll yang dapat mendukung perkembangan
anak.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoBodyTextIndent" style="margin-left: 0in;">
<span style="font-family: "Times New Roman","serif";">B. DIAGNOSE KEPERAWATAN<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">1.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Ketidakmampuan penyesuaian
berhubungan dengan kelahiran/diagnosis gangguan perkembangan anak.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 32.25pt; mso-list: l6 level1 lfo11; tab-stops: list 32.25pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">2.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Perubahan kemampuan peran orang
tua berhubungan dengan kesulitan memenuhi dan mengasuh anak.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 32.25pt; mso-list: l6 level1 lfo11; tab-stops: list 32.25pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">3.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Ketidakefektifan kemampuan anak
dalam pola makan b.d ketidakmampuan lidah,kelumpuhan otot dan kelemahan
menelan.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 32.25pt; mso-list: l6 level1 lfo11; tab-stops: list 32.25pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">4.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Perubahan tumbang b.d
ketidakmampuan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 32.25pt; mso-list: l6 level1 lfo11; tab-stops: list 32.25pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">5.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Isolasi social b.d kelainan
perkembangan<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 32.25pt; mso-list: l6 level1 lfo11; tab-stops: list 32.25pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif";">6.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif";">Resiko cedera b.d perkembangan
(sesuai dgn tingkat usia perkembangan anak).<o:p></o:p></span></div>
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<br /></div>
<div class="MsoBodyTextIndent">
<br /></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman","serif";"> </span><span style="font-family: 'Times New Roman', serif;"> </span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman","serif";"> DAFTAR PUSTAKA<o:p></o:p></span></div>
<div align="left" class="MsoBodyTextIndent" style="margin-left: 0in;">
<br /></div>
<div align="left" class="MsoBodyTextIndent" style="text-indent: -1in;">
<span style="font-family: "Times New Roman","serif";">Wong DL, 1995, Nursing Care Of
Infant and Children Fifth Edition,Mosby Year Book,Philadelpia <st1:country-region w:st="on"><st1:place w:st="on">USA</st1:place></st1:country-region>.<o:p></o:p></span></div>
<div align="left" class="MsoBodyTextIndent" style="text-indent: -1in;">
<br /></div>
<div align="left" class="MsoBodyTextIndent" style="margin-left: 0in;">
<span style="font-family: "Times New Roman","serif";">Mansjoer A, 1999,kapita selekta
Kedokteran Jilid II,media Aesculapius FK UI Jakarta<o:p></o:p></span></div>
<div align="left" class="MsoBodyTextIndent" style="margin-left: 0in;">
<br /></div>
<div align="left" class="MsoBodyTextIndent" style="margin-left: 0in;">
<span style="font-family: "Times New Roman","serif";">Potter and Perry,1993,Fundamental
Of Nursing, Mosby Year Book,Philadelpia <st1:country-region w:st="on"><st1:place w:st="on">USA</st1:place></st1:country-region>.<o:p></o:p></span></div>
<div align="left" class="MsoBodyTextIndent" style="margin-left: 0in;">
<br /></div>
<div align="left" class="MsoBodyTextIndent" style="margin-left: 0in;">
<span style="font-family: "Times New Roman","serif";">Short JR, 1994 Penyakit anak
Jilid 2,Bina Aksara,<st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city><o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 0in;">
<br /></div>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-26808924217473415102012-12-19T20:39:00.000-08:002012-12-19T20:39:21.069-08:00ENSEFALITIS<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<h1 style="line-height: 150%; text-align: center;">
<b style="line-height: 150%;"><span style="font-size: 14.0pt; line-height: 150%;">ENSEFALITIS</span></b></h1>
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<span style="font-size: 12.0pt; line-height: 150%;"> </span><b style="line-height: 150%;"><span style="font-size: 12.0pt; line-height: 150%;"> </span></b></div>
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<b><span style="font-size: 12.0pt; line-height: 150%;">A. Definisi<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify; text-indent: .25in;">
<span style="font-size: 12.0pt; line-height: 150%;">Ialah infeksi jaringan
otak oleh berbagai macam mikro-organisme. Terminologi ensefalopati yang dulu
dipakai untuk gejala yang sama, tanpa tanda-tanda infeksi sekarang tidak
dipakai lagi.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span style="font-size: 12.0pt; line-height: 150%;">B. Etiologi<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; line-height: 150%;">Berbagai macam
mikroorganisme dapat menimbulkan ensefalitis, misalnya bakteri, protozoa,
spirokaeta namun penyebab utama dan tersering ialah virus. Infeksi dapat
terjadi karena virus langsung menyerang otak atau reaksi radang akut karena
infeksi sistemik atau vaksinasi terdahulu.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-size: 12.0pt; line-height: 150%;">Berbagai jenis virus dapat
menimbulkan ensefalitis, meskipun gejala klinisnya sama.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span style="font-size: 12.0pt; line-height: 150%;">C. Gejala klinis<o:p></o:p></span></b></div>
<div class="MsoBodyText" style="line-height: 150%; text-align: justify; text-indent: 0.25in;">
<span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">didapatkan suhu yang
mendadak naik, seringkali ditemukan hiperpireksia. Kesadaran dengan cepat
menurun. Anak besar sebelum kesadaran menurun seringkali mengeluh nyeri kepala.
Muntah sering ditemukan. Kejang-kejang bersifat umum atau fokal atau hanya
twiching saja. Kejang dapat berlangsung berjam-jam. Gejala serebrum yang
beranekaragam dapat timbul sendiri-sendiri atau bersama-sama, misalnya paresis
atau paralisis, afasia dan sebagainya. LCS seringkali dalam batas normal,
kadang-kadang ditemukan sedikit peninggian jumlah sel, kadar protein atau
glukosa. </span><span lang="ES" style="line-height: 150%; mso-ansi-language: ES; mso-bidi-font-size: 12.0pt;">Pada kelompok ensefalitis pasca infeksi, gejala
penyakit primer sendiri dapat membantu diagnosis. </span><span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">EEG sering menunjukkan
akufitas listrik yang merendah yang sesuai dengan kesadaran yang menurun.<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
<a name='more'></a><span style="font-size: 12pt; line-height: 150%;"> </span><br />
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<b><span style="font-size: 12.0pt; line-height: 150%;">D. Pemeriksaan penunjang<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .6in; mso-list: l2 level1 lfo1; tab-stops: list .6in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Biakan darah<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .6in; mso-list: l2 level1 lfo1; tab-stops: list .6in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Lumbal punksi, kemungkinan didapat:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 61.5pt; mso-list: l4 level1 lfo6; tab-stops: list 61.5pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">LCS
jernih<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 61.5pt; mso-list: l4 level1 lfo6; tab-stops: list 61.5pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="ES" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: ES;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="ES" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: ES;">Jumlah sel : 0-beberapa ribu sel PMN<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 61.5pt; mso-list: l4 level1 lfo6; tab-stops: list 61.5pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="ES" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: ES;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="ES" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: ES;">Protein normal atau naik sedikit<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 61.5pt; mso-list: l4 level1 lfo6; tab-stops: list 61.5pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="ES" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: ES;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="ES" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: ES;">Gula normal<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 61.5pt; mso-list: l4 level1 lfo6; tab-stops: list 61.5pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="ES" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: ES;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span lang="ES" style="font-size: 12.0pt; line-height: 150%; mso-ansi-language: ES;">Kulutr 70-80% (+)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 46.35pt; mso-list: l2 level1 lfo1; tab-stops: list 46.35pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Pemeriksaan penunjang:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 67.5pt; mso-list: l6 level1 lfo7; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Courier New"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">CRP
positif untuk bakteri (namun tidak bisa dinilai pada klien dengan rheumatoid
artritis)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 67.5pt; mso-list: l6 level1 lfo7; tab-stops: list 67.5pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Courier New"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Analisa
kimia untuk penderita akut bakteri:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 82.35pt; mso-list: l5 level1 lfo8; tab-stops: list 82.35pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">kadar
glukosa menurun kurang dari 45 mg/100 cc<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 82.35pt; mso-list: l5 level1 lfo8; tab-stops: list 82.35pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">kadar
Cl menurun kurang dari 700 mg/100 cc<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 82.35pt; mso-list: l5 level1 lfo8; tab-stops: list 82.35pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">kadar
protein naik lebih dari 70 mg/100 cc<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 82.35pt; mso-list: l5 level1 lfo8; tab-stops: list 82.35pt; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%;">-<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">sebab
virus: kadar glukosa normal dan kadar protein dibawah 100 mg/dl<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 55.85pt; mso-list: l7 level1 lfo3; tab-stops: 45.0pt list 53.0pt; text-align: justify; text-indent: -19.85pt;">
<!--[if !supportLists]--><span style="font-family: "Courier New"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;"> Serologi Ig M, Ig G<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "Courier New"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">EEG
: multifokal, pseudokompleks<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 55.85pt; mso-list: l7 level1 lfo3; tab-stops: list 53.0pt; text-align: justify; text-indent: -19.85pt;">
<!--[if !supportLists]--><span style="font-family: "Courier New"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Courier New";">o<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">CT
scan kepala: edema otot, tanda bercak tuberkuloma/tuberkel terfokus<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 28.35pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span style="font-size: 12.0pt; line-height: 150%;">E. Komplikasi:<o:p></o:p></span></b></div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span style="font-size: 12.0pt; line-height: 150%;">Retardasi
mental<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span style="font-size: 12.0pt; line-height: 150%;">Iritabel.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span style="font-size: 12.0pt; line-height: 150%;">Gangguan
motorik.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span style="font-size: 12.0pt; line-height: 150%;">Epilepsy.<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo5; tab-stops: list .5in; text-align: justify;"><span style="font-size: 12.0pt; line-height: 150%;">Emosi
tidak stabil, sulit tidur, halusinasi.<o:p></o:p></span></li>
</ul>
<div class="MsoNormal" style="line-height: 150%; margin-left: .5in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span style="font-size: 12.0pt; line-height: 150%;">F. Penatalaksanaan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .35in; mso-list: l8 level1 lfo2; tab-stops: list .35in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Antikonvulsan untuk mengatasi kejang,
tergantung keperluan, biasanya diberikan valium dan atau luminal. Segera
lakukan pemasangan IVFD bila terdapat tanda-tanda dehidrasi<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .35in; mso-list: l8 level1 lfo2; tab-stops: list .35in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Untuk mengatasi hiperpireksia berikan
surface coolling dengan menempatkan es pada permukaan tubuh yang mempunyai
pembuluh darah besar (tepiid songe). Sebagai hibernasi berikan largaktil
2mg/kgBB/hari dan phenergan 4mg/kgBB/hari i.v atau i.m dalam 3x pemberian<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .35in; mso-list: l8 level1 lfo2; tab-stops: list .35in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Pemberian manitol untuk menurunkan
udem otak<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .35in; mso-list: l8 level1 lfo2; tab-stops: list .35in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">antibiotika<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .35in; mso-list: l8 level1 lfo2; tab-stops: list .35in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Gizi: peroral bila sadar,
intragastrik bila tak sadar. TKTP<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .35in; mso-list: l8 level1 lfo2; tab-stops: list .35in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Perawatan rutin: pemantauan KU, VS,
intake.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .35in; mso-list: l8 level1 lfo2; tab-stops: list .35in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Rawat di rumah sakit<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .35in; mso-list: l8 level1 lfo2; tab-stops: list .35in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Bila terdapat peningkatan tekanan
intracranial dapat diberikan manitol 0,5-2g/kgBB iv dalam periode 8-12 jam.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><span style="font-size: 12.0pt; line-height: 150%;">G. Diagnosa Keperawatan yang
mungkin muncul<o:p></o:p></span></b></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span style="font-size: 12.0pt; line-height: 150%;">Hipertermi<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span style="font-size: 12.0pt; line-height: 150%;">Ketidakseimbangan
cairan kurang dari kebutuhan tubuh<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span style="font-size: 12.0pt; line-height: 150%;">Resiko
aspirasi<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span style="font-size: 12.0pt; line-height: 150%;">Sindrom
kurang perawatan diri<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo9; tab-stops: list .5in; text-align: justify;"><span style="font-size: 12.0pt; line-height: 150%;">Cemas<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<span lang="ES" style="font-size: 12.0pt; mso-ansi-language: ES;">DAFTAR PUSTAKA<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l1 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%;">1.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">Carpenito, <i>Buku Saku Diagnosa Keperawatan</i>, edisi 8, Penerbit Buku Kedokteran
EGC, <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>,
2000<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0.25in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">2.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">Doenges, <i>Rencana Asuhan Keperawatan:Pedoman untuk
Perencanaan dan Pendokumentasian pasien</i>, Edisi 3, Penerbit Buku Kedokteran
EGC, <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>
1999<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0.25in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">3.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">Joyce Engel, <i>Pengkajian Pediatrik</i>, Edisi 2, Penerbit
Buku Kedokteran EGC, <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>,
1998<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0.25in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">4.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">Komite Medik RS dr. Sardjito
dan Fakultas Kedokteran UGM, <i>Standar
Pelayanan Medis</i>, buku 2, <st1:place w:st="on"><st1:placename w:st="on">Gadjah</st1:placename>
<st1:placename w:st="on">Mada</st1:placename> <st1:placetype w:st="on">University</st1:placetype></st1:place>,
1996<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l1 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%;">5.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%;">NANDA, <i>Nursing diagnoses: Definitions and Classification</i> 2001-2002, <st1:city w:st="on"><st1:place w:st="on">Philadelphia</st1:place></st1:city>, 2002<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0.25in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">6.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">Sacharin, <i>Prinsip Keperawatan Pediatrik</i>, Edisi 2,
Penerbit Buku Kedokteran EGC, <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>,
1996<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="line-height: 150%; margin-left: 0.25in; text-align: justify; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="line-height: 150%; mso-bidi-font-size: 12.0pt;">7.<span style="font-size: 7pt; line-height: normal;"> </span></span><!--[endif]-->Staf
pengajar IKA KFUI, <i>Ilmu kesehatan Anak</i>,
Bagian IKA FKUI, 1985<span style="line-height: 150%; mso-bidi-font-size: 12.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l1 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold;">8.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold;">MC.Clokey, J. C Bulechek : Nursing Intervention
Clasifikation (NIC), Mosby st, Louis, 1996.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: .25in; mso-list: l1 level1 lfo4; tab-stops: list .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold;">9.<span style="font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-weight: bold;"><a href="http://www/">http://www</a>.
Us.elsevierhealth.com.nursing diagnosis, outcomes and interventions.<o:p></o:p></span></div>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-14065437686214879642012-11-18T21:48:00.000-08:002012-11-18T21:48:19.146-08:00HIPOSPADIA<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="MsoTitle" style="text-align: center;">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><b>HIPOSPADIA</b><o:p></o:p></span></div>
<div class="MsoTitle" style="text-align: center;">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><b><br /></b></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Definisi<o:p></o:p></span></b></div>
<div class="MsoBodyText" style="line-height: normal; text-align: justify;">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Hipospadia
adalah suatu kelainan kongenital dimana meatus eksternus terletak pada
posterior penis. Merupakan salah satu dari kelainan kongenital paling sering
pada genitalia laki-laki, terjadi pada salah satu dalam 350 kelahiran laki-laki.
Hal ini dapat dikaitkan dengan kelainan kongenital lain seperti anomali ginjal,
undesensus testikulorum dan penyakit genetik seperti sindroma klinefelter.<o:p></o:p></span></div>
<div class="MsoBodyText2">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>Terdapat
berbagai derajat kelainan, tergantung pada posisi meatus uretra. Hal ini
mungkin pada glans (<i style="mso-bidi-font-style: normal;">hipospadia glanduler</i>),
pada korona (<i style="mso-bidi-font-style: normal;">hipospadia koronal</i>),
pada batang (<i style="mso-bidi-font-style: normal;">hipospadia penis</i>), pada
sambungan batang dan skrotum (<i style="mso-bidi-font-style: normal;">hipospadia
penoskrotal</i>) dan pada perineum (<i style="mso-bidi-font-style: normal;">hipospadia
perineal</i>). Penis biasanya bengkok kebawah yang lebih nyata pada keadaan ereksi.<o:p></o:p></span></div>
<div class="MsoBodyText2">
<br /></div>
<div class="MsoBodyText2">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Etiologi<o:p></o:p></span></b></div>
<div class="MsoBodyText2">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Penyebab secara jelas dari hipospadia belum
diketahui, namun diduga terjadi kesalahan pada trimester 1 yaitu pembentukan
embrionik sekitar minggu ke 6-8. <st1:place w:st="on">Para</st1:place> ahli
menyetakan penyebab hipospadia dari berbagai faktor yaitu genetik dan non genetik.<o:p></o:p></span></div>
<div class="MsoBodyText2" style="margin-left: 25.2pt; mso-list: l0 level1 lfo13; tab-stops: list 25.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Genetik<o:p></o:p></span></div>
<div class="MsoBodyText2" style="margin-left: 25.2pt; mso-list: l0 level1 lfo13; tab-stops: list 25.2pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Nongenetik<o:p></o:p></span></div>
<div class="MsoBodyText2" style="text-indent: 36.0pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Faktor
lingkungan tidak dianggap sebagai faktor yang menentukan atau yang paling
mempengaruhi. Hal tersebut antara lain karena usia marital atau keadaan pada
saat konsepsi. Di luar banyak pakar kesehatan menganggap bahwa insidensi
tertinggi hipospadia terjadi pada konsepsi pada musim gugur. Analisis lain
menyatakan bahwa insidensi hipospadia meningkat pada tingkat sosial ekonomi
yang rendah serta usia orang tua yang masih muda saat melakukan konsepsi.<o:p></o:p></span></div>
<div class="MsoBodyText2" style="text-indent: 36.0pt;">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Progestin serta
substansi androgen lain juga diduga berkaitan dengan insidensi hipospadia. <st1:city w:st="on"><st1:place w:st="on">Ada</st1:place></st1:city> juga hubungan antara
hipospadia dengan penggunaan antikonvulsan pada ibu hamil (termasuk
thalidomide). <st1:city w:st="on"><st1:place w:st="on">Ada</st1:place></st1:city>
hubungan yang kuat juga dengan rubella pada ibu hamil serta diabetes.<o:p></o:p></span></div>
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<a name='more'></a><br /></div>
<h1>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Gambaran
klinik<o:p></o:p></span></h1>
<div class="MsoNormal" style="text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US" style="font-size: 12.0pt;">Kondisi ini mudah dikenal saat lahir.
Aliran urin dapat membengkok kearah bawah atau menyebar dan mengalir kembali
sepanjang batang penis. Anak dengan hipospadia penoskrotal atau perineal akan
berkemih dengan posisi duduk. Sedangkan pada hipospadia glanduler atau koronal
anak akan mampu berkemih berdiri dengan sedikit mengangkat penis keatas.<o:p></o:p></span></div>
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<br /></div>
<h1>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Prinsip
terapi dan managemen perawatan<o:p></o:p></span></h1>
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<span lang="EN-US" style="font-size: 12.0pt;">Pada hampir semua perbaikan preputium diperlukan
sumber kulit ekstra, karena itu tidak dilakukan sirkumsisi pada neonatus:<o:p></o:p></span></div>
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<!--[if !supportLists]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><!--[endif]--><span dir="LTR"></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">koreksi bedah<o:p></o:p></span></b></div>
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<span lang="EN-US" style="font-size: 12.0pt;">ini harus dilakukan sebelum anak mulai sekolah untuk
menghindarkan masalah sosial dan emosional. Tujuan terapi adalah<span style="mso-spacerun: yes;"> </span>membentuk penyesuaian dan panjang uretra
adekuat, membuka pada ujung dari glans; untuk memberikan orifisium yang tidak
tersumbat yang diarahakan kedepan untuk mencegah penyebaran dan memberikan
penis yang cukup lurus untuk memungkinkan hubungan seksual. Koreksi dari
deformitas biasanya dilakukan dalam 2 stadium. Pembedahan pertama dilakukan
jika anak berumur tiga tahun untuk mengkoreksi korde (kordektomi). Dengan
tujuan meluruskan penis dan menyiapkan jalan untuk uretroplasti. Operasi kedua
dilakukan beberapa bulan kemudian untuk membawa orifisium sedekat mungkin pada
ujung glans (uretroplasti). Ini memerlukan diversi dari aliran urin, biasanya
melalui uretrostomi yang dibuat sementara pada perimeun, melalui uretrostomi
yang dibuat sementara pada perineum, melalui uretrostomi foley keteter
diinsersikan kedalam kandung kemih. Hal ini memungkinkan penyembuhan luka.
Kulit penis dibalik kedalam untuk membentuk tuba urinarius yang baru.<o:p></o:p></span></div>
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<!--[if !supportLists]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><!--[endif]--><span dir="LTR"></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Persiapan pra bedah<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><!--[endif]--><span dir="LTR"></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Penatalaksanaan pasca bedah<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Anak harus dalam tirah
baring hingga kateter diangkat. Harus berhati-hati agar anak tidak menarik
kateter. Kemungkinan diperlukan penahan tetapi sedapat mungkin hal ini
dihindarkan.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Baik luka penis dan
tempat luka donor dijaga tetap bersih dan kering. Swab harus diambil bila
dicurigai adanya infeksi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Perawatan kateter<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Pemeriksaan urin untuk
memeriksa kandungan bakteri<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Masukan cairan yang
adekuat untuk mempertahankan aliran ginjal dan mengencerkan toksin<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Pengangkatan jahitan
kulit setelah 5-7 hari<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Anak dipulangkan
segera setelah kateter diangkat dan dapat berkemih dengan baik.<o:p></o:p></span></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Diagnosa keperawatan yang
mungkin muncul<o:p></o:p></span></b></div>
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<br /></div>
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<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">PRE-OP:<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><!--[endif]--><span dir="LTR"></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">cemas b/d krisis situasional<o:p></o:p></span></b></div>
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<span lang="EN-US" style="font-size: 12.0pt;">INTERVENSI<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt;">RASIONAL<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt;">Membangun hubungan saling percaya<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt;">Memudahkan perawat menggali perasaan dan kecemasan
klien<o:p></o:p></span></div>
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<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Memberikan ketenangan:<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt;">Tinggal bersama klien<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt;">Berbicara dengan suara lembut dan tenang<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt;">Bersikap empati<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt;">Ketenangan dan suasana nyaman akan menurunkan
kecemasan<o:p></o:p></span></div>
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<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Menyakinkan bahwa setiap orang berhak untuk merasa
takut atau ragu-ragu<o:p></o:p></span></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Agar klien tidak merasa tertekan<o:p></o:p></span></div>
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<tr style="mso-yfti-irow: 4;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengkaji hal-hal yang dapat menurunkan kecemasan<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt;">Membantu perawat menentukan intervensi yang tepat<o:p></o:p></span></div>
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<tr style="mso-yfti-irow: 5; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Melakukan teknik distraksi<o:p></o:p></span></div>
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<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Untuk membantu mengalihkan perhatian<o:p></o:p></span></div>
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</tbody></table>
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<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l5 level1 lfo2; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><!--[endif]--><span dir="LTR"></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Kurang pengetahuan akan
prosedur operasi b/d kurangnya informasi<o:p></o:p></span></b></div>
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<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">INTERVENSI<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">RASIONAL<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengkaji tingkat pengetahuan klien dan keluarga<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Menentukan intervensi yang akan diberikan<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2; page-break-inside: avoid;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Menjelaskan dengan bahasa sederhana<o:p></o:p></span></div>
</td>
<td rowspan="3" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Meningkatkan pemahaman<o:p></o:p></span></div>
</td>
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<tr style="mso-yfti-irow: 3; page-break-inside: avoid;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengkaji ulang hal-hal yang masih belum jelas<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 4; page-break-inside: avoid;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Menilai kembali tingkat pengetahuan klien dan
keluarga<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 5;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengklarifikasi anggapan yang kurang tepat<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Meluruskan informasi<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 6; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Memberikan tambahan pengetahuan dengan poster,
gambar atau leaflet<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Untuk memperjelas informasi<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">POST-OP:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><!--[endif]--><span dir="LTR"></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">nyeri b/d luka pembedahan<o:p></o:p></span></b></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">INTERVENSI<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">RASIONAL<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengkaji tingkat nyeri<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Menentukan teknik intervensi<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengajarkan teknik nafas dalam <o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Menurunkan nyeri<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 3;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengkaji hal yang biasa dilakukan untuk mengatasi
nyeri<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Membantu intervensi<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 4;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Melakukan teknik distraksi<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Untuk pengalih perhatian<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 5;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Memberikan kesempatan pada klien untuk mengungkapkan
perasaannya<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Membagi perasaan dapat menurunkan stres<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 6;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Kolaborasi pemberian analgesik<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Penurun nyeri<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 7; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengobservasi keefektifan analgesik thd klien<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Menilai seberapa jauh penurunan nyeri<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><!--[endif]--><span dir="LTR"></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">resiko infeksi b/d luka
pembedahan<o:p></o:p></span></b></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">INTERVENSI<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">RASIONAL<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengkaji TTV<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Indikasi adanya gangguan<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengamati manfestasi klinis infeksi<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Deteksi dini dan melakukan penanganan awal
secepatnya<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 3;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Kolaborasi pemberian antibiotika<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mencegah terjadinya infeksi<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 4; page-break-inside: avoid;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mengajarkan pada klien dan klg untuk menjaga
kebersihan<o:p></o:p></span></div>
</td>
<td rowspan="3" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Meminimalkan mikroorganisme yang masuk ke tubuh
klien<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 5; page-break-inside: avoid;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Melakukan perawatan luka dengan prinsip steril<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 6; mso-yfti-lastrow: yes; page-break-inside: avoid;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 221.4pt;" valign="top" width="295"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Mencuci tangan sebelum dan sesudah kontak dengan
klien<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h2>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">FORMAT
PENGKAJIAN<o:p></o:p></span></h2>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">======================================================<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l22 level1 lfo5; tab-stops: list 36.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">I.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">IDENTITAS DATA<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Nama<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>An T.R<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">TTL<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>Bantul, 1 Januari 1993<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Usia<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>11 tahun<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Nama Ayah<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>Samijan<span style="mso-tab-count: 3;"> </span>Nama
Ibu<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>Sudiyah<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Pendidkan<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>tidak sekolah<span style="mso-tab-count: 3;"> </span>Pendidikan<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;">
</span>SD (tidak tamat)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Pekerjaan<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>petani<span style="mso-tab-count: 3;"> </span>Pekerjaan<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;">
</span>Petani<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Alamat<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>Gluntung lor RT 1/3 Caturharjo, pandak,
Bantul<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">No. RM<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>01-09-97-44<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Tgl masuk<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>17 Januari 2004<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Tgl pengkajian<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>19 Januari 2004<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l22 level1 lfo5; tab-stops: list 36.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">II.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">KELUHAN UTAMA<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Klien mengeluh posisi penisnya melengkung, kencing dari
lubang bawah, sering menetes atau merembes<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l22 level1 lfo5; tab-stops: list 36.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">III.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">RIWAYAT KEHAMILAN DAN KELAHIRAN<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">1. prenatal<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>ibu jarang memeriksakan kehamilannya, pada
bulan pertama tidak menyadari kehamilannya. Tidak pernah sakit dan tidak pernah
mengkonsumsi obat selama hamil<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">2. intranatal<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>persalinan spontan normal dengan bantuan
dukun, lahir normal cukup bulan dan langsung menangis. BBL 3200 kg<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">3. postnatal<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>klien tidak mengalami masalah dengan
kesehatan pada masa neonatal, tidak ada riwayat penyakit berat yang menyebabkan
klien harus dirawat di RS<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l22 level1 lfo5; tab-stops: list 36.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">IV.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">RIWAYAT MASA LAMPAU<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">1. penyakit waktu kecil<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>tidak pernah
sakit berat, hanya batuk dan pilek biasa. Kontrol kesehatan dipuskesmas, kadang
beli obat di warung.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">2. pernah dirawat :<span style="mso-spacerun: yes;">
</span>9 bulan yang lalu orchidopeksi di RSS, menginap selama 16 hari<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">3. obat-obat yg digunakan<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>-<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">4. tindakan (operasi)<span style="mso-tab-count: 1;"> </span>:
9 bulan yang lalu orchidopeksi di RSS, menginap selama 16 hari<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">5. Alergi<span style="mso-tab-count: 3;"> </span>:<span style="mso-spacerun: yes;"> </span>-<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">6. Kecelakaan<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>pernah<span style="mso-spacerun: yes;">
</span>jatuh dari sepeda namun hanya luka lecet biasa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">7. imunisasi<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>lengkap : DPT, Polio, BCG, Campak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l22 level1 lfo5; tab-stops: list 36.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">V.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">RIWAYAT KELUARGA(Genogram)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 324.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US" style="font-size: 12.0pt;">Ket:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 324.0pt; text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>laki-laki<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 324.0pt; text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>perempuan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 324.0pt; text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>meninggal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 324.0pt; text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>klien<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 324.0pt; text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>serumah<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 2;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l22 level1 lfo5; tab-stops: list 36.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">VI.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">RIWAYAT SOSIAL<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt;">1. yang mengasuh<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>ibu<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">2. hub. Dg anggota klg<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>baik, cukup akrab dengan adik dan kaka<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">3. hub. Dg teman<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>baik, mudah akrab dengan teman sebaya<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">4. pembawaan umum<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>aktif, ceria dan mudah akrab<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">5. lingkungan rumah<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>rumah tipe gubuk dengan 2 kamar, lantai dari
tanah, ventilasi 2, Kamar mandi terpisah dari banggunan utama, sumber air dari
sumur<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l22 level1 lfo5; tab-stops: list 36.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">VII.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">KEBUTUHAN DASAR<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">1. Makanan yang disukai : ibu mengatakan klien tidak
mempunyai kesulitan untuk makan, selera makan baik. Jatah RS selalu habis
kadang masih kurang<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">2. Pola tidur<span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>klien tidur jam 8/9 malam dan
bangun jam 6 pagi. Tidak pernah tidur siang<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">3. Mandi<span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>2 x/hari, mampu mandi sendiri<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">4. aktivitas bermain<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>bersama teman-teman, bermain sepak bola dan
kelereng<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">5. eliminasi<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>BAB<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>1x/hari, kadang siang kadang sore<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 4;"> </span><span style="mso-spacerun: yes;"> </span>selama di RS baru 1x<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 3;"> </span><span style="mso-spacerun: yes;"> </span>BAK<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>4-5x/hari, namun sering menetes atau merembes
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<h3>
<!--[if !supportLists]--><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-bidi-font-size: 12.0pt;"><span style="mso-list: Ignore;">VIII.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-bidi-font-size: 12.0pt;">KEADAAN KESEHATAN SAAT INI<o:p></o:p></span></h3>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">1. Diagnosa Medis<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>hipospadia tipe penoscrotal<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">2. Tindakan operasi<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>post orchidopeksi 9 bln yang lalu<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 3;"> </span><span style="mso-spacerun: yes;"> </span>pro kordektomi (jadwal hari jumat, 23
januari 2004)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">3. Status nutrisi<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>baik, pola makan baik, BB 25 kg<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">4. status cairan<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>baik, klien minum 8 gelas perhari (@ 100 cc)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">5. obat<span style="mso-tab-count: 3;"> </span>:<span style="mso-spacerun: yes;"> </span>-<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">6. aktivitas<span style="mso-tab-count: 2;"> </span>:<span style="mso-spacerun: yes;"> </span>aktif, bergerak tanpa kesulitan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">7. tindakan keperawatan<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>-<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">8. hasil lab.<span style="mso-tab-count: 2;"> </span>:
19 januari 2004<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 3;"> </span>Na
(serum)<span style="mso-tab-count: 1;"> </span>:<span style="mso-tab-count: 1;"> </span>140<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 3;"> </span>K
(serum)<span style="mso-tab-count: 1;"> </span>:<span style="mso-tab-count: 1;"> </span>3,8<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 3;"> </span>Cl
(serum)<span style="mso-tab-count: 1;"> </span>:<span style="mso-tab-count: 1;"> </span>105<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 3;"> </span>TP<span style="mso-tab-count: 2;"> </span>:<span style="mso-tab-count: 1;"> </span>7,66<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 3;"> </span>Alb<span style="mso-tab-count: 2;"> </span>:<span style="mso-tab-count: 1;"> </span>4<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l22 level1 lfo5; tab-stops: list 36.0pt; text-align: justify; text-indent: -36.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">IX.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">PEMERIKSAAN FISIK<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">1. Keadaan umum<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Anak terlihat aktif, bergerak tanpa kesulitan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Suhu<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;"> </span>36,5 C<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Nadi<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;"> </span>110x/menit<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Pernapasan<span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>30x/menit<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Tekanan darah<span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>120/80 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Berat<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;"> </span>25 Kg<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">TB<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;"> </span>120 cm<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">2. Integumen<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">kulit</span></i><span lang="EN-US" style="font-size: 12.0pt;"> :<span style="mso-spacerun: yes;">
</span>hangat, agak kering pada tangan dan kak, elastis, tidak ada edema<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">membran mukosa</span></i><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>kemerahan, agak kering<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">bantalan kuku</span></i><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>merah muda, tekstur tegas,
tidak clubbing<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">rambut dan kuku</span></i><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>rambut bersih, lembut, kulit
kepala bersih, tidak ada lesi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">kepala dan leher<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">kepala</span></i><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>:
normosefalik, LK :<span style="mso-spacerun: yes;"> </span>50 cm<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">leher</span></i><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>ROM penuh, simetris, trakea di
garis tengah, tiroid tidak teraba. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">telinga<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Tidak ada lesi, saluran bersih dan bebas dari serumen,
tidak ada masalah dengan pendengaran.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">mata :kongjungtiva
bening, sklera bening<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">muka hidung dan rongga
mulut<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">muka, hidung dan gerakan muka :<span style="mso-spacerun: yes;"> </span>simetris, anak mudah tersenyum , tidak ada
nyeri pada palpasi pipi dan area di atas alis mata<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">rongga mulut<span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>bibir kering, agak pecah-pecah,
tidak ada lesi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">gusi<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;"> </span>tidak ada edema atau bengkak<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">gigi<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;"> </span>bersih<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Dada dan paru-paru<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Dada oval, simetris, tidak tertarik ke dalam,
Pernafasan diafragmatik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Sistem vasikuler :Jantung<span style="mso-spacerun: yes;"> </span>:<span style="mso-spacerun: yes;">
</span>normal<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Sistem vaskuler<span style="mso-spacerun: yes;">
</span>:<span style="mso-spacerun: yes;"> </span>nadi radialis dan perifer sama,
teratur dan kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">abdomen<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">simetris, tidak teraba adanya tonjolan atau <st1:city w:st="on"><st1:place w:st="on">massa</st1:place></st1:city>, tidak ada hernia<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">10.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">sistem genitourinaria<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">hipospadia penoskrotal, ada refleks BAK, namun ada
rembesan sehingga celana sering basah karena urin (inkontinensia refleks)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l10 level1 lfo3; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">11.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">sistem muskuloskeletal<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">perkembangan otot dan <st1:city w:st="on"><st1:place w:st="on">massa</st1:place></st1:city> normal sesuai umur, gerakan simetris,
cara berjalan normal, jari-jari lengkap, persendian tidak ada nyeri tekan,
tidak bengkak, ROM penuh<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">ANALISA DATA<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">DATA<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 103.5pt;" valign="top" width="138"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">ETIOLOGI<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 108.9pt;" valign="top" width="145"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">MASALAH<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">DO:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l26 level1 lfo16; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Ibu menanyakan apa
yang perlu dipersiapkan menjelang operasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l26 level1 lfo16; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Ibu tidak tahu
ketika ditanya prosedur yang perlu dilakukan setelah operasi<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 103.5pt;" valign="top" width="138"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Kurangnya informasi; keterbatasan kognitif<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 108.9pt;" valign="top" width="145"><div class="MsoNormal" style="text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Kurang pengetahuan<o:p></o:p></span></i></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">DO:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l18 level1 lfo17; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Celana klien selalu
basah <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l27 level1 lfo18; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Inkontinensia <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">DS:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l16 level1 lfo19; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Ibu mengatakan
celana klien memang selalu basah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l15 level1 lfo20; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Klien mengaku
merasakan adanya sensasi berkemih, namun tidak merasakan adanya rembesan<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 103.5pt;" valign="top" width="138"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Inkontinensia<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 108.9pt;" valign="top" width="145"><div class="MsoNormal" style="text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Resiko gangguan integritas
kulit<o:p></o:p></span></i></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">DIAGNOSA KEPERAWATAN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo21; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><!--[endif]--><span dir="LTR"></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">kurang pengetahuan b/d
kurangnya informasi; ketebatasan kognitif<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Tujuan:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Setelah dilakukan pembelajaran atau penyuluhan selama
2x15 menit, pemahaman klien dan keluarga mengenai prosedur peroperatif
hipospadia akan bertambah.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Kriteria Evaluasi</span></b><span lang="EN-US" style="font-size: 12.0pt;">:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level1 lfo22; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Klien dan keluarga
dapat menyebutkan hal-hal yang perlu dilakukan sebelum operasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level1 lfo22; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Klien dan keluarga
dapat menyebutkan hal-hal yang perlu dilakukan setelah operasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level1 lfo22; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Klien dan keluarga
dapat menyebutkan perawatan pada luka operasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l2 level1 lfo21; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span></b><!--[endif]--><span dir="LTR"></span><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Resiko gangguan integritas
kulit b/d inkontinensia<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Tujuan:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Setelah dilakukan tindakan keperawatan selama 2x10
menit, pemahaman klien tentang faktor resiko meningkat, sehingga tidak terjadi
gangguan integritas kulit.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Kriteria Evaluasi:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo23; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Klien dan keluarga
memahami penyebab gangguan integritas kulit<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo23; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Klien dan keluarga
dapat memahami manifestasi klinis gangguan integritas kulit<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l3 level1 lfo23; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Klien dan keluarga
dapat memahani cara mencegah terjadinya gangguan integritas kulit<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<h4>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-bidi-font-size: 12.0pt;">CATATAN
PERKEMBANGAN<o:p></o:p></span></h4>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.4pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">No. dx<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 67.5pt;" valign="top" width="90"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Tgl/jam<o:p></o:p></span></div>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 184.5pt;" valign="top" width="246"><h4>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-bidi-font-size: 12.0pt;">INTERVENSI<o:p></o:p></span></h4>
</td>
<td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 140.4pt;" valign="top" width="187"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">EVALUASI<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1; page-break-inside: avoid;">
<td rowspan="4" style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.4pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">1.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 67.5pt;" valign="top" width="90"><div class="MsoNormal" style="text-align: justify;">
<st1:date day="20" month="1" w:st="on" year="2004"><span lang="EN-US" style="font-size: 12.0pt;">20-01-2004</span></st1:date><span lang="EN-US" style="font-size: 12.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">10.00<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 184.5pt;" valign="top" width="246"><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l8 level1 lfo12; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengkaji tingkat
pengetahuan orang tua tentang prosedur perioperative<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-no-proof: yes; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">à</span></span><span lang="EN-US" style="font-size: 12.0pt;"> klien
dan klg lupa mengenai <span style="mso-spacerun: yes;"> </span>prosedur op. 9
bln yang lalu<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l8 level1 lfo12; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Melakukan pendidikan
kesehatan mengenai prosedur operasi hipospadia<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l8 level1 lfo12; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengevaluasi proses
pendidikan kesehatan<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 140.4pt;" valign="top" width="187"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">S: keluarga mengatak belum memahami sepenuhnya<span style="mso-spacerun: yes;"> </span>mengenai prosedur operasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">O: keluarga blm dpt menyebutkan prosedur pre dan
post op<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">A: masalah blm teratasi <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">P: lanjutkan intervensi<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2; page-break-inside: avoid;">
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 67.5pt;" valign="top" width="90"><div class="MsoNormal" style="text-align: justify;">
<st1:date day="21" month="1" w:st="on" year="2004"><span lang="EN-US" style="font-size: 12.0pt;">21-01-2004</span></st1:date><span lang="EN-US" style="font-size: 12.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">18.00<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 184.5pt;" valign="top" width="246"><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo11; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengkaji keefektifan
pengetahuan tentang prosedur perioperative yang telah diberikan kemarin<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l7 level1 lfo11; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Melakukan pendidikan
kesehatan sesuai SAP<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 140.4pt;" valign="top" width="187"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">S: keluarga menyatakan mengerti mengenai prosedur
perioperative<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">O: keluarga dapat menyebutkan prosedur pre dan post
op<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">A: masalah teratasi sebagian<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">P: lanjutkan intervensi<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 3; page-break-inside: avoid;">
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 67.5pt;" valign="top" width="90"><div class="MsoNormal" style="text-align: justify;">
<st1:date day="22" month="1" w:st="on" year="2004"><span lang="EN-US" style="font-size: 12.0pt;">22-01-2004</span></st1:date><span lang="EN-US" style="font-size: 12.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">09.00<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 184.5pt;" valign="top" width="246"><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l24 level1 lfo24; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengingatkan klien
dan keluarga mengenai prosedur perioperative<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l24 level1 lfo24; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengkaji keefektifan
penkes<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l24 level1 lfo24; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Menanyakan pada
klien dan klg tentang hal-hal yang dirasa masih belum jelas<o:p></o:p></span></div>
</td>
<td rowspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 140.4pt;" valign="top" width="187"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">S: klien dan klg menyatakan pemahaman akan prosedur
perioperative<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">O: klien dan klg dapat menyebutkan tindakan
perioperative dan tindakan perawatan post-op<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">A: masalah teratasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">P: hentikan intervensi<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 4; page-break-inside: avoid;">
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 67.5pt;" valign="top" width="90"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">21.00<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 184.5pt;" valign="top" width="246"><div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l23 level1 lfo25; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengingatkan kembali
akan informasi yang telah diberikan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l23 level1 lfo25; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Menkaji keefektifan
penkes yang telah diberikan<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 5;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.4pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">2.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 67.5pt;" valign="top" width="90"><div class="MsoNormal" style="text-align: justify;">
<st1:date day="20" month="1" w:st="on" year="2004"><span lang="EN-US" style="font-size: 12.0pt;">20-01-2004</span></st1:date><span lang="EN-US" style="font-size: 12.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">10.00<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 184.5pt;" valign="top" width="246"><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l21 level1 lfo10; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengamati adanya
manifestasi gangguan interitas kulit<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-no-proof: yes; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">à</span></span><span lang="EN-US" style="font-size: 12.0pt;"> ada
kemerahan, tidak ada lesi, bau urine menyengat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l20 level1 lfo9; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengkaji hal-hal
yang biasa dilakukan dirumah untuk menangani masalah inkontinensia<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-no-proof: yes; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">à</span></span><span lang="EN-US" style="font-size: 12.0pt;"> klien
dan keluarga tidak menganggap hal tersebut sebagai masalah, klien sering
pulang sekolah dalam keadaan celana basah, sehingga berbau<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo26; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Keluarga mengatakan
klien berganti celana 2x sehari, ketika mandi saja<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l25 level1 lfo8; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Memberikan
penjelasan mengenai pentingnya menjaga kebersihan area perineal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l25 level1 lfo8; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Menganjurkan klien
untuk segera mengganti celana bila basah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l25 level1 lfo8; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Menganjurkan klien
untuk melapisi celana dengan kain untuk mencegah perembesan di kain celana<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 140.4pt;" valign="top" width="187"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">S: ibu mengatakan tidak mengerti mengenai faktor
resiko<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">O: klien blm dapt menyebutkan faktor resiko gangguan
integritas kulit yang mungkin dialami<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">A: masalah belum teratasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">P: lanjutkan intervensi<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 6;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.4pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 67.5pt;" valign="top" width="90"><div class="MsoNormal" style="text-align: justify;">
<st1:date day="21" month="1" w:st="on" year="2004"><span lang="EN-US" style="font-size: 12.0pt;">21-01-2004</span></st1:date><span lang="EN-US" style="font-size: 12.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">17.00<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 184.5pt;" valign="top" width="246"><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level1 lfo6; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengamati
manifestasi klinis kerusakan integritas kulit di area perineal<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-no-proof: yes; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">à</span></span><span lang="EN-US" style="font-size: 12.0pt;"> ada
kemerahan, tidak ada lesi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l19 level1 lfo7; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Menganjurkan anak
untuk membersihkan area perineal lebih sering, menggunakan sabun dan
mengeringkan dengan handuk<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l19 level1 lfo7; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengajarkan pada
keluarga mengenai tanda-tanda klinis kerusakan integritas kulit<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 140.4pt;" valign="top" width="187"><div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">S: klg menyatakan pemahaman mengenai pentingnya
perawatan area perineal<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">O: klien dan klg dapat menyebutkan tanda-tanda
klinis kerusakan integritas kulit<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Klien terlihat lebih sering berganti celana<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">A: masalah teratasi tap faktor resiko masih ada<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">P: lanjutkan penkes<o:p></o:p></span></div>
</td>
</tr>
<tr style="mso-yfti-irow: 7; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 50.4pt;" valign="top" width="67"><div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 67.5pt;" valign="top" width="90"><div class="MsoNormal" style="text-align: justify;">
<st1:date day="22" month="1" w:st="on" year="2004"><span lang="EN-US" style="font-size: 12.0pt;">22-01-2004</span></st1:date><span lang="EN-US" style="font-size: 12.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">09.00<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 184.5pt;" valign="top" width="246"><div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo27; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Mengkaji manifestasi
klinis kerusakan integritas kulit<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l1 level1 lfo27; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Menganjurkan klg
untuk meminimalkan efek buruk inkontinensia pada lingkungan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-no-proof: yes; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">à</span></span><span lang="EN-US" style="font-size: 12.0pt;">
menganjurkan ibu untuk memberikan alas dengan plastik pada tempat tidur klien
untuk menghindarkan rembesan di kasur<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l9 level1 lfo28; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">mengkaji ulang
pengetahuan keluarga mengenai manifestasi klinis gangguan integritas kulit<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 140.4pt;" valign="top" width="187"><div class="MsoBodyText3">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-bidi-font-size: 12.0pt;">S: klien dan klg memahami faktor
resiko dan pencegahan terjadinya gangguan integritas kulit<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">O: klien dan klg dapat menyebutkan menifestasi
klinis gangguan integritas kulit, menyebutkan faktor resiko dan pencegahannya<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">A: masalah teratasi, faktor resiko masih ada<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">P: lanjutkan intervensi<o:p></o:p></span></div>
<h5>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-bidi-font-size: 12.0pt;">PK
inkontinensia urin<o:p></o:p></span></h5>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">PERSIAPAN PREOPERASI<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Tgl 22 januari 2004<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">Jam 21.00 <span style="mso-tab-count: 1;"> </span>Menginstruksikan
klien untuk berpuasa <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 2;"> </span>Mengingatkan
klien untuk beristirahat<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 2;"> </span>Menyiapkan
berkas-berkas preoperasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">23 januari 2004<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;">jam 05.00<span style="mso-tab-count: 1;"> </span>Menyiapkan
informed consent<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 2;"> </span>membantu
ibu mengisi informed concent<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify; text-indent: 36.0pt;">
<span lang="EN-US" style="font-size: 12.0pt;">Melakukan pemasangan infus
dengan prinsip steril <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-tab-count: 2;"> </span>Memberikan
injeksi cefotaxime 1 gram<o:p></o:p></span></div>
<h4>
<span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-bidi-font-size: 12.0pt;"><o:p> </o:p></span></h4>
<div class="MsoNormal">
<span lang="EN-US"><o:p> </o:p></span> </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<h4 align="center" style="text-align: center;">
<span lang="EN-US" style="font-family: "Times New Roman","serif"; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>DAFTARPUSTAKA<o:p></o:p></span></h4>
<div class="MsoNormal" style="margin-left: 0cm; mso-list: l17 level1 lfo15; tab-stops: list 18.0pt; text-align: justify; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Ashcraft, <i style="mso-bidi-font-style: normal;">pediatric urology</i>, W.B saunders, 1990<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0cm; mso-list: l17 level1 lfo15; tab-stops: list 18.0pt; text-align: justify; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">Carpenito, <i style="mso-bidi-font-style: normal;">Buku Saku Diagnosa Keperawatan</i>, edisi 8,
Penerbit Buku Kedokteran EGC, <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>,
2000<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 0cm; mso-list: l17 level1 lfo15; tab-stops: list 18.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="mso-bidi-font-size: 12.0pt;">Doenges, <i style="mso-bidi-font-style: normal;">Rencana Asuhan Keperawatan:Pedoman untuk
Perencanaan dan Pendokumentasian pasien</i>, Edisi 3, Penerbit Buku Kedokteran
EGC, <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>
1999<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 0cm; mso-list: l17 level1 lfo15; tab-stops: list 18.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="mso-bidi-font-size: 12.0pt;">Joyce Engel, <i style="mso-bidi-font-style: normal;">Pengkajian Pediatrik</i>, Edisi 2, Penerbit
Buku Kedokteran EGC, <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>,
1998<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 0cm; mso-list: l17 level1 lfo15; tab-stops: list 18.0pt; text-align: justify; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 12.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="font-size: 12.0pt;">NANDA, <i style="mso-bidi-font-style: normal;">Nursing diagnoses: Definitions and
Classification</i> 2001-2002, <st1:city w:st="on"><st1:place w:st="on">Philadelphia</st1:place></st1:city>,
2002<o:p></o:p></span></div>
<div class="MsoBodyTextIndent" style="margin-left: 0cm; mso-list: l12 level1 lfo14; tab-stops: list 18.0pt; text-indent: 0cm;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">§<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span dir="LTR"></span><span lang="EN-US" style="mso-bidi-font-size: 12.0pt;">Sacharin, <i style="mso-bidi-font-style: normal;">Prinsip Keperawatan Pediatrik</i>, Edisi 2,
Penerbit Buku Kedokteran EGC, <st1:city w:st="on"><st1:place w:st="on">Jakarta</st1:place></st1:city>,
1996<o:p></o:p></span></div>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-78012372734479616042012-11-07T18:14:00.007-08:002012-11-07T18:14:41.652-08:00GANGGUAN KETIDAKSEIMBANGAN ASAM BASA<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">GANGGUAN
KETIDAKSEIMBANGAN ASAM BASA</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penilaian Sistematik daam Penilaian gangguan asam
basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">___________________________________________________________________________<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Awali dengan kecurigaan klinis yang tinggi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l5 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ini membutuhkan pengetahuan tentang patogensis dari berbagai gangguan
asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contohnya, asidosis respiratorik mungkin dapat diperkirakan timbul pada
penderita penyakit paru obstruksi menahun.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan tanda dan gejala klinis yang mengarah
kepada gangguan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sayang sekali, banyak tanda dan gejala dari gangguan asam basa tidak
jelas dan non spesifik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, pernafasan kussmaul pada pasien
diabetes dapat merupakan tanda kompensasi pernafasan terhadap asidosis
metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Periksa hasil pemeriksaan laboratorium untuk
elektrolit dan data lainnya yang mengarah <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> kepada
proses penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, hipokalemia sering berkaitan dengan alkalosis metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, peningkatan kadar kreatinin serum menunjukkan insufesiensi
ginjal dan insufesiensi serta gagal ginjal sering disertai asidosis metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<a name='more'></a><br />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menilai variabel-variabel asam basa untuk mengetahui
tipe gangguan.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Pertama, periksa PH darah arteri untuk menentukan
arah dan besarnya gangguan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika menurun, pasien mengalami asidemia dengan dua sebab yang mungkin :
asidosis metabolik atau asidosis respiratorik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika meningkat, pasien mengalami alkalemia dengan dua sebab yang
mungkin : alkalosis metabolik atau alkalosis respiratorik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1066"
style='position:absolute;left:0;text-align:left;z-index:251560448;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="140.4pt,34.8pt" to="147.65pt,34.85pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 186px; margin-top: 45px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251560448;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1066" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ingatlah bahwa kampensasi ginjal dan pernafasan
jarang memulihkan PH kembali normal sehingga jika ditemukan PH yang normal
meskipun ada perubahan dalam PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ,mungkin ada gangguan campuran ; contohnya
seorang pasien dengan asidosis respiratorik yang bercampur dengan alkalosis
metabolik mungkin akan mempunyai PH yang normal.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1079"
style='position:absolute;left:0;text-align:left;z-index:251573760;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="306pt,.2pt" to="313.25pt,.25pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251573760;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1079" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan variabel pernafasan (PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">) dan metabolik HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , yang berhubungan dengan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> PH untuk
mencoba mengetahui apakah gangguan primer bersifat respiratorik, metabolik <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> atau
campuran.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (40 mmHg), meningkat
atau menurun ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1045"
style='position:absolute;left:0;text-align:left;z-index:251538944;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,.85pt" to="133.25pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251538944;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1045" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (24 mEq/L), meningkat
atau menurun ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tambahan : apakah ada kelebihan atau kekurangan basa ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1055"
style='position:absolute;left:0;text-align:left;z-index:251549184;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="320.4pt,-.4pt" to="327.65pt,-.35pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251549184;"><span style="height: 3px; left: 0px; left: 426px; position: absolute; top: -2px; width: 12px;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1055" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pada gangguan asam basa sederhana, PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> selalu berubah dalam arah yang sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1035"
style='position:absolute;left:0;text-align:left;z-index:251528704;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="234pt,0" to="241.25pt,.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251528704;"><span style="height: 2px; left: 0px; left: 311px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1035" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyimpangan dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dalam darah yang berlawanan
menunjukkan adanya gangguan asam basa campuran.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cobalah untuk menduga campuran primer dengan menghubungkan hasil
pemeriksaan yang ditemukan dengan keadaan klinis.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Perkirakan respon kompensatorik yang bakal
terjadi pada gangguan asam basa primer.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika respon kompensatorik
lebih berat atau ringan dari pada yang diperkirakan, mungkin ada gangguan asam
basa campuran (normogram asam basa juga dapat digunakan untuk mengetahui
gangguan asan basa campuran) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hitung selisih (gap) anion
plasma.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika
meningkat ( >16 mEq/l ), mungkin sekali terjadi acidosis metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt;"> </span></span><!--[endif]--><!--[if gte vml 1]><v:line
id="_x0000_s1046" style='position:absolute;left:0;text-align:left;z-index:251539968;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="241.2pt,2.45pt" to="248.45pt,2.5pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 320px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251539968;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1046" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bandingkan besarnya penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> plasma dengan peningkatan selisih anion :
seharusnya sama besar.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1067"
style='position:absolute;left:0;text-align:left;z-index:251561472;
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from="363.6pt,17.65pt" to="370.85pt,17.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 484px; margin-top: 22px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251561472;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1067" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1056"
style='position:absolute;left:0;text-align:left;z-index:251550208;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="349.2pt,3.25pt" to="356.45pt,3.3pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 464px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251550208;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1056" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan
< dari selisih anion penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , mungkin komponen dari
acidosis metabolik disebabkan oleh kehilangan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1080"
style='position:absolute;left:0;text-align:left;z-index:251574784;
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from="450pt,3.05pt" to="457.25pt,3.1pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 599px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251574784;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1080" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan selisih dari anion jauh lebih besar
dari penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> berarti ada alkalosis metabolik yang
menyertainya.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Buat penafsiran tahap akhir.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">gangguan asam-basa sederhana<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Akut (tidak terkompensasi)
atau<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kronik (sebagian atau
sepenuhnya terkompensasi )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam-basa campuran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik dengan selisih anion normal atau lebar.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1122"
style='position:absolute;left:0;text-align:left;z-index:251617792;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,10.75pt" to="291.65pt,10.8pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="13" width="378"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1122" width="12" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> )<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1107" style='position:absolute;left:0;text-align:left;z-index:251602432;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="75.6pt,14.65pt" to="82.85pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 100px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251602432;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1107" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer kadar bikarbonat sehingga terjadi
penurunan PH ( peningkatan ion H) . HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF =22 mEq/L
dan PH =7,35. Kompensasi pernafasan segera dimulai untuk menurunkan PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> melalui hiperventilasi
sehinga asidosis metabolik jarang terjadi secara akut.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui
saluran cerna : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Diare<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Ilieotomi ; fistula
pankreas, kantong empedu atau usus halus.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Ureterosigmoidostomi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Asidosis tubulus
proksimal ginjal (RTA)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Inhibitor Karbonik
Anhidrase (Asetazolamid)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Hipoaldosteronisme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1026" style='position:absolute;left:0;text-align:left;z-index:251519488;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="212.4pt,10.55pt" to="241.25pt,10.6pt" o:allowincell="f" strokecolor="blue"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrow="open"
endarrowwidth="narrow" endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 282px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 42px; z-index: 251519488;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image007.gif" v:shapes="_x0000_s1026" width="42" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida (NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cl
NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> + HCl <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan
hiperalimentasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan
secara cepat .<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Peningkatan produksi asam
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat : laktat (perfusi jaringan atau aksigenasi yang tidak
memadai seperti pada syok atau henti kardiopulmonar)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ketoasidosis diabetik : Beta-hidroksibutirat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelaparan: peningkatan asam - asam keto<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi alkohol : peningkatan asam-asam keto<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Menelan substansi toksik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kelebihan dosis salisilat
: Salisilat, laktat, keton<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Metanol atau formaldehid
: formad<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Etilglikol (antibeku) :
oksilat, glikolat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Kegagalan ekskresi asam
: tidak adanya ekskresi NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ; retensi asam sulfat dan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> asam fosfat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. gagal ginjal akut dan
kronik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi
asidosis metabolik<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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<td></td>
<td align="left" valign="top"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image008.gif" v:shapes="_x0000_s1057" width="69" /></td>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<br /></div>
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1
20<o:p></o:p></span></div>
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<td height="9" width="234"></td>
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" Keton dan
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<td><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image014.gif" v:shapes="_x0000_s1138" width="70" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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style='position:absolute;left:0;text-align:left;margin-left:68.4pt;
margin-top:8.95pt;width:64.85pt;height:64.85pt;z-index:251618816;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 90px; margin-top: 11px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251618816;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image015.gif" v:shapes="_x0000_s1123" width="89" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> d ! B <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
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<table align="left" cellpadding="0" cellspacing="0">
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<td height="3" width="128"></td>
<td width="12"></td>
<td width="104"></td>
<td width="40"></td>
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<td height="20"></td>
<td colspan="2"></td>
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<tr>
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<tr>
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</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1234" style='position:absolute;left:0;text-align:left;
margin-left:262.8pt;margin-top:6.75pt;width:57.65pt;height:57.65pt;z-index:251732480;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 349px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251732480;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1234" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ! ` ! B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;margin-left:82.8pt;
margin-top:2.25pt;width:57.65pt;height:57.65pt;z-index:251723264;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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from="118.8pt,10.35pt" to="298.85pt,46.4pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 157px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 243px; z-index: 251744768;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image027.gif" v:shapes="_x0000_s1246" width="243" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
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<div class="MsoNormal" style="text-align: justify;">
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mso-position-vertical-relative:text' from="104.4pt,6.75pt" to="111.65pt,14pt"
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 153.9pt;" valign="top" width="205">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkao banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan Bikarbonat , mengeluarkan H+, dam
anion lain urin asam. NaHCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">,
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</tbody></table>
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
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<tr>
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<td width="180"></td>
<td width="79"></td>
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<tr>
<td height="79"></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image029.gif" v:shapes="_x0000_s1281" width="79" /></td>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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20<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
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from="147.6pt,19.4pt" to="154.85pt,19.45pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251529728;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1036" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">peningkatan primer kadar bikarbonat plasma, sehingga
terjadi peningkatan Ph (penurunan H ).
HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF = 2,6 mEq/l dan PH = 7,45. Kompensasi pernapasan berupa
peningkatan Pa CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dengan hipoventilasi ; akan
tetapi tingkat hipoventilasi adalah terbatas karena parnapasan terus berjalan
karena dorongan hipoxia/<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan mela|}i
saluran cerna (berkurangnya volume ECF)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Muntah atau penyedotan
nasogastrik <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Diare dengan kehilangan
klorida<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kehilangan melalui ginjal<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Diuretik simpai atau
tiazid (pembatasan NaCl + berkurangnya ECF)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kelebihan
mineralokortikoid<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1). Hiperaldosteronisme<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2). Syndvom cushing ;
tgrapi kortikosteroid eksogen )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3). Makan licorice
berlebihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Karbenisillin atqu
penicillio dosis tinggi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 148px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251563520;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image033.gif" v:shapes="_x0000_s1069" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian Natrium Bikarbonat
berlebihan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sundrom susu alkali
(antasid, susu, natrium bkkarbonat)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Darah simpan (sitrat) yang
banyak (>8unit)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik
hiperkapnia (setelah koreksi pada asidosiw respiratorik kronik)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ventinasi mekanis: penurunan yang cepat dari PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> tapi HCO tetap tinggi
sampai0kinjal mengeksekresi kelebihannya.<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya disertai penurunan ECF<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mun|ah atau penyeditan Nasogastrik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deuretik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasca-hiperkapnea<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya tidak dirsertai penurunan Volume
ECF <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelebihan mineralokortikoid<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Edematosa (gagal jantung kongestif, sirosis, sindrom nefrotik).<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
Alkalosis metabolik<o:p></o:p></span></div>
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<br /></div>
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B<o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 224px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251663872;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image037.gif" v:shapes="_x0000_s1167" width="22" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1205" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:37.1pt;width:50.45pt;height:50.45pt;z-index:251702784;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251702784;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1205" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1193"
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strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251690496;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1193" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1180"
style='position:absolute;left:0;text-align:left;z-index:251677184;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="342pt,15.5pt" to="349.25pt,15.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251677184;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1180" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat karena kehilangan Cl atau karena makan banyak Na bikarbonat<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1215" style='position:absolute;left:0;text-align:left;
margin-left:241.2pt;margin-top:9.5pt;width:64.85pt;height:57.65pt;z-index:251713024;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 320px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251713024;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image039.gif" v:shapes="_x0000_s1215" width="89" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1226"
style='position:absolute;left:0;text-align:left;z-index:251724288;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="104.4pt,3.55pt" to="284.45pt,25.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 138px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251724288;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image040.gif" v:shapes="_x0000_s1226" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1247"
style='position:absolute;left:0;text-align:left;z-index:251745792;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="198pt,3.95pt" to="212.45pt,25.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 263px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251745792;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image041.gif" v:shapes="_x0000_s1247" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1235"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251733504;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="176.4pt,3.95pt" to="190.85pt,25.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251733504;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1235" width="22" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1257"
style='position:absolute;left:0;text-align:left;z-index:251756032;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="176.4pt,11.5pt" to="212.45pt,11.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251756032;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1257" width="50" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1083" style='position:absolute;left:0;text-align:left;
margin-left:190.8pt;margin-top:58.05pt;width:72.05pt;height:64.85pt;
z-index:251577856;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251577856;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1083" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1070"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251564544;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251564544;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1070" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal mengeluarkan ion
bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi basa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1181" style='position:absolute;left:0;text-align:left;flip:y;
z-index:251678208;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="54pt,2.45pt" to="61.25pt,9.7pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 71px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251678208;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1181" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1154"
style='position:absolute;left:0;text-align:left;z-index:251650560;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="75.6pt,9.65pt" to="205.25pt,45.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 100px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 175px; z-index: 251650560;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image046.gif" v:shapes="_x0000_s1154" width="175" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1095"
style='position:absolute;left:0;text-align:left;z-index:251590144;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 71px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251590144;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image047.gif" v:shapes="_x0000_s1095" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
1<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1110"
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from="126pt,32pt" to="154.85pt,32.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1125" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251620864;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="126pt,3.2pt" to="140.45pt,32.05pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1140" style='position:absolute;left:0;
text-align:left;z-index:251636224;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="140.4pt,3.2pt" to="154.85pt,32.05pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1168" style='position:absolute;left:0;
text-align:left;z-index:251664896;mso-position-horizontal-relative:text;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1110 _x0000_s1125 _x0000_s1140" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1168" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1258" style='position:absolute;left:0;text-align:left;z-index:251757056;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,12.45pt" to="291.65pt,12.5pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251757056;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1258" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang mengandung Cl , atau NH4Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1194"
style='position:absolute;left:0;text-align:left;margin-left:61.2pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251691520;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1206"
style='position:absolute;left:0;text-align:left;margin-left:234pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251703808;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="15" width="80"></td>
<td width="80"></td>
<td width="151"></td>
<td width="79"></td>
</tr>
<tr>
<td height="80"></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image050.gif" v:shapes="_x0000_s1194" width="80" /></td>
<td></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1206" width="79" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1216"
style='position:absolute;left:0;text-align:left;margin-left:75.6pt;
margin-top:0;width:201.65pt;height:7.25pt;z-index:251714048;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1227"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251725312;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="162pt,7.2pt" to="176.45pt,28.85pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1236" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251714048;"><span style="height: 41px; left: 0px; left: 100px; position: absolute; top: -1px; width: 271px;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image052.gif" v:shapes="_x0000_s1216 _x0000_s1227 _x0000_s1236" width="271" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ditandai dengan peningkatan
primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hiperkapnea), sehingga
terjadi penurunan PH; PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> >
45 mmHg dan PH . 7,35.<o:p></o:p></span></div>
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id="_x0000_s1058" style='position:absolute;left:0;text-align:left;z-index:251552256;
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from="255.6pt,4.85pt" to="262.85pt,4.9pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 340px; margin-top: 5px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251552256;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1058" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kompensasi ginjal mengakibatkan peningkatan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum. Asidosis respirasi dapat timbul secara
akut maupun kronik. Hipoksemia (PaO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> rendah) selalu menyertai asidosis respiratorik. Jika pasien bernafas
dalam udara ruangan.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat pernafasan di medula oblongata<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obat-obatan : Kelebihan
dosis opiat, sedatif, anestetik (akut)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Terapi oksigen pada
hiperkapnea kronik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti jantung (akut)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apnea saat tidur <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyakit neuromuskuler :
miastenia gravis, sindrom guillain-Barre, poliomielitis, sklerosis lateral
amiotropik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deformitas rongga dada :
kifoskoliosis<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obesitas yang berlebihan :
sindrom pickwikian<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera dinding dada seperti
patah tulang-tulang iga <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PPOM (emfisema dan
bronkitis)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tahap akhir penyakit paru
intrinsik yang difus<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumona atau asama yang
berat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Edema paru akut<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumotorak<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas yang akut <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Aspirasi benda asing atau
muntah<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laringospasme atau edema
laring, bronkospasme berat <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum
Asidosis<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru
menahan CO2<o:p></o:p></span></div>
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B<o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 349px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251665920;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image060.gif" v:shapes="_x0000_s1169" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></div>
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<div class="MsoNormal" style="text-align: justify;">
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<tbody>
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<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="22" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image063.gif" v:shapes="_x0000_s1182 _x0000_s1195 _x0000_s1207" width="21" /></td>
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<tr>
<td height="12"></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image064.gif" v:shapes="_x0000_s1155" width="2" /></td>
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</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 261.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="13" width="52"></td>
<td width="98"></td>
<td width="151"></td>
<td width="89"></td>
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<td height="79"></td>
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<br /></div>
<br clear="ALL" />
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1237"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<tbody>
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<td height="5" width="71"></td>
</tr>
<tr>
<td></td>
<td><img height="61" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image067.gif" v:shapes="_x0000_s1237 _x0000_s1249 _x0000_s1259 _x0000_s1266 _x0000_s1270 _x0000_s1274" width="319" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;z-index:251777536;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 215px; margin-top: 26px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251777536;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image068.gif" v:shapes="_x0000_s1278" width="21" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
2 Urin
menjadi asam<o:p></o:p></span></div>
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1112"
style='position:absolute;left:0;text-align:left;margin-left:234pt;
margin-top:1.65pt;width:64.85pt;height:64.85pt;z-index:251607552;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
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<tbody>
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<td height="1" width="61"></td>
<td width="89"></td>
<td width="161"></td>
<td width="89"></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image069.gif" v:shapes="_x0000_s1097" width="89" /></td>
<td></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image070.gif" v:shapes="_x0000_s1112" width="89" /></td>
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<br /></div>
<br clear="ALL" />
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="13" width="90"></td>
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<td></td>
<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image071.gif" v:shapes="_x0000_s1127 _x0000_s1142 _x0000_s1156 _x0000_s1170" width="290" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image075.gif" v:shapes="_x0000_s1085" width="50" /></td>
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
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<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
</td>
</tr>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="3" width="109"></td>
<td width="89"></td>
<td width="257"></td>
<td width="108"></td>
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<tr>
<td height="10"></td>
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<td height="38"></td>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251653632;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image080.gif" v:shapes="_x0000_s1157" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5<o:p></o:p></span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
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20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<table align="left" cellpadding="0" cellspacing="0">
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<td height="10" width="100"></td>
<td width="88"></td>
<td width="219"></td>
<td width="108"></td>
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<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image082.gif" v:shapes="_x0000_s1039" width="88" /></td>
<td></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image083.gif" v:shapes="_x0000_s1050" width="108" /></td>
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<tr>
<td height="19"></td>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<tbody>
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<td height="7" width="128"></td>
</tr>
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<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image084.gif" v:shapes="_x0000_s1061 _x0000_s1073 _x0000_s1086" width="339" /></td>
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251594240;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1099" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="263"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1144" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
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<br /></div>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<br /></div>
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<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image091.gif" v:shapes="_x0000_s1185 _x0000_s1197 _x0000_s1208" width="348" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<br clear="ALL" />
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
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<tbody>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 541px; margin-top: 53px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251736576;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1238" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1218"
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251716096;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1218" width="41" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
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<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
</td>
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<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1029" style='position:absolute;left:0;text-align:left;z-index:251522560;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251522560;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1029" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1030" style='position:absolute;left:0;text-align:left;z-index:251523584;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251523584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1030" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
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<br /></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251533824;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1040" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Respiratorik
</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 103.5pt;" valign="top" width="138">
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 + :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH $ :<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.3pt;" valign="top" width="142">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">24,0
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">20
: 1<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">40,0
mmIg<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ` <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunen eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 ` 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Respiratorik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">FIK UI B’
95</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
</tr>
<!--[if !supportMisalignedColumns]-->
<tr height="0">
<td style="border: none;" width="169"></td>
<td style="border: none;" width="138"></td>
<td style="border: none;" width="142"></td>
<td style="border: none;" width="165"></td>
</tr>
<!--[endif]-->
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b><u><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">DAFTAR KEPUSTAKAAN</span></u></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Guyton, Arthur C, Fisiologi Manusia dan Mekanisme
Penyakit, EGC Penerbitan Buku Kedokteran, Jakarta, 1987.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Price Sylvia Anderson; Wilson Mc. Carty,
Pathofisiologi Konsep Klinik Proses-proses Penyakit, EGC Penerbit Buku
Kedokteran, Jakarta, 1993.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Soeparman, Ilmu Penyakit Dalam, UI Press, Jakarta,
1991.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">-------, Dasar-dasar
Keperawatan Kardiotorasik, Rumah Sakit Jantung “Harapan Kita”, Jakarta, 1989<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">Gangguan
Keseimbangan Asam Basa<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">A. Penilaian
Ketidakseimbangan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Penilaian
Sistematik dan Penilaian gangguan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">_____________________________________________________<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">kecurigaan
klinis<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan tanda dan gejala
klinis yang mengarah kepada gangguan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Periksa hasil pemeriksaan
laboratorium untuk elektrolit dan data lainnya yang mengarah kepada proses
penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menilai
variabel-variabel asam basa untuk mengetahui tipe gangguan.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pertama, periksa PH darah
arteri untuk menentukan arah dan besarnya gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1087"
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from="306pt,.2pt" to="313.25pt,.25pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251581952;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1087" width="12" /></span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan
variabel pernafasan (PaCO2) dan metabolik HCO3
, yang berhubungan dengan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">PH untuk mencoba mengetahui
apakah gangguan primer bersifat
respiratorik, metabolik atau campuran.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perkirakan respon
kompensatorik yang bakal terjadi pada gangguan asam basa primer.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Buat penafsiran tahap akhir.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO3 )<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui saluran cerna : <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></b></div>
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from="277.2pt,10.4pt" to="327.65pt,10.45pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 368px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 71px; z-index: 251766272;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image092.gif" v:shapes="_x0000_s1267" width="71" /></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida
(NH4Cl NH3 + HCl) <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan hiperalimentasi <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan secara cepat .<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan produksi asam :<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menelan substansi toksik.
Kegagalan ekskresi asam : tidak adanya
ekskresi NH4 ; retensi asam sulfat dan
asam fosfat (gagal ginjal akut dan kronik)<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi asidosis metabolik<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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20<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Keton dan peningkatan Cl
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></b></div>
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<table align="left" cellpadding="0" cellspacing="0">
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<td height="1" width="320"></td>
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<td></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1131"
style='position:absolute;left:0;text-align:left;margin-left:68.4pt;
margin-top:8.95pt;width:64.85pt;height:64.85pt;z-index:251627008;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 90px; margin-top: 11px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251627008;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image015.gif" v:shapes="_x0000_s1131" width="89" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
10 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="128"></td>
<td width="12"></td>
<td width="104"></td>
<td width="40"></td>
</tr>
<tr>
<td height="20"></td>
<td colspan="2"></td>
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<td height="12"></td>
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<tr>
<td height="1"></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1240" style='position:absolute;left:0;text-align:left;
margin-left:262.8pt;margin-top:6.75pt;width:57.65pt;height:57.65pt;z-index:251738624;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 349px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251738624;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1240" width="79" /></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1229"
style='position:absolute;left:0;text-align:left;margin-left:82.8pt;
margin-top:2.25pt;width:57.65pt;height:57.65pt;z-index:251727360;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="2" width="109"></td>
</tr>
<tr>
<td></td>
<td><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1229" width="79" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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from="118.8pt,10.35pt" to="298.85pt,46.4pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 157px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 243px; z-index: 251749888;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image027.gif" v:shapes="_x0000_s1251" width="243" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
10 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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from="104.4pt,6.75pt" to="111.65pt,14pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="8" width="138"></td>
</tr>
<tr>
<td></td>
<td><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1296" width="12" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,75<o:p></o:p></span></b></div>
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<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 153.9pt;" valign="top" width="205">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru
mengeluarkan banyak CO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan Bikarbonat , mengeluarkan H+, dam anion lain urin asam. NaHCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, larutan laktat diberikan
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="2" width="100"></td>
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<td width="180"></td>
<td width="79"></td>
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<tr>
<td height="79"></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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margin-top:3.75pt;width:208.85pt;height:7.25pt;z-index:251785728;
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="4" width="128"></td>
</tr>
<tr>
<td></td>
<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image031.gif" v:shapes="_x0000_s1286 _x0000_s1288 _x0000_s1290" width="281" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1292"
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</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="6" width="244"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image032.gif" v:shapes="_x0000_s1292" width="40" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi Alkalosis metabolik<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1101"
style='position:absolute;left:0;text-align:left;margin-left:75.6pt;
margin-top:5.1pt;width:50.45pt;height:50.45pt;z-index:251596288;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1116"
style='position:absolute;left:0;text-align:left;margin-left:234pt;
margin-top:5.1pt;width:50.45pt;height:50.45pt;z-index:251611648;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="6" width="100"></td>
<td width="69"></td>
<td width="142"></td>
<td width="69"></td>
</tr>
<tr>
<td height="69"></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image034.gif" v:shapes="_x0000_s1101" width="69" /></td>
<td></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image035.gif" v:shapes="_x0000_s1116" width="69" /></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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style='position:absolute;left:0;text-align:left;margin-left:97.2pt;
margin-top:13.5pt;width:165.65pt;height:7.25pt;z-index:251628032;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1146"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1160" style='position:absolute;left:0;
text-align:left;z-index:251656704;mso-position-horizontal-relative:text;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="17" width="128"></td>
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<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image036.gif" v:shapes="_x0000_s1132 _x0000_s1146 _x0000_s1160" width="224" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1174"
style='position:absolute;left:0;text-align:left;z-index:251671040;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="169.2pt,7.15pt" to="183.65pt,7.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 224px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251671040;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image037.gif" v:shapes="_x0000_s1174" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1210" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:37.1pt;width:50.45pt;height:50.45pt;z-index:251707904;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251707904;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1210" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1199"
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strokeweight="1pt">
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251696640;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1199" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1186"
style='position:absolute;left:0;text-align:left;z-index:251683328;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="342pt,15.5pt" to="349.25pt,15.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251683328;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1186" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat
karena kehilangan Cl atau karena makan
banyak Na bikarbonat<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1220" style='position:absolute;left:0;text-align:left;
margin-left:241.2pt;margin-top:9.5pt;width:64.85pt;height:57.65pt;z-index:251718144;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 320px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251718144;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image039.gif" v:shapes="_x0000_s1220" width="89" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1230"
style='position:absolute;left:0;text-align:left;z-index:251728384;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="104.4pt,3.55pt" to="284.45pt,25.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 138px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251728384;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image040.gif" v:shapes="_x0000_s1230" width="242" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1252"
style='position:absolute;left:0;text-align:left;z-index:251750912;
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from="198pt,3.95pt" to="212.45pt,25.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 263px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251750912;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image041.gif" v:shapes="_x0000_s1252" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1241"
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from="176.4pt,3.95pt" to="190.85pt,25.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251739648;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1241" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1262"
style='position:absolute;left:0;text-align:left;z-index:251761152;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="176.4pt,11.5pt" to="212.45pt,11.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251761152;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1262" width="50" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1089" style='position:absolute;left:0;text-align:left;
margin-left:190.8pt;margin-top:58.05pt;width:72.05pt;height:64.85pt;
z-index:251584000;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251584000;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1089" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1075"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251569664;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251569664;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1075" width="79" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal
mengeluarkan ion bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi
basa<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
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<tbody>
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<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1117 _x0000_s1133 _x0000_s1147" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1175" width="2" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah pengobatan<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
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id="_x0000_s1263" style='position:absolute;left:0;text-align:left;z-index:251762176;
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strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251762176;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1263" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang
mengandung Cl , atau NH4Cl<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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<tbody>
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<td height="0" width="215"></td>
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<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image053.gif" v:shapes="_x0000_s1253" width="31" /></td>
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</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat
pernafasan di medula oblongata<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas
yang akut <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum Asidosis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru menahan CO2<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<td height="15" width="292"></td>
</tr>
<tr>
<td></td>
<td><img height="60" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image058.gif" v:shapes="_x0000_s1118" width="69" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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margin-left:39.6pt;margin-top:5.65pt;width:72.05pt;height:64.85pt;z-index:251598336;
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<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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20<o:p></o:p></span></div>
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="22" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image063.gif" v:shapes="_x0000_s1188 _x0000_s1201 _x0000_s1212" width="21" /></td>
</tr>
<tr>
<td height="12"></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image064.gif" v:shapes="_x0000_s1162" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 261.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="13" width="52"></td>
<td width="98"></td>
<td width="151"></td>
<td width="89"></td>
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<td height="79"></td>
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<tr>
<td height="19"></td>
</tr>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<tbody>
<tr>
<td height="5" width="71"></td>
</tr>
<tr>
<td></td>
<td><img height="61" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image067.gif" v:shapes="_x0000_s1243 _x0000_s1254 _x0000_s1264 _x0000_s1268 _x0000_s1272 _x0000_s1276" width="319" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 215px; margin-top: 26px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251779584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image068.gif" v:shapes="_x0000_s1280" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
Urin menjadi asam<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan
setelah pengobatan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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margin-top:1.65pt;width:64.85pt;height:64.85pt;z-index:251614720;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="1" width="61"></td>
<td width="89"></td>
<td width="161"></td>
<td width="89"></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image069.gif" v:shapes="_x0000_s1104" width="89" /></td>
<td></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image070.gif" v:shapes="_x0000_s1119" width="89" /></td>
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</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<tbody>
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<td height="13" width="90"></td>
</tr>
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<td></td>
<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image071.gif" v:shapes="_x0000_s1135 _x0000_s1149 _x0000_s1163 _x0000_s1177" width="290" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo17; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo17; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo17; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1 20<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
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20 <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251601408;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1106" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="263"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1151" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1179"
style='position:absolute;left:0;text-align:left;margin-left:320.4pt;
margin-top:3.55pt;width:79.25pt;height:79.25pt;z-index:251676160;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="4" width="119"></td>
<td width="89"></td>
<td width="218"></td>
<td width="108"></td>
</tr>
<tr>
<td height="19"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image089.gif" v:shapes="_x0000_s1179" width="108" /></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image090.gif" v:shapes="_x0000_s1165" width="89" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1203"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="16" width="148"></td>
</tr>
<tr>
<td></td>
<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image091.gif" v:shapes="_x0000_s1191 _x0000_s1203 _x0000_s1213" width="348" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 293.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1244" style='position:absolute;left:0;text-align:left;z-index:251742720;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="406.8pt,40.35pt" to="414.05pt,40.4pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 541px; margin-top: 53px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251742720;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1244" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1223"
style='position:absolute;left:0;text-align:left;z-index:251721216;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251721216;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1223" width="41" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
</td>
<td style="background: #CCCCCC; border-left: none; border: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1033" style='position:absolute;left:0;text-align:left;z-index:251526656;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251526656;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1033" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251527680;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1034" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
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<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1044" style='position:absolute;left:0;text-align:left;z-index:251537920;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,14.65pt" to="133.25pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251537920;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1044" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
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<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Respiratorik
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Metabolik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 198.0pt;" valign="top" width="264">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 +
24,0 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 20 : 1<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 11.8pt;" valign="top" width="16">
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Metabolik
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunan eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Respiratorik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-27824703647529207452012-11-07T18:14:00.005-08:002012-11-07T18:14:26.941-08:00GANGGUAN KETIDAKSEIMBANGAN ASAM BASA<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">GANGGUAN
KETIDAKSEIMBANGAN ASAM BASA</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penilaian Sistematik daam Penilaian gangguan asam
basa<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">___________________________________________________________________________<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Awali dengan kecurigaan klinis yang tinggi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ini membutuhkan pengetahuan tentang patogensis dari berbagai gangguan
asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contohnya, asidosis respiratorik mungkin dapat diperkirakan timbul pada
penderita penyakit paru obstruksi menahun.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan tanda dan gejala klinis yang mengarah
kepada gangguan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sayang sekali, banyak tanda dan gejala dari gangguan asam basa tidak
jelas dan non spesifik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, pernafasan kussmaul pada pasien
diabetes dapat merupakan tanda kompensasi pernafasan terhadap asidosis
metabolik.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Periksa hasil pemeriksaan laboratorium untuk
elektrolit dan data lainnya yang mengarah <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> kepada
proses penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, hipokalemia sering berkaitan dengan alkalosis metabolik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, peningkatan kadar kreatinin serum menunjukkan insufesiensi
ginjal dan insufesiensi serta gagal ginjal sering disertai asidosis metabolik.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menilai variabel-variabel asam basa untuk mengetahui
tipe gangguan.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Pertama, periksa PH darah arteri untuk menentukan
arah dan besarnya gangguan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika menurun, pasien mengalami asidemia dengan dua sebab yang mungkin :
asidosis metabolik atau asidosis respiratorik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika meningkat, pasien mengalami alkalemia dengan dua sebab yang
mungkin : alkalosis metabolik atau alkalosis respiratorik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1066"
style='position:absolute;left:0;text-align:left;z-index:251560448;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="140.4pt,34.8pt" to="147.65pt,34.85pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 186px; margin-top: 45px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251560448;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1066" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ingatlah bahwa kampensasi ginjal dan pernafasan
jarang memulihkan PH kembali normal sehingga jika ditemukan PH yang normal
meskipun ada perubahan dalam PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ,mungkin ada gangguan campuran ; contohnya
seorang pasien dengan asidosis respiratorik yang bercampur dengan alkalosis
metabolik mungkin akan mempunyai PH yang normal.<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1079"
style='position:absolute;left:0;text-align:left;z-index:251573760;
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251573760;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1079" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan variabel pernafasan (PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">) dan metabolik HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , yang berhubungan dengan<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> PH untuk
mencoba mengetahui apakah gangguan primer bersifat respiratorik, metabolik <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> atau
campuran.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (40 mmHg), meningkat
atau menurun ?<o:p></o:p></span></div>
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</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1045"
style='position:absolute;left:0;text-align:left;z-index:251538944;
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from="126pt,.85pt" to="133.25pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251538944;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1045" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (24 mEq/L), meningkat
atau menurun ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tambahan : apakah ada kelebihan atau kekurangan basa ?<o:p></o:p></span></div>
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</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1055"
style='position:absolute;left:0;text-align:left;z-index:251549184;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="320.4pt,-.4pt" to="327.65pt,-.35pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251549184;"><span style="height: 3px; left: 0px; left: 426px; position: absolute; top: -2px; width: 12px;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1055" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pada gangguan asam basa sederhana, PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> selalu berubah dalam arah yang sama.<o:p></o:p></span></div>
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</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1035"
style='position:absolute;left:0;text-align:left;z-index:251528704;
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from="234pt,0" to="241.25pt,.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251528704;"><span style="height: 2px; left: 0px; left: 311px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1035" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyimpangan dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dalam darah yang berlawanan
menunjukkan adanya gangguan asam basa campuran.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cobalah untuk menduga campuran primer dengan menghubungkan hasil
pemeriksaan yang ditemukan dengan keadaan klinis.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Perkirakan respon kompensatorik yang bakal
terjadi pada gangguan asam basa primer.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika respon kompensatorik
lebih berat atau ringan dari pada yang diperkirakan, mungkin ada gangguan asam
basa campuran (normogram asam basa juga dapat digunakan untuk mengetahui
gangguan asan basa campuran) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hitung selisih (gap) anion
plasma.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika
meningkat ( >16 mEq/l ), mungkin sekali terjadi acidosis metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt;"> </span></span><!--[endif]--><!--[if gte vml 1]><v:line
id="_x0000_s1046" style='position:absolute;left:0;text-align:left;z-index:251539968;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="241.2pt,2.45pt" to="248.45pt,2.5pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 320px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251539968;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1046" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bandingkan besarnya penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> plasma dengan peningkatan selisih anion :
seharusnya sama besar.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1067"
style='position:absolute;left:0;text-align:left;z-index:251561472;
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from="363.6pt,17.65pt" to="370.85pt,17.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 484px; margin-top: 22px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251561472;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1067" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1056"
style='position:absolute;left:0;text-align:left;z-index:251550208;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="349.2pt,3.25pt" to="356.45pt,3.3pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 464px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251550208;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1056" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan
< dari selisih anion penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , mungkin komponen dari
acidosis metabolik disebabkan oleh kehilangan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1080"
style='position:absolute;left:0;text-align:left;z-index:251574784;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="450pt,3.05pt" to="457.25pt,3.1pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 599px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251574784;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1080" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan selisih dari anion jauh lebih besar
dari penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> berarti ada alkalosis metabolik yang
menyertainya.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Buat penafsiran tahap akhir.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">gangguan asam-basa sederhana<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Akut (tidak terkompensasi)
atau<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kronik (sebagian atau
sepenuhnya terkompensasi )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam-basa campuran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik dengan selisih anion normal atau lebar.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1122"
style='position:absolute;left:0;text-align:left;z-index:251617792;
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from="284.4pt,10.75pt" to="291.65pt,10.8pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="13" width="378"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1122" width="12" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> )<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1107" style='position:absolute;left:0;text-align:left;z-index:251602432;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="75.6pt,14.65pt" to="82.85pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 100px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251602432;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1107" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer kadar bikarbonat sehingga terjadi
penurunan PH ( peningkatan ion H) . HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF =22 mEq/L
dan PH =7,35. Kompensasi pernafasan segera dimulai untuk menurunkan PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> melalui hiperventilasi
sehinga asidosis metabolik jarang terjadi secara akut.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui
saluran cerna : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Diare<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Ilieotomi ; fistula
pankreas, kantong empedu atau usus halus.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Ureterosigmoidostomi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Asidosis tubulus
proksimal ginjal (RTA)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Inhibitor Karbonik
Anhidrase (Asetazolamid)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Hipoaldosteronisme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1026" style='position:absolute;left:0;text-align:left;z-index:251519488;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="212.4pt,10.55pt" to="241.25pt,10.6pt" o:allowincell="f" strokecolor="blue"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrow="open"
endarrowwidth="narrow" endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 282px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 42px; z-index: 251519488;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image007.gif" v:shapes="_x0000_s1026" width="42" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida (NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cl
NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> + HCl <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan
hiperalimentasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan
secara cepat .<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Peningkatan produksi asam
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat : laktat (perfusi jaringan atau aksigenasi yang tidak
memadai seperti pada syok atau henti kardiopulmonar)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ketoasidosis diabetik : Beta-hidroksibutirat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelaparan: peningkatan asam - asam keto<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi alkohol : peningkatan asam-asam keto<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Menelan substansi toksik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kelebihan dosis salisilat
: Salisilat, laktat, keton<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Metanol atau formaldehid
: formad<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Etilglikol (antibeku) :
oksilat, glikolat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Kegagalan ekskresi asam
: tidak adanya ekskresi NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ; retensi asam sulfat dan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> asam fosfat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. gagal ginjal akut dan
kronik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi
asidosis metabolik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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<td width="171"></td>
<td width="69"></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
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<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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<div class="MsoNormal" style="margin-left: 324.0pt; text-align: justify;">
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" Keton dan
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></div>
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 90px; margin-top: 11px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251618816;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image015.gif" v:shapes="_x0000_s1123" width="89" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> d ! B <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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id="_x0000_s1234" style='position:absolute;left:0;text-align:left;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 349px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251732480;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1234" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh<b><o:p></o:p></b></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 157px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 243px; z-index: 251744768;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image027.gif" v:shapes="_x0000_s1246" width="243" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
10 ` <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">M</span></b><!--[if gte vml 1]><v:line
id="_x0000_s1295" style='position:absolute;left:0;text-align:left;flip:x;
z-index:251794944;mso-position-horizontal-relative:text;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 138px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251794944;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1295" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ( 0,75<o:p></o:p></span></b></div>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 153.9pt;" valign="top" width="205">
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkao banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan Bikarbonat , mengeluarkan H+, dam
anion lain urin asam. NaHCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">,
larutan lak|at diberikan I V. <o:p></o:p></span></div>
</td>
</tr>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></div>
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<br /></div>
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<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image029.gif" v:shapes="_x0000_s1281" width="79" /></td>
<td></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image030.gif" v:shapes="_x0000_s1283" width="79" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<br /></div>
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<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image031.gif" v:shapes="_x0000_s1285 _x0000_s1287 _x0000_s1289" width="281" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<td height="6" width="244"></td>
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<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image032.gif" v:shapes="_x0000_s1291" width="40" /></td>
</tr>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1036" style='position:absolute;left:0;text-align:left;z-index:251529728;
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from="147.6pt,19.4pt" to="154.85pt,19.45pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251529728;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1036" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">peningkatan primer kadar bikarbonat plasma, sehingga
terjadi peningkatan Ph (penurunan H ).
HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF = 2,6 mEq/l dan PH = 7,45. Kompensasi pernapasan berupa
peningkatan Pa CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dengan hipoventilasi ; akan
tetapi tingkat hipoventilasi adalah terbatas karena parnapasan terus berjalan
karena dorongan hipoxia/<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan mela|}i
saluran cerna (berkurangnya volume ECF)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Muntah atau penyedotan
nasogastrik <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Diare dengan kehilangan
klorida<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kehilangan melalui ginjal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Diuretik simpai atau
tiazid (pembatasan NaCl + berkurangnya ECF)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kelebihan
mineralokortikoid<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1). Hiperaldosteronisme<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2). Syndvom cushing ;
tgrapi kortikosteroid eksogen )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3). Makan licorice
berlebihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Karbenisillin atqu
penicillio dosis tinggi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1069" style='position:absolute;left:0;text-align:left;z-index:251563520;
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from="111.6pt,.85pt" to="126.05pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 148px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251563520;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image033.gif" v:shapes="_x0000_s1069" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian Natrium Bikarbonat
berlebihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sundrom susu alkali
(antasid, susu, natrium bkkarbonat)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Darah simpan (sitrat) yang
banyak (>8unit)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik
hiperkapnia (setelah koreksi pada asidosiw respiratorik kronik)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ventinasi mekanis: penurunan yang cepat dari PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> tapi HCO tetap tinggi
sampai0kinjal mengeksekresi kelebihannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya disertai penurunan ECF<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mun|ah atau penyeditan Nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasca-hiperkapnea<o:p></o:p></span></div>
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<tbody>
<tr>
<td height="13" width="397"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1082" width="12" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya tidak dirsertai penurunan Volume
ECF <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelebihan mineralokortikoid<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Edematosa (gagal jantung kongestif, sirosis, sindrom nefrotik).<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
Alkalosis metabolik<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1094"
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
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<td width="142"></td>
<td width="69"></td>
</tr>
<tr>
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<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image034.gif" v:shapes="_x0000_s1094" width="69" /></td>
<td></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image035.gif" v:shapes="_x0000_s1109" width="69" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<tbody>
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<td height="17" width="128"></td>
</tr>
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<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image036.gif" v:shapes="_x0000_s1124 _x0000_s1139 _x0000_s1153" width="224" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1167"
style='position:absolute;left:0;text-align:left;z-index:251663872;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="169.2pt,7.15pt" to="183.65pt,7.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 224px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251663872;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image037.gif" v:shapes="_x0000_s1167" width="22" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251702784;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1205" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1193"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251690496;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1193" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1180"
style='position:absolute;left:0;text-align:left;z-index:251677184;
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from="342pt,15.5pt" to="349.25pt,15.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251677184;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1180" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat karena kehilangan Cl atau karena makan banyak Na bikarbonat<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 320px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251713024;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image039.gif" v:shapes="_x0000_s1215" width="89" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1226"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 138px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251724288;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image040.gif" v:shapes="_x0000_s1226" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 263px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251745792;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image041.gif" v:shapes="_x0000_s1247" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1235"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251733504;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1235" width="22" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251756032;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1257" width="50" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></div>
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<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
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z-index:251577856;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251577856;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1083" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1070"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251564544;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251564544;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1070" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal mengeluarkan ion
bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi basa<o:p></o:p></span></div>
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</tr>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 71px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251590144;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image047.gif" v:shapes="_x0000_s1095" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
1<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1110 _x0000_s1125 _x0000_s1140" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1168" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1258" style='position:absolute;left:0;text-align:left;z-index:251757056;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,12.45pt" to="291.65pt,12.5pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251757056;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1258" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang mengandung Cl , atau NH4Cl<o:p></o:p></span></div>
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</tr>
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<br /></div>
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<td height="80"></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image050.gif" v:shapes="_x0000_s1194" width="80" /></td>
<td></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1206" width="79" /></td>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<br /></div>
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<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></div>
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<br /></div>
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<!--[if gte vml 1]><v:rect id="_x0000_s1216"
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251714048;"><span style="height: 41px; left: 0px; left: 100px; position: absolute; top: -1px; width: 271px;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image052.gif" v:shapes="_x0000_s1216 _x0000_s1227 _x0000_s1236" width="271" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></div>
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<tbody>
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<td height="0" width="215"></td>
</tr>
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<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image053.gif" v:shapes="_x0000_s1248" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ditandai dengan peningkatan
primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hiperkapnea), sehingga
terjadi penurunan PH; PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> >
45 mmHg dan PH . 7,35.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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id="_x0000_s1058" style='position:absolute;left:0;text-align:left;z-index:251552256;
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 340px; margin-top: 5px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251552256;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1058" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kompensasi ginjal mengakibatkan peningkatan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum. Asidosis respirasi dapat timbul secara
akut maupun kronik. Hipoksemia (PaO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> rendah) selalu menyertai asidosis respiratorik. Jika pasien bernafas
dalam udara ruangan.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat pernafasan di medula oblongata<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obat-obatan : Kelebihan
dosis opiat, sedatif, anestetik (akut)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Terapi oksigen pada
hiperkapnea kronik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti jantung (akut)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apnea saat tidur <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyakit neuromuskuler :
miastenia gravis, sindrom guillain-Barre, poliomielitis, sklerosis lateral
amiotropik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deformitas rongga dada :
kifoskoliosis<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obesitas yang berlebihan :
sindrom pickwikian<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera dinding dada seperti
patah tulang-tulang iga <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PPOM (emfisema dan
bronkitis)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tahap akhir penyakit paru
intrinsik yang difus<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumona atau asama yang
berat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Edema paru akut<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumotorak<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas yang akut <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l13 level1 lfo9; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Aspirasi benda asing atau
muntah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l13 level1 lfo9; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laringospasme atau edema
laring, bronkospasme berat <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum
Asidosis<o:p></o:p></span></div>
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<br /></div>
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<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image054.gif" v:shapes="_x0000_s1027" width="79" /></td>
<td></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image055.gif" v:shapes="_x0000_s1037" width="79" /></td>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="13" width="80"></td>
</tr>
<tr>
<td></td>
<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image056.gif" v:shapes="_x0000_s1048 _x0000_s1059 _x0000_s1071" width="272" /></td>
</tr>
</tbody></table>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1084"
style='position:absolute;left:0;text-align:left;z-index:251578880;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 40px; z-index: 251578880;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image057.gif" v:shapes="_x0000_s1084" width="40" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru
menahan CO2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="15" width="292"></td>
</tr>
<tr>
<td></td>
<td><img height="60" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image058.gif" v:shapes="_x0000_s1111" width="69" /></td>
</tr>
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<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 52px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 98px; z-index: 251591168;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image059.gif" v:shapes="_x0000_s1096" width="98" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1169" style='position:absolute;left:0;text-align:left;z-index:251665920;
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 349px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251665920;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image060.gif" v:shapes="_x0000_s1169" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251637248;"><span style="height: 41px; left: 0px; left: 119px; position: absolute; top: -2px; width: 213px;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image061.gif" v:shapes="_x0000_s1141" width="213" /></span></span><!--[endif]--><!--[if gte vml 1]><v:line
id="_x0000_s1126" style='position:absolute;left:0;text-align:left;flip:y;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251621888;"><span style="height: 51px; left: 0px; left: 90px; position: absolute; top: -2px; width: 271px;"><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image062.gif" v:shapes="_x0000_s1126" width="271" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 20<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1182" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251679232;mso-position-horizontal-relative:text;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1195" style='position:absolute;left:0;
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="22" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image063.gif" v:shapes="_x0000_s1182 _x0000_s1195 _x0000_s1207" width="21" /></td>
</tr>
<tr>
<td height="12"></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image064.gif" v:shapes="_x0000_s1155" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 261.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1217"
style='position:absolute;left:0;text-align:left;margin-left:39.6pt;
margin-top:10.4pt;width:72.05pt;height:72.05pt;z-index:251715072;
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1228"
style='position:absolute;left:0;text-align:left;margin-left:226.8pt;
margin-top:10.4pt;width:64.85pt;height:57.65pt;z-index:251726336;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="13" width="52"></td>
<td width="98"></td>
<td width="151"></td>
<td width="89"></td>
</tr>
<tr>
<td height="79"></td>
<td align="left" rowspan="2" valign="top"><img height="98" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image065.gif" v:shapes="_x0000_s1217" width="98" /></td>
<td></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image066.gif" v:shapes="_x0000_s1228" width="89" /></td>
</tr>
<tr>
<td height="19"></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1237"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1249" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1259" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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o:allowincell="f" strokeweight="1pt">
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="5" width="71"></td>
</tr>
<tr>
<td></td>
<td><img height="61" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image067.gif" v:shapes="_x0000_s1237 _x0000_s1249 _x0000_s1259 _x0000_s1266 _x0000_s1270 _x0000_s1274" width="319" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1278"
style='position:absolute;left:0;text-align:left;z-index:251777536;
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from="162pt,20pt" to="176.45pt,20.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 215px; margin-top: 26px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251777536;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image068.gif" v:shapes="_x0000_s1278" width="21" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
2 Urin
menjadi asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1097"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:1.65pt;width:64.85pt;height:64.85pt;z-index:251592192;
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1112"
style='position:absolute;left:0;text-align:left;margin-left:234pt;
margin-top:1.65pt;width:64.85pt;height:64.85pt;z-index:251607552;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="1" width="61"></td>
<td width="89"></td>
<td width="161"></td>
<td width="89"></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image069.gif" v:shapes="_x0000_s1097" width="89" /></td>
<td></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image070.gif" v:shapes="_x0000_s1112" width="89" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1127"
style='position:absolute;left:0;text-align:left;margin-left:68.4pt;
margin-top:10.4pt;width:216.05pt;height:7.25pt;z-index:251622912;
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1142"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="13" width="90"></td>
</tr>
<tr>
<td></td>
<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image071.gif" v:shapes="_x0000_s1127 _x0000_s1142 _x0000_s1156 _x0000_s1170" width="290" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<!--[if gte vml 1]><v:rect id="_x0000_s1049"
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> B <o:p></o:p></span></b></div>
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20 <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 282px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251624960;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image085.gif" v:shapes="_x0000_s1129" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1114"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 263px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251609600;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image086.gif" v:shapes="_x0000_s1114" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1099"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251594240;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1099" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="263"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1144" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1172"
style='position:absolute;left:0;text-align:left;margin-left:320.4pt;
margin-top:3.55pt;width:79.25pt;height:79.25pt;z-index:251668992;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="4" width="119"></td>
<td width="89"></td>
<td width="218"></td>
<td width="108"></td>
</tr>
<tr>
<td height="19"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image089.gif" v:shapes="_x0000_s1172" width="108" /></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image090.gif" v:shapes="_x0000_s1158" width="89" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="16" width="148"></td>
</tr>
<tr>
<td></td>
<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image091.gif" v:shapes="_x0000_s1185 _x0000_s1197 _x0000_s1208" width="348" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 293.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1238" style='position:absolute;left:0;text-align:left;z-index:251736576;
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strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 541px; margin-top: 53px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251736576;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1238" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1218"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251716096;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1218" width="41" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
</td>
<td style="background: #CCCCCC; border-left: none; border: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1029" style='position:absolute;left:0;text-align:left;z-index:251522560;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251522560;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1029" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1030" style='position:absolute;left:0;text-align:left;z-index:251523584;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251523584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1030" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1040" style='position:absolute;left:0;text-align:left;z-index:251533824;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,14.65pt" to="133.25pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251533824;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1040" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Respiratorik
</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 103.5pt;" valign="top" width="138">
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 + :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH $ :<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.3pt;" valign="top" width="142">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">24,0
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">20
: 1<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">40,0
mmIg<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ` <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunen eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 ` 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
</td>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Respiratorik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">FIK UI B’
95</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
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<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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<b><u><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">DAFTAR KEPUSTAKAAN</span></u></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Guyton, Arthur C, Fisiologi Manusia dan Mekanisme
Penyakit, EGC Penerbitan Buku Kedokteran, Jakarta, 1987.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Price Sylvia Anderson; Wilson Mc. Carty,
Pathofisiologi Konsep Klinik Proses-proses Penyakit, EGC Penerbit Buku
Kedokteran, Jakarta, 1993.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Soeparman, Ilmu Penyakit Dalam, UI Press, Jakarta,
1991.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">-------, Dasar-dasar
Keperawatan Kardiotorasik, Rumah Sakit Jantung “Harapan Kita”, Jakarta, 1989<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">Gangguan
Keseimbangan Asam Basa<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">A. Penilaian
Ketidakseimbangan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Penilaian
Sistematik dan Penilaian gangguan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">_____________________________________________________<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">kecurigaan
klinis<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan tanda dan gejala
klinis yang mengarah kepada gangguan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Periksa hasil pemeriksaan
laboratorium untuk elektrolit dan data lainnya yang mengarah kepada proses
penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menilai
variabel-variabel asam basa untuk mengetahui tipe gangguan.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pertama, periksa PH darah
arteri untuk menentukan arah dan besarnya gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1087"
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251581952;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1087" width="12" /></span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan
variabel pernafasan (PaCO2) dan metabolik HCO3
, yang berhubungan dengan<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">PH untuk mencoba mengetahui
apakah gangguan primer bersifat
respiratorik, metabolik atau campuran.<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perkirakan respon
kompensatorik yang bakal terjadi pada gangguan asam basa primer.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Buat penafsiran tahap akhir.<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO3 )<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui saluran cerna : <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal :<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></b></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 368px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 71px; z-index: 251766272;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image092.gif" v:shapes="_x0000_s1267" width="71" /></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida
(NH4Cl NH3 + HCl) <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan hiperalimentasi <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan secara cepat .<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan produksi asam :<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menelan substansi toksik.
Kegagalan ekskresi asam : tidak adanya
ekskresi NH4 ; retensi asam sulfat dan
asam fosfat (gagal ginjal akut dan kronik)<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi asidosis metabolik<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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20<o:p></o:p></span></b></div>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Keton dan peningkatan Cl
menggganti ion bikarbonat<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></b></div>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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B <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
10 <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
10 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<tbody>
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<td height="8" width="138"></td>
</tr>
<tr>
<td></td>
<td><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1296" width="12" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,75<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 306.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 153.9pt;" valign="top" width="205">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru
mengeluarkan banyak CO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan Bikarbonat , mengeluarkan H+, dam anion lain urin asam. NaHCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, larutan laktat diberikan
I V. <o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="2" width="100"></td>
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<td width="180"></td>
<td width="79"></td>
</tr>
<tr>
<td height="79"></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image029.gif" v:shapes="_x0000_s1282" width="79" /></td>
<td></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image030.gif" v:shapes="_x0000_s1284" width="79" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1286"
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<tbody>
<tr>
<td height="6" width="244"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image032.gif" v:shapes="_x0000_s1292" width="40" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi Alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="6" width="100"></td>
<td width="69"></td>
<td width="142"></td>
<td width="69"></td>
</tr>
<tr>
<td height="69"></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image034.gif" v:shapes="_x0000_s1101" width="69" /></td>
<td></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image035.gif" v:shapes="_x0000_s1116" width="69" /></td>
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<br /></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image036.gif" v:shapes="_x0000_s1132 _x0000_s1146 _x0000_s1160" width="224" /></td>
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 224px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251671040;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image037.gif" v:shapes="_x0000_s1174" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1210" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:37.1pt;width:50.45pt;height:50.45pt;z-index:251707904;
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251696640;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1199" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1186"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251683328;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1186" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat
karena kehilangan Cl atau karena makan
banyak Na bikarbonat<o:p></o:p></span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1230"
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B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251739648;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1241" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251761152;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1262" width="50" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
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mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251584000;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1089" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1075"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251569664;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251569664;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1075" width="79" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal
mengeluarkan ion bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi
basa<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 100px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 175px; z-index: 251657728;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image046.gif" v:shapes="_x0000_s1161" width="175" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1102"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 71px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251597312;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image047.gif" v:shapes="_x0000_s1102" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1117"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1133" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1147" style='position:absolute;left:0;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1117 _x0000_s1133 _x0000_s1147" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1175" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah pengobatan<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1263" style='position:absolute;left:0;text-align:left;z-index:251762176;
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from="284.4pt,12.45pt" to="291.65pt,12.5pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251762176;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1263" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang
mengandung Cl , atau NH4Cl<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251697664;
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1211"
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="15" width="80"></td>
<td width="80"></td>
<td width="151"></td>
<td width="79"></td>
</tr>
<tr>
<td height="80"></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image050.gif" v:shapes="_x0000_s1200" width="80" /></td>
<td></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1211" width="79" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1231"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251719168;"><span style="height: 41px; left: 0px; left: 100px; position: absolute; top: -1px; width: 271px;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image052.gif" v:shapes="_x0000_s1221 _x0000_s1231 _x0000_s1242" width="271" /></span></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1253" style='position:absolute;left:0;text-align:left;z-index:251751936;
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from="162pt,.85pt" to="183.65pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="215"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image053.gif" v:shapes="_x0000_s1253" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat
pernafasan di medula oblongata<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas
yang akut <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum Asidosis<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></b></div>
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<br /></div>
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<br /></div>
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20<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru menahan CO2<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
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20<o:p></o:p></span></div>
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<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
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<tr>
<td height="12"></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image064.gif" v:shapes="_x0000_s1162" width="2" /></td>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></b></div>
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<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></b></div>
</td>
</tr>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK B <o:p></o:p></span></b></div>
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<td></td>
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<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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30<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
Urin menjadi asam<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan
setelah pengobatan<o:p></o:p></span></b></div>
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="1" width="61"></td>
<td width="89"></td>
<td width="161"></td>
<td width="89"></td>
</tr>
<tr>
<td height="89"></td>
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<td></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image070.gif" v:shapes="_x0000_s1119" width="89" /></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
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<div class="MsoNormal" style="text-align: justify;">
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo17; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo17; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 320px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251675136;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image079.gif" v:shapes="_x0000_s1178" width="22" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1164"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1190"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251687424;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image081.gif" v:shapes="_x0000_s1190" width="41" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="100"></td>
<td width="88"></td>
<td width="219"></td>
<td width="108"></td>
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<tr>
<td height="89"></td>
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<td></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="7" width="128"></td>
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<tr>
<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image084.gif" v:shapes="_x0000_s1065 _x0000_s1078 _x0000_s1092" width="339" /></td>
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</tbody></table>
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 282px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251633152;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image085.gif" v:shapes="_x0000_s1137" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1121"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 263px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251616768;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image086.gif" v:shapes="_x0000_s1121" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1106"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251601408;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1106" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="263"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1151" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1165" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:18.2pt;width:64.85pt;height:64.85pt;z-index:251661824;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1179"
style='position:absolute;left:0;text-align:left;margin-left:320.4pt;
margin-top:3.55pt;width:79.25pt;height:79.25pt;z-index:251676160;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="4" width="119"></td>
<td width="89"></td>
<td width="218"></td>
<td width="108"></td>
</tr>
<tr>
<td height="19"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image089.gif" v:shapes="_x0000_s1179" width="108" /></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image090.gif" v:shapes="_x0000_s1165" width="89" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1203"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="16" width="148"></td>
</tr>
<tr>
<td></td>
<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image091.gif" v:shapes="_x0000_s1191 _x0000_s1203 _x0000_s1213" width="348" /></td>
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</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 293.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
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id="_x0000_s1244" style='position:absolute;left:0;text-align:left;z-index:251742720;
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strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 541px; margin-top: 53px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251742720;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1244" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1223"
style='position:absolute;left:0;text-align:left;z-index:251721216;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251721216;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1223" width="41" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
</td>
<td style="background: #CCCCCC; border-left: none; border: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1033" style='position:absolute;left:0;text-align:left;z-index:251526656;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251526656;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1033" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1034" style='position:absolute;left:0;text-align:left;z-index:251527680;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251527680;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1034" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1044" style='position:absolute;left:0;text-align:left;z-index:251537920;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,14.65pt" to="133.25pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251537920;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1044" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Respiratorik
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Metabolik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 198.0pt;" valign="top" width="264">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 +
24,0 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 20 : 1<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 11.8pt;" valign="top" width="16">
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Metabolik
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunan eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Respiratorik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
</td>
</tr>
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<td style="border: none;" width="169"></td>
<td style="border: none;" width="138"></td>
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<td style="border: none;" width="16"></td>
<td style="border: none;" width="165"></td>
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</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-58516816590516403602012-11-07T18:14:00.003-08:002012-11-07T18:14:15.294-08:00GANGGUAN KETIDAKSEIMBANGAN ASAM BASA<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">GANGGUAN
KETIDAKSEIMBANGAN ASAM BASA</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penilaian Sistematik daam Penilaian gangguan asam
basa<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">___________________________________________________________________________<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Awali dengan kecurigaan klinis yang tinggi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ini membutuhkan pengetahuan tentang patogensis dari berbagai gangguan
asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contohnya, asidosis respiratorik mungkin dapat diperkirakan timbul pada
penderita penyakit paru obstruksi menahun.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan tanda dan gejala klinis yang mengarah
kepada gangguan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sayang sekali, banyak tanda dan gejala dari gangguan asam basa tidak
jelas dan non spesifik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, pernafasan kussmaul pada pasien
diabetes dapat merupakan tanda kompensasi pernafasan terhadap asidosis
metabolik.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Periksa hasil pemeriksaan laboratorium untuk
elektrolit dan data lainnya yang mengarah <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> kepada
proses penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, hipokalemia sering berkaitan dengan alkalosis metabolik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, peningkatan kadar kreatinin serum menunjukkan insufesiensi
ginjal dan insufesiensi serta gagal ginjal sering disertai asidosis metabolik.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menilai variabel-variabel asam basa untuk mengetahui
tipe gangguan.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Pertama, periksa PH darah arteri untuk menentukan
arah dan besarnya gangguan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika menurun, pasien mengalami asidemia dengan dua sebab yang mungkin :
asidosis metabolik atau asidosis respiratorik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika meningkat, pasien mengalami alkalemia dengan dua sebab yang
mungkin : alkalosis metabolik atau alkalosis respiratorik.<o:p></o:p></span></div>
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</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1066"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 186px; margin-top: 45px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251560448;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1066" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ingatlah bahwa kampensasi ginjal dan pernafasan
jarang memulihkan PH kembali normal sehingga jika ditemukan PH yang normal
meskipun ada perubahan dalam PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ,mungkin ada gangguan campuran ; contohnya
seorang pasien dengan asidosis respiratorik yang bercampur dengan alkalosis
metabolik mungkin akan mempunyai PH yang normal.<o:p></o:p></span></div>
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251573760;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1079" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan variabel pernafasan (PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">) dan metabolik HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , yang berhubungan dengan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> PH untuk
mencoba mengetahui apakah gangguan primer bersifat respiratorik, metabolik <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> atau
campuran.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (40 mmHg), meningkat
atau menurun ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1045"
style='position:absolute;left:0;text-align:left;z-index:251538944;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,.85pt" to="133.25pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251538944;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1045" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (24 mEq/L), meningkat
atau menurun ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tambahan : apakah ada kelebihan atau kekurangan basa ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1055"
style='position:absolute;left:0;text-align:left;z-index:251549184;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="320.4pt,-.4pt" to="327.65pt,-.35pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251549184;"><span style="height: 3px; left: 0px; left: 426px; position: absolute; top: -2px; width: 12px;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1055" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pada gangguan asam basa sederhana, PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> selalu berubah dalam arah yang sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1035"
style='position:absolute;left:0;text-align:left;z-index:251528704;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="234pt,0" to="241.25pt,.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251528704;"><span style="height: 2px; left: 0px; left: 311px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1035" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyimpangan dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dalam darah yang berlawanan
menunjukkan adanya gangguan asam basa campuran.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cobalah untuk menduga campuran primer dengan menghubungkan hasil
pemeriksaan yang ditemukan dengan keadaan klinis.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Perkirakan respon kompensatorik yang bakal
terjadi pada gangguan asam basa primer.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika respon kompensatorik
lebih berat atau ringan dari pada yang diperkirakan, mungkin ada gangguan asam
basa campuran (normogram asam basa juga dapat digunakan untuk mengetahui
gangguan asan basa campuran) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hitung selisih (gap) anion
plasma.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika
meningkat ( >16 mEq/l ), mungkin sekali terjadi acidosis metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt;"> </span></span><!--[endif]--><!--[if gte vml 1]><v:line
id="_x0000_s1046" style='position:absolute;left:0;text-align:left;z-index:251539968;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="241.2pt,2.45pt" to="248.45pt,2.5pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 320px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251539968;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1046" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bandingkan besarnya penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> plasma dengan peningkatan selisih anion :
seharusnya sama besar.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1067"
style='position:absolute;left:0;text-align:left;z-index:251561472;
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from="363.6pt,17.65pt" to="370.85pt,17.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 484px; margin-top: 22px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251561472;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1067" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1056"
style='position:absolute;left:0;text-align:left;z-index:251550208;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="349.2pt,3.25pt" to="356.45pt,3.3pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 464px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251550208;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1056" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan
< dari selisih anion penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , mungkin komponen dari
acidosis metabolik disebabkan oleh kehilangan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1080"
style='position:absolute;left:0;text-align:left;z-index:251574784;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="450pt,3.05pt" to="457.25pt,3.1pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 599px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251574784;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1080" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan selisih dari anion jauh lebih besar
dari penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> berarti ada alkalosis metabolik yang
menyertainya.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Buat penafsiran tahap akhir.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">gangguan asam-basa sederhana<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Akut (tidak terkompensasi)
atau<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kronik (sebagian atau
sepenuhnya terkompensasi )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam-basa campuran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik dengan selisih anion normal atau lebar.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1122"
style='position:absolute;left:0;text-align:left;z-index:251617792;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,10.75pt" to="291.65pt,10.8pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="13" width="378"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1122" width="12" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> )<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1107" style='position:absolute;left:0;text-align:left;z-index:251602432;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="75.6pt,14.65pt" to="82.85pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 100px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251602432;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1107" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer kadar bikarbonat sehingga terjadi
penurunan PH ( peningkatan ion H) . HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF =22 mEq/L
dan PH =7,35. Kompensasi pernafasan segera dimulai untuk menurunkan PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> melalui hiperventilasi
sehinga asidosis metabolik jarang terjadi secara akut.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui
saluran cerna : <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Diare<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Ilieotomi ; fistula
pankreas, kantong empedu atau usus halus.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Ureterosigmoidostomi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Asidosis tubulus
proksimal ginjal (RTA)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Inhibitor Karbonik
Anhidrase (Asetazolamid)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Hipoaldosteronisme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:line
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from="212.4pt,10.55pt" to="241.25pt,10.6pt" o:allowincell="f" strokecolor="blue"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrow="open"
endarrowwidth="narrow" endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 282px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 42px; z-index: 251519488;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image007.gif" v:shapes="_x0000_s1026" width="42" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida (NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cl
NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> + HCl <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan
hiperalimentasi <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan
secara cepat .<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Peningkatan produksi asam
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat : laktat (perfusi jaringan atau aksigenasi yang tidak
memadai seperti pada syok atau henti kardiopulmonar)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ketoasidosis diabetik : Beta-hidroksibutirat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelaparan: peningkatan asam - asam keto<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi alkohol : peningkatan asam-asam keto<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Menelan substansi toksik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kelebihan dosis salisilat
: Salisilat, laktat, keton<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Metanol atau formaldehid
: formad<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Etilglikol (antibeku) :
oksilat, glikolat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Kegagalan ekskresi asam
: tidak adanya ekskresi NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ; retensi asam sulfat dan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> asam fosfat<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. gagal ginjal akut dan
kronik<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi
asidosis metabolik<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<br /></div>
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1
20<o:p></o:p></span></div>
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" Keton dan
peningkatan Cl
! a menggganti ion bikarbonat<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK `
!
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
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<!--[if gte vml 1]><v:oval
id="_x0000_s1234" style='position:absolute;left:0;text-align:left;
margin-left:262.8pt;margin-top:6.75pt;width:57.65pt;height:57.65pt;z-index:251732480;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 349px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251732480;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1234" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh<b><o:p></o:p></b></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ! ` ! B <o:p></o:p></span></b></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 157px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 243px; z-index: 251744768;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image027.gif" v:shapes="_x0000_s1246" width="243" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
10 ` <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">M</span></b><!--[if gte vml 1]><v:line
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkao banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan Bikarbonat , mengeluarkan H+, dam
anion lain urin asam. NaHCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">,
larutan lak|at diberikan I V. <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></div>
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<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image030.gif" v:shapes="_x0000_s1283" width="79" /></td>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:rect id="_x0000_s1285"
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image032.gif" v:shapes="_x0000_s1291" width="40" /></td>
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1036" style='position:absolute;left:0;text-align:left;z-index:251529728;
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from="147.6pt,19.4pt" to="154.85pt,19.45pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251529728;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1036" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">peningkatan primer kadar bikarbonat plasma, sehingga
terjadi peningkatan Ph (penurunan H ).
HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF = 2,6 mEq/l dan PH = 7,45. Kompensasi pernapasan berupa
peningkatan Pa CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dengan hipoventilasi ; akan
tetapi tingkat hipoventilasi adalah terbatas karena parnapasan terus berjalan
karena dorongan hipoxia/<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan mela|}i
saluran cerna (berkurangnya volume ECF)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Muntah atau penyedotan
nasogastrik <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Diare dengan kehilangan
klorida<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kehilangan melalui ginjal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Diuretik simpai atau
tiazid (pembatasan NaCl + berkurangnya ECF)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kelebihan
mineralokortikoid<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1). Hiperaldosteronisme<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2). Syndvom cushing ;
tgrapi kortikosteroid eksogen )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3). Makan licorice
berlebihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Karbenisillin atqu
penicillio dosis tinggi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1069" style='position:absolute;left:0;text-align:left;z-index:251563520;
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 148px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251563520;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image033.gif" v:shapes="_x0000_s1069" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian Natrium Bikarbonat
berlebihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sundrom susu alkali
(antasid, susu, natrium bkkarbonat)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Darah simpan (sitrat) yang
banyak (>8unit)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik
hiperkapnia (setelah koreksi pada asidosiw respiratorik kronik)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ventinasi mekanis: penurunan yang cepat dari PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> tapi HCO tetap tinggi
sampai0kinjal mengeksekresi kelebihannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya disertai penurunan ECF<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mun|ah atau penyeditan Nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasca-hiperkapnea<o:p></o:p></span></div>
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id="_x0000_s1082" style='position:absolute;left:0;text-align:left;z-index:251576832;
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<tbody>
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<td height="13" width="397"></td>
</tr>
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<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1082" width="12" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya tidak dirsertai penurunan Volume
ECF <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelebihan mineralokortikoid<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Edematosa (gagal jantung kongestif, sirosis, sindrom nefrotik).<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
Alkalosis metabolik<o:p></o:p></span></div>
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<br /></div>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image036.gif" v:shapes="_x0000_s1124 _x0000_s1139 _x0000_s1153" width="224" /></td>
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<br /></div>
<br clear="ALL" />
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<!--[if gte vml 1]><v:line id="_x0000_s1167"
style='position:absolute;left:0;text-align:left;z-index:251663872;
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 224px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251663872;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image037.gif" v:shapes="_x0000_s1167" width="22" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251702784;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1205" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1193"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251690496;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1193" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1180"
style='position:absolute;left:0;text-align:left;z-index:251677184;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251677184;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1180" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat karena kehilangan Cl atau karena makan banyak Na bikarbonat<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></div>
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<br /></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 138px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251724288;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image040.gif" v:shapes="_x0000_s1226" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 263px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251745792;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image041.gif" v:shapes="_x0000_s1247" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1235"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251733504;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1235" width="22" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></div>
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style='position:absolute;left:0;text-align:left;z-index:251756032;
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from="176.4pt,11.5pt" to="212.45pt,11.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251756032;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1257" width="50" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
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id="_x0000_s1083" style='position:absolute;left:0;text-align:left;
margin-left:190.8pt;margin-top:58.05pt;width:72.05pt;height:64.85pt;
z-index:251577856;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251577856;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1083" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1070"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251564544;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251564544;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1070" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal mengeluarkan ion
bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi basa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 71px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251678208;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1181" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1154"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 100px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 175px; z-index: 251650560;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image046.gif" v:shapes="_x0000_s1154" width="175" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1095"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 71px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251590144;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image047.gif" v:shapes="_x0000_s1095" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
1<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1110"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1125" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251620864;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="126pt,3.2pt" to="140.45pt,32.05pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1140" style='position:absolute;left:0;
text-align:left;z-index:251636224;mso-position-horizontal-relative:text;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1168" style='position:absolute;left:0;
text-align:left;z-index:251664896;mso-position-horizontal-relative:text;
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o:allowincell="f" strokeweight="1pt">
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1110 _x0000_s1125 _x0000_s1140" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1168" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
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<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1258" style='position:absolute;left:0;text-align:left;z-index:251757056;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,12.45pt" to="291.65pt,12.5pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251757056;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1258" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang mengandung Cl , atau NH4Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1194"
style='position:absolute;left:0;text-align:left;margin-left:61.2pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251691520;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1206"
style='position:absolute;left:0;text-align:left;margin-left:234pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251703808;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="15" width="80"></td>
<td width="80"></td>
<td width="151"></td>
<td width="79"></td>
</tr>
<tr>
<td height="80"></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image050.gif" v:shapes="_x0000_s1194" width="80" /></td>
<td></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1206" width="79" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1216"
style='position:absolute;left:0;text-align:left;margin-left:75.6pt;
margin-top:0;width:201.65pt;height:7.25pt;z-index:251714048;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1227"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251725312;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1236" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251714048;"><span style="height: 41px; left: 0px; left: 100px; position: absolute; top: -1px; width: 271px;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image052.gif" v:shapes="_x0000_s1216 _x0000_s1227 _x0000_s1236" width="271" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1248" style='position:absolute;left:0;text-align:left;z-index:251746816;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="162pt,.85pt" to="183.65pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="215"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image053.gif" v:shapes="_x0000_s1248" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ditandai dengan peningkatan
primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hiperkapnea), sehingga
terjadi penurunan PH; PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> >
45 mmHg dan PH . 7,35.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1058" style='position:absolute;left:0;text-align:left;z-index:251552256;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="255.6pt,4.85pt" to="262.85pt,4.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 340px; margin-top: 5px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251552256;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1058" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kompensasi ginjal mengakibatkan peningkatan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum. Asidosis respirasi dapat timbul secara
akut maupun kronik. Hipoksemia (PaO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> rendah) selalu menyertai asidosis respiratorik. Jika pasien bernafas
dalam udara ruangan.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat pernafasan di medula oblongata<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obat-obatan : Kelebihan
dosis opiat, sedatif, anestetik (akut)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Terapi oksigen pada
hiperkapnea kronik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti jantung (akut)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apnea saat tidur <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyakit neuromuskuler :
miastenia gravis, sindrom guillain-Barre, poliomielitis, sklerosis lateral
amiotropik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deformitas rongga dada :
kifoskoliosis<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obesitas yang berlebihan :
sindrom pickwikian<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera dinding dada seperti
patah tulang-tulang iga <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PPOM (emfisema dan
bronkitis)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tahap akhir penyakit paru
intrinsik yang difus<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumona atau asama yang
berat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Edema paru akut<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumotorak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas yang akut <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l13 level1 lfo9; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Aspirasi benda asing atau
muntah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l13 level1 lfo9; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laringospasme atau edema
laring, bronkospasme berat <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum
Asidosis<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
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<td width="79"></td>
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<td></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="13" width="80"></td>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;z-index:251578880;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 40px; z-index: 251578880;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image057.gif" v:shapes="_x0000_s1084" width="40" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru
menahan CO2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="15" width="292"></td>
</tr>
<tr>
<td></td>
<td><img height="60" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image058.gif" v:shapes="_x0000_s1111" width="69" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1096" style='position:absolute;left:0;text-align:left;
margin-left:39.6pt;margin-top:5.65pt;width:72.05pt;height:64.85pt;z-index:251591168;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 52px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 98px; z-index: 251591168;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image059.gif" v:shapes="_x0000_s1096" width="98" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1169" style='position:absolute;left:0;text-align:left;z-index:251665920;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 349px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251665920;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image060.gif" v:shapes="_x0000_s1169" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251637248;"><span style="height: 41px; left: 0px; left: 119px; position: absolute; top: -2px; width: 213px;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image061.gif" v:shapes="_x0000_s1141" width="213" /></span></span><!--[endif]--><!--[if gte vml 1]><v:line
id="_x0000_s1126" style='position:absolute;left:0;text-align:left;flip:y;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251621888;"><span style="height: 51px; left: 0px; left: 90px; position: absolute; top: -2px; width: 271px;"><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image062.gif" v:shapes="_x0000_s1126" width="271" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 20<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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</v:line><v:line id="_x0000_s1182" style='position:absolute;left:0;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1195" style='position:absolute;left:0;
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="22" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image063.gif" v:shapes="_x0000_s1182 _x0000_s1195 _x0000_s1207" width="21" /></td>
</tr>
<tr>
<td height="12"></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image064.gif" v:shapes="_x0000_s1155" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 261.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<tbody>
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<td height="13" width="52"></td>
<td width="98"></td>
<td width="151"></td>
<td width="89"></td>
</tr>
<tr>
<td height="79"></td>
<td align="left" rowspan="2" valign="top"><img height="98" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image065.gif" v:shapes="_x0000_s1217" width="98" /></td>
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<tr>
<td height="19"></td>
</tr>
</tbody></table>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1278"
style='position:absolute;left:0;text-align:left;z-index:251777536;
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 215px; margin-top: 26px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251777536;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image068.gif" v:shapes="_x0000_s1278" width="21" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
2 Urin
menjadi asam<o:p></o:p></span></div>
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<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;margin-left:75.6pt;
margin-top:1pt;width:72.05pt;height:72.05pt;z-index:251521536;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
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<td height="0" width="100"></td>
<td width="98"></td>
<td width="247"></td>
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<td align="left" valign="top"><img height="99" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image072.gif" v:shapes="_x0000_s1028" width="98" /></td>
<td></td>
<td align="left" valign="top"><img height="99" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image073.gif" v:shapes="_x0000_s1038" width="99" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="6" width="138"></td>
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<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image074.gif" v:shapes="_x0000_s1049 _x0000_s1060 _x0000_s1072" width="377" /></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1085"
style='position:absolute;left:0;text-align:left;z-index:251579904;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
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<tbody>
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<td height="0" width="292"></td>
</tr>
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<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image075.gif" v:shapes="_x0000_s1085" width="50" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
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<br /></div>
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margin-top:3.15pt;width:64.85pt;height:64.85pt;z-index:251593216;
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<td height="3" width="109"></td>
<td width="89"></td>
<td width="257"></td>
<td width="108"></td>
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<td height="10"></td>
<td align="left" rowspan="2" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image069.gif" v:shapes="_x0000_s1098" width="89" /></td>
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<td height="79"></td>
<td></td>
<td align="left" rowspan="2" valign="top"><img height="117" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image076.gif" v:shapes="_x0000_s1113" width="108" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1128"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1183" style='position:absolute;left:0;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 522px; margin-top: 21px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251693568;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image078.gif" v:shapes="_x0000_s1196" width="2" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1171"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 320px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251667968;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image079.gif" v:shapes="_x0000_s1171" width="22" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1157"
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="226.8pt,8.55pt" to="241.25pt,30.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251653632;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image080.gif" v:shapes="_x0000_s1157" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1184"
style='position:absolute;left:0;text-align:left;z-index:251681280;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="226.8pt,3.15pt" to="255.65pt,3.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251681280;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image081.gif" v:shapes="_x0000_s1184" width="41" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;margin-left:75.6pt;
margin-top:8.55pt;width:64.85pt;height:64.85pt;z-index:251532800;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1050"
style='position:absolute;left:0;text-align:left;margin-left:306pt;
margin-top:8.55pt;width:79.25pt;height:79.25pt;z-index:251544064;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="100"></td>
<td width="88"></td>
<td width="219"></td>
<td width="108"></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image082.gif" v:shapes="_x0000_s1039" width="88" /></td>
<td></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image083.gif" v:shapes="_x0000_s1050" width="108" /></td>
</tr>
<tr>
<td height="19"></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1061"
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</v:line><v:line id="_x0000_s1073" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1086" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="7" width="128"></td>
</tr>
<tr>
<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image084.gif" v:shapes="_x0000_s1061 _x0000_s1073 _x0000_s1086" width="339" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 282px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251624960;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image085.gif" v:shapes="_x0000_s1129" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1114"
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 263px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251609600;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image086.gif" v:shapes="_x0000_s1114" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1099"
style='position:absolute;left:0;text-align:left;z-index:251594240;
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from="349.2pt,6.75pt" to="349.25pt,14pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251594240;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1099" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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from="198pt,8.55pt" to="219.65pt,8.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="263"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1144" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1158" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:18.2pt;width:64.85pt;height:64.85pt;z-index:251654656;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1172"
style='position:absolute;left:0;text-align:left;margin-left:320.4pt;
margin-top:3.55pt;width:79.25pt;height:79.25pt;z-index:251668992;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="4" width="119"></td>
<td width="89"></td>
<td width="218"></td>
<td width="108"></td>
</tr>
<tr>
<td height="19"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image089.gif" v:shapes="_x0000_s1172" width="108" /></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image090.gif" v:shapes="_x0000_s1158" width="89" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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margin-top:12.7pt;width:259.25pt;height:7.25pt;z-index:251682304;
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1197"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="16" width="148"></td>
</tr>
<tr>
<td></td>
<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image091.gif" v:shapes="_x0000_s1185 _x0000_s1197 _x0000_s1208" width="348" /></td>
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</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 293.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
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id="_x0000_s1238" style='position:absolute;left:0;text-align:left;z-index:251736576;
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strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 541px; margin-top: 53px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251736576;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1238" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1218"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251716096;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1218" width="41" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
</td>
<td style="background: #CCCCCC; border-left: none; border: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1029" style='position:absolute;left:0;text-align:left;z-index:251522560;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251522560;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1029" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1030" style='position:absolute;left:0;text-align:left;z-index:251523584;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251523584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1030" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1040" style='position:absolute;left:0;text-align:left;z-index:251533824;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,14.65pt" to="133.25pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251533824;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1040" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Respiratorik
</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 103.5pt;" valign="top" width="138">
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 + :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH $ :<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.3pt;" valign="top" width="142">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">24,0
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">20
: 1<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">40,0
mmIg<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ` <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunen eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 ` 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Respiratorik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">FIK UI B’
95</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
</tr>
<!--[if !supportMisalignedColumns]-->
<tr height="0">
<td style="border: none;" width="169"></td>
<td style="border: none;" width="138"></td>
<td style="border: none;" width="142"></td>
<td style="border: none;" width="165"></td>
</tr>
<!--[endif]-->
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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<br /></div>
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<br /></div>
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<b><u><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">DAFTAR KEPUSTAKAAN</span></u></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Guyton, Arthur C, Fisiologi Manusia dan Mekanisme
Penyakit, EGC Penerbitan Buku Kedokteran, Jakarta, 1987.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Price Sylvia Anderson; Wilson Mc. Carty,
Pathofisiologi Konsep Klinik Proses-proses Penyakit, EGC Penerbit Buku
Kedokteran, Jakarta, 1993.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Soeparman, Ilmu Penyakit Dalam, UI Press, Jakarta,
1991.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">-------, Dasar-dasar
Keperawatan Kardiotorasik, Rumah Sakit Jantung “Harapan Kita”, Jakarta, 1989<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<br /></div>
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<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">Gangguan
Keseimbangan Asam Basa<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">A. Penilaian
Ketidakseimbangan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Penilaian
Sistematik dan Penilaian gangguan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">_____________________________________________________<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">kecurigaan
klinis<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan tanda dan gejala
klinis yang mengarah kepada gangguan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Periksa hasil pemeriksaan
laboratorium untuk elektrolit dan data lainnya yang mengarah kepada proses
penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menilai
variabel-variabel asam basa untuk mengetahui tipe gangguan.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pertama, periksa PH darah
arteri untuk menentukan arah dan besarnya gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1087"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251581952;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1087" width="12" /></span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan
variabel pernafasan (PaCO2) dan metabolik HCO3
, yang berhubungan dengan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">PH untuk mencoba mengetahui
apakah gangguan primer bersifat
respiratorik, metabolik atau campuran.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perkirakan respon
kompensatorik yang bakal terjadi pada gangguan asam basa primer.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Buat penafsiran tahap akhir.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1130" width="12" /></td>
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<!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO3 )<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui saluran cerna : <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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id="_x0000_s1267" style='position:absolute;left:0;text-align:left;z-index:251766272;
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endarrowwidth="narrow" endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 368px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 71px; z-index: 251766272;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image092.gif" v:shapes="_x0000_s1267" width="71" /></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida
(NH4Cl NH3 + HCl) <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan hiperalimentasi <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan secara cepat .<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l2 level1 lfo14; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan produksi asam :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l2 level1 lfo14; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menelan substansi toksik.
Kegagalan ekskresi asam : tidak adanya
ekskresi NH4 ; retensi asam sulfat dan
asam fosfat (gagal ginjal akut dan kronik)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi asidosis metabolik<o:p></o:p></span></b></div>
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<br /></div>
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<td></td>
<td align="left" valign="top"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image008.gif" v:shapes="_x0000_s1062" width="69" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251582976;"><span style="height: 31px; left: 0px; left: 234px; position: absolute; top: -1px; width: 22px;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1088" width="22" /></span></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<td height="9" width="234"></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Keton dan peningkatan Cl
menggganti ion bikarbonat<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></b></div>
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<td height="1" width="320"></td>
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<td><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image014.gif" v:shapes="_x0000_s1145" width="70" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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B <o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
10 <o:p></o:p></span></b></div>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1240" style='position:absolute;left:0;text-align:left;
margin-left:262.8pt;margin-top:6.75pt;width:57.65pt;height:57.65pt;z-index:251738624;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 349px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251738624;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1240" width="79" /></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
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<tbody>
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<td height="2" width="109"></td>
</tr>
<tr>
<td></td>
<td><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1229" width="79" /></td>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 157px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 243px; z-index: 251749888;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image027.gif" v:shapes="_x0000_s1251" width="243" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
10 <o:p></o:p></span></b></div>
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<br /></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1296"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="8" width="138"></td>
</tr>
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<td></td>
<td><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1296" width="12" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,75<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 306.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 153.9pt;" valign="top" width="205">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru
mengeluarkan banyak CO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan Bikarbonat , mengeluarkan H+, dam anion lain urin asam. NaHCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, larutan laktat diberikan
I V. <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if gte vml 1]><v:oval id="_x0000_s1282"
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<td height="2" width="100"></td>
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<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image029.gif" v:shapes="_x0000_s1282" width="79" /></td>
<td></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image030.gif" v:shapes="_x0000_s1284" width="79" /></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1286"
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margin-top:3.75pt;width:208.85pt;height:7.25pt;z-index:251785728;
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<td height="4" width="128"></td>
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<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image031.gif" v:shapes="_x0000_s1286 _x0000_s1288 _x0000_s1290" width="281" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1292"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="6" width="244"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image032.gif" v:shapes="_x0000_s1292" width="40" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi Alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="6" width="100"></td>
<td width="69"></td>
<td width="142"></td>
<td width="69"></td>
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<td height="69"></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image034.gif" v:shapes="_x0000_s1101" width="69" /></td>
<td></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image035.gif" v:shapes="_x0000_s1116" width="69" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1132"
style='position:absolute;left:0;text-align:left;margin-left:97.2pt;
margin-top:13.5pt;width:165.65pt;height:7.25pt;z-index:251628032;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1146"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251642368;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="169.2pt,21pt" to="176.45pt,35.45pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1160" style='position:absolute;left:0;
text-align:left;z-index:251656704;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="176.4pt,21pt" to="183.65pt,35.45pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="17" width="128"></td>
</tr>
<tr>
<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image036.gif" v:shapes="_x0000_s1132 _x0000_s1146 _x0000_s1160" width="224" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1174"
style='position:absolute;left:0;text-align:left;z-index:251671040;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="169.2pt,7.15pt" to="183.65pt,7.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 224px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251671040;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image037.gif" v:shapes="_x0000_s1174" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1210" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:37.1pt;width:50.45pt;height:50.45pt;z-index:251707904;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251707904;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1210" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1199"
style='position:absolute;left:0;text-align:left;z-index:251696640;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="320.4pt,29.9pt" to="327.65pt,29.95pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251696640;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1199" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1186"
style='position:absolute;left:0;text-align:left;z-index:251683328;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="342pt,15.5pt" to="349.25pt,15.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251683328;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1186" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat
karena kehilangan Cl atau karena makan
banyak Na bikarbonat<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1220" style='position:absolute;left:0;text-align:left;
margin-left:241.2pt;margin-top:9.5pt;width:64.85pt;height:57.65pt;z-index:251718144;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 320px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251718144;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image039.gif" v:shapes="_x0000_s1220" width="89" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1230"
style='position:absolute;left:0;text-align:left;z-index:251728384;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="104.4pt,3.55pt" to="284.45pt,25.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 138px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251728384;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image040.gif" v:shapes="_x0000_s1230" width="242" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1252"
style='position:absolute;left:0;text-align:left;z-index:251750912;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="198pt,3.95pt" to="212.45pt,25.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 263px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251750912;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image041.gif" v:shapes="_x0000_s1252" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1241"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251739648;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="176.4pt,3.95pt" to="190.85pt,25.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251739648;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1241" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1262"
style='position:absolute;left:0;text-align:left;z-index:251761152;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="176.4pt,11.5pt" to="212.45pt,11.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251761152;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1262" width="50" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1089" style='position:absolute;left:0;text-align:left;
margin-left:190.8pt;margin-top:58.05pt;width:72.05pt;height:64.85pt;
z-index:251584000;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251584000;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1089" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1075"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251569664;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251569664;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1075" width="79" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal
mengeluarkan ion bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi
basa<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1187" style='position:absolute;left:0;text-align:left;flip:y;
z-index:251684352;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="54pt,2.45pt" to="61.25pt,9.7pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 71px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251684352;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1187" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1161"
style='position:absolute;left:0;text-align:left;z-index:251657728;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="75.6pt,9.65pt" to="205.25pt,45.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 100px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 175px; z-index: 251657728;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image046.gif" v:shapes="_x0000_s1161" width="175" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1102"
style='position:absolute;left:0;text-align:left;z-index:251597312;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="54pt,9.65pt" to="234.05pt,60.1pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 71px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251597312;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image047.gif" v:shapes="_x0000_s1102" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1117"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251612672;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,32pt" to="154.85pt,32.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1133" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251629056;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="126pt,3.2pt" to="140.45pt,32.05pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1147" style='position:absolute;left:0;
text-align:left;z-index:251643392;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="140.4pt,3.2pt" to="154.85pt,32.05pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1175" style='position:absolute;left:0;
text-align:left;z-index:251672064;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="234pt,25.05pt" to="234.05pt,32.3pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1117 _x0000_s1133 _x0000_s1147" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1175" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah pengobatan<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1263" style='position:absolute;left:0;text-align:left;z-index:251762176;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,12.45pt" to="291.65pt,12.5pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251762176;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1263" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang
mengandung Cl , atau NH4Cl<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1200"
style='position:absolute;left:0;text-align:left;margin-left:61.2pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251697664;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1211"
style='position:absolute;left:0;text-align:left;margin-left:234pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251708928;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<td></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1211" width="79" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></b></div>
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<br /></div>
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<br clear="ALL" />
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></b></div>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<br /></div>
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<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat
pernafasan di medula oblongata<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas
yang akut <o:p></o:p></span></b></div>
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum Asidosis<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></b></div>
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20<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru menahan CO2<o:p></o:p></span></b></div>
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B<o:p></o:p></span></div>
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20<o:p></o:p></span></div>
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<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
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<td height="12"></td>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></b></div>
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<tbody>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<td><img height="61" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image067.gif" v:shapes="_x0000_s1243 _x0000_s1254 _x0000_s1264 _x0000_s1268 _x0000_s1272 _x0000_s1276" width="319" /></td>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 215px; margin-top: 26px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251779584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image068.gif" v:shapes="_x0000_s1280" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
Urin menjadi asam<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan
setelah pengobatan<o:p></o:p></span></b></div>
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<td height="1" width="61"></td>
<td width="89"></td>
<td width="161"></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
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<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo17; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo17; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo17; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td width="247"></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="292"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image075.gif" v:shapes="_x0000_s1091" width="50" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="3" width="109"></td>
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<tr>
<td height="79"></td>
<td></td>
<td align="left" rowspan="2" valign="top"><img height="117" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image076.gif" v:shapes="_x0000_s1120" width="108" /></td>
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</tbody></table>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 522px; margin-top: 21px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251699712;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image078.gif" v:shapes="_x0000_s1202" width="2" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1178"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 320px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251675136;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image079.gif" v:shapes="_x0000_s1178" width="22" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1164"
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="226.8pt,8.55pt" to="241.25pt,30.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251660800;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image080.gif" v:shapes="_x0000_s1164" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1190"
style='position:absolute;left:0;text-align:left;z-index:251687424;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251687424;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image081.gif" v:shapes="_x0000_s1190" width="41" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1043"
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1054"
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="10" width="100"></td>
<td width="88"></td>
<td width="219"></td>
<td width="108"></td>
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<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image082.gif" v:shapes="_x0000_s1043" width="88" /></td>
<td></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image083.gif" v:shapes="_x0000_s1054" width="108" /></td>
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<tr>
<td height="19"></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1065"
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</v:line><v:line id="_x0000_s1078" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1092" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="7" width="128"></td>
</tr>
<tr>
<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image084.gif" v:shapes="_x0000_s1065 _x0000_s1078 _x0000_s1092" width="339" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 282px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251633152;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image085.gif" v:shapes="_x0000_s1137" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1121"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 263px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251616768;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image086.gif" v:shapes="_x0000_s1121" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1106"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251601408;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1106" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="263"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1151" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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id="_x0000_s1165" style='position:absolute;left:0;text-align:left;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="4" width="119"></td>
<td width="89"></td>
<td width="218"></td>
<td width="108"></td>
</tr>
<tr>
<td height="19"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image089.gif" v:shapes="_x0000_s1179" width="108" /></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image090.gif" v:shapes="_x0000_s1165" width="89" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
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<tr>
<td height="16" width="148"></td>
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<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image091.gif" v:shapes="_x0000_s1191 _x0000_s1203 _x0000_s1213" width="348" /></td>
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<br clear="ALL" />
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
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<tbody>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
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<o:p></o:p></span></div>
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<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
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<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
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<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
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<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
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<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1033" style='position:absolute;left:0;text-align:left;z-index:251526656;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251526656;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1033" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1034" style='position:absolute;left:0;text-align:left;z-index:251527680;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251527680;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1034" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
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<br /></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1044" style='position:absolute;left:0;text-align:left;z-index:251537920;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,14.65pt" to="133.25pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251537920;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1044" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
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<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Respiratorik
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Metabolik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 198.0pt;" valign="top" width="264">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 +
24,0 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 20 : 1<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 11.8pt;" valign="top" width="16">
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Metabolik
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunan eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Respiratorik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
</td>
</tr>
<!--[if !supportMisalignedColumns]-->
<tr height="0">
<td style="border: none;" width="169"></td>
<td style="border: none;" width="138"></td>
<td style="border: none;" width="126"></td>
<td style="border: none;" width="16"></td>
<td style="border: none;" width="165"></td>
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</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-38054986517472428052012-11-07T18:14:00.001-08:002012-11-07T18:14:13.115-08:00GANGGUAN KETIDAKSEIMBANGAN ASAM BASA<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">GANGGUAN
KETIDAKSEIMBANGAN ASAM BASA</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penilaian Sistematik daam Penilaian gangguan asam
basa<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">___________________________________________________________________________<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Awali dengan kecurigaan klinis yang tinggi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ini membutuhkan pengetahuan tentang patogensis dari berbagai gangguan
asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contohnya, asidosis respiratorik mungkin dapat diperkirakan timbul pada
penderita penyakit paru obstruksi menahun.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan tanda dan gejala klinis yang mengarah
kepada gangguan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sayang sekali, banyak tanda dan gejala dari gangguan asam basa tidak
jelas dan non spesifik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, pernafasan kussmaul pada pasien
diabetes dapat merupakan tanda kompensasi pernafasan terhadap asidosis
metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Periksa hasil pemeriksaan laboratorium untuk
elektrolit dan data lainnya yang mengarah <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> kepada
proses penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, hipokalemia sering berkaitan dengan alkalosis metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, peningkatan kadar kreatinin serum menunjukkan insufesiensi
ginjal dan insufesiensi serta gagal ginjal sering disertai asidosis metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<a name='more'></a><br />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menilai variabel-variabel asam basa untuk mengetahui
tipe gangguan.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Pertama, periksa PH darah arteri untuk menentukan
arah dan besarnya gangguan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika menurun, pasien mengalami asidemia dengan dua sebab yang mungkin :
asidosis metabolik atau asidosis respiratorik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika meningkat, pasien mengalami alkalemia dengan dua sebab yang
mungkin : alkalosis metabolik atau alkalosis respiratorik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1066"
style='position:absolute;left:0;text-align:left;z-index:251560448;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="140.4pt,34.8pt" to="147.65pt,34.85pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 186px; margin-top: 45px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251560448;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1066" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ingatlah bahwa kampensasi ginjal dan pernafasan
jarang memulihkan PH kembali normal sehingga jika ditemukan PH yang normal
meskipun ada perubahan dalam PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ,mungkin ada gangguan campuran ; contohnya
seorang pasien dengan asidosis respiratorik yang bercampur dengan alkalosis
metabolik mungkin akan mempunyai PH yang normal.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1079"
style='position:absolute;left:0;text-align:left;z-index:251573760;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="306pt,.2pt" to="313.25pt,.25pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251573760;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1079" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan variabel pernafasan (PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">) dan metabolik HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , yang berhubungan dengan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> PH untuk
mencoba mengetahui apakah gangguan primer bersifat respiratorik, metabolik <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> atau
campuran.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (40 mmHg), meningkat
atau menurun ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1045"
style='position:absolute;left:0;text-align:left;z-index:251538944;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,.85pt" to="133.25pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251538944;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1045" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (24 mEq/L), meningkat
atau menurun ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tambahan : apakah ada kelebihan atau kekurangan basa ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1055"
style='position:absolute;left:0;text-align:left;z-index:251549184;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="320.4pt,-.4pt" to="327.65pt,-.35pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251549184;"><span style="height: 3px; left: 0px; left: 426px; position: absolute; top: -2px; width: 12px;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1055" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pada gangguan asam basa sederhana, PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> selalu berubah dalam arah yang sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1035"
style='position:absolute;left:0;text-align:left;z-index:251528704;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="234pt,0" to="241.25pt,.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251528704;"><span style="height: 2px; left: 0px; left: 311px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1035" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyimpangan dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dalam darah yang berlawanan
menunjukkan adanya gangguan asam basa campuran.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cobalah untuk menduga campuran primer dengan menghubungkan hasil
pemeriksaan yang ditemukan dengan keadaan klinis.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Perkirakan respon kompensatorik yang bakal
terjadi pada gangguan asam basa primer.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika respon kompensatorik
lebih berat atau ringan dari pada yang diperkirakan, mungkin ada gangguan asam
basa campuran (normogram asam basa juga dapat digunakan untuk mengetahui
gangguan asan basa campuran) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hitung selisih (gap) anion
plasma.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika
meningkat ( >16 mEq/l ), mungkin sekali terjadi acidosis metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt;"> </span></span><!--[endif]--><!--[if gte vml 1]><v:line
id="_x0000_s1046" style='position:absolute;left:0;text-align:left;z-index:251539968;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="241.2pt,2.45pt" to="248.45pt,2.5pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 320px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251539968;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1046" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bandingkan besarnya penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> plasma dengan peningkatan selisih anion :
seharusnya sama besar.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1067"
style='position:absolute;left:0;text-align:left;z-index:251561472;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="363.6pt,17.65pt" to="370.85pt,17.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 484px; margin-top: 22px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251561472;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1067" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1056"
style='position:absolute;left:0;text-align:left;z-index:251550208;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="349.2pt,3.25pt" to="356.45pt,3.3pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 464px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251550208;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1056" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan
< dari selisih anion penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , mungkin komponen dari
acidosis metabolik disebabkan oleh kehilangan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1080"
style='position:absolute;left:0;text-align:left;z-index:251574784;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="450pt,3.05pt" to="457.25pt,3.1pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 599px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251574784;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1080" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan selisih dari anion jauh lebih besar
dari penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> berarti ada alkalosis metabolik yang
menyertainya.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Buat penafsiran tahap akhir.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">gangguan asam-basa sederhana<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Akut (tidak terkompensasi)
atau<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kronik (sebagian atau
sepenuhnya terkompensasi )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam-basa campuran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik dengan selisih anion normal atau lebar.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1122"
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endarrowlength="long"/>
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="13" width="378"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1122" width="12" /></td>
</tr>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> )<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1107" style='position:absolute;left:0;text-align:left;z-index:251602432;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="75.6pt,14.65pt" to="82.85pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 100px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251602432;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1107" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer kadar bikarbonat sehingga terjadi
penurunan PH ( peningkatan ion H) . HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF =22 mEq/L
dan PH =7,35. Kompensasi pernafasan segera dimulai untuk menurunkan PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> melalui hiperventilasi
sehinga asidosis metabolik jarang terjadi secara akut.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui
saluran cerna : <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Diare<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Ilieotomi ; fistula
pankreas, kantong empedu atau usus halus.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Ureterosigmoidostomi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Asidosis tubulus
proksimal ginjal (RTA)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Inhibitor Karbonik
Anhidrase (Asetazolamid)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Hipoaldosteronisme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:line
id="_x0000_s1026" style='position:absolute;left:0;text-align:left;z-index:251519488;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="212.4pt,10.55pt" to="241.25pt,10.6pt" o:allowincell="f" strokecolor="blue"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrow="open"
endarrowwidth="narrow" endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 282px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 42px; z-index: 251519488;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image007.gif" v:shapes="_x0000_s1026" width="42" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida (NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cl
NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> + HCl <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan
hiperalimentasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan
secara cepat .<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Peningkatan produksi asam
:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat : laktat (perfusi jaringan atau aksigenasi yang tidak
memadai seperti pada syok atau henti kardiopulmonar)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ketoasidosis diabetik : Beta-hidroksibutirat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelaparan: peningkatan asam - asam keto<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi alkohol : peningkatan asam-asam keto<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Menelan substansi toksik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kelebihan dosis salisilat
: Salisilat, laktat, keton<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Metanol atau formaldehid
: formad<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Etilglikol (antibeku) :
oksilat, glikolat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Kegagalan ekskresi asam
: tidak adanya ekskresi NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ; retensi asam sulfat dan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> asam fosfat<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. gagal ginjal akut dan
kronik<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi
asidosis metabolik<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
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1
20<o:p></o:p></span></div>
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" Keton dan
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<tr>
<td></td>
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<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;margin-left:68.4pt;
margin-top:8.95pt;width:64.85pt;height:64.85pt;z-index:251618816;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 90px; margin-top: 11px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251618816;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image015.gif" v:shapes="_x0000_s1123" width="89" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> d ! B <o:p></o:p></span></div>
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<td width="104"></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1234" style='position:absolute;left:0;text-align:left;
margin-left:262.8pt;margin-top:6.75pt;width:57.65pt;height:57.65pt;z-index:251732480;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 349px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251732480;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1234" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;margin-left:82.8pt;
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
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from="118.8pt,10.35pt" to="298.85pt,46.4pt" o:allowincell="f" strokeweight="1pt">
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
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mso-position-vertical-relative:text' from="104.4pt,6.75pt" to="111.65pt,14pt"
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<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkao banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></div>
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></div>
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<div class="MsoNormal" style="text-align: justify;">
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margin-top:3.75pt;width:208.85pt;height:7.25pt;z-index:251784704;
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
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from="147.6pt,19.4pt" to="154.85pt,19.45pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251529728;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1036" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">peningkatan primer kadar bikarbonat plasma, sehingga
terjadi peningkatan Ph (penurunan H ).
HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF = 2,6 mEq/l dan PH = 7,45. Kompensasi pernapasan berupa
peningkatan Pa CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dengan hipoventilasi ; akan
tetapi tingkat hipoventilasi adalah terbatas karena parnapasan terus berjalan
karena dorongan hipoxia/<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan mela|}i
saluran cerna (berkurangnya volume ECF)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Muntah atau penyedotan
nasogastrik <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Diare dengan kehilangan
klorida<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kehilangan melalui ginjal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Diuretik simpai atau
tiazid (pembatasan NaCl + berkurangnya ECF)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kelebihan
mineralokortikoid<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1). Hiperaldosteronisme<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2). Syndvom cushing ;
tgrapi kortikosteroid eksogen )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3). Makan licorice
berlebihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Karbenisillin atqu
penicillio dosis tinggi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 148px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251563520;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image033.gif" v:shapes="_x0000_s1069" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian Natrium Bikarbonat
berlebihan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sundrom susu alkali
(antasid, susu, natrium bkkarbonat)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Darah simpan (sitrat) yang
banyak (>8unit)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik
hiperkapnia (setelah koreksi pada asidosiw respiratorik kronik)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ventinasi mekanis: penurunan yang cepat dari PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> tapi HCO tetap tinggi
sampai0kinjal mengeksekresi kelebihannya.<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya disertai penurunan ECF<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mun|ah atau penyeditan Nasogastrik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deuretik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasca-hiperkapnea<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya tidak dirsertai penurunan Volume
ECF <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelebihan mineralokortikoid<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Edematosa (gagal jantung kongestif, sirosis, sindrom nefrotik).<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
Alkalosis metabolik<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></div>
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<br /></div>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1205" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:37.1pt;width:50.45pt;height:50.45pt;z-index:251702784;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251702784;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1205" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1193"
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strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251690496;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1193" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1180"
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="342pt,15.5pt" to="349.25pt,15.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251677184;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1180" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat karena kehilangan Cl atau karena makan banyak Na bikarbonat<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1215" style='position:absolute;left:0;text-align:left;
margin-left:241.2pt;margin-top:9.5pt;width:64.85pt;height:57.65pt;z-index:251713024;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 320px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251713024;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image039.gif" v:shapes="_x0000_s1215" width="89" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1226"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 138px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251724288;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image040.gif" v:shapes="_x0000_s1226" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1247"
style='position:absolute;left:0;text-align:left;z-index:251745792;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 263px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251745792;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image041.gif" v:shapes="_x0000_s1247" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1235"
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="176.4pt,3.95pt" to="190.85pt,25.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251733504;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1235" width="22" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1257"
style='position:absolute;left:0;text-align:left;z-index:251756032;
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from="176.4pt,11.5pt" to="212.45pt,11.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251756032;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1257" width="50" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1083" style='position:absolute;left:0;text-align:left;
margin-left:190.8pt;margin-top:58.05pt;width:72.05pt;height:64.85pt;
z-index:251577856;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251577856;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1083" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1070"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251564544;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251564544;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1070" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal mengeluarkan ion
bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi basa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1181" style='position:absolute;left:0;text-align:left;flip:y;
z-index:251678208;mso-position-horizontal-relative:text;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 71px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251678208;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1181" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1154"
style='position:absolute;left:0;text-align:left;z-index:251650560;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 100px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 175px; z-index: 251650560;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image046.gif" v:shapes="_x0000_s1154" width="175" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1095"
style='position:absolute;left:0;text-align:left;z-index:251590144;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 71px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251590144;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image047.gif" v:shapes="_x0000_s1095" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
1<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1110"
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,32pt" to="154.85pt,32.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1125" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1140" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1168" style='position:absolute;left:0;
text-align:left;z-index:251664896;mso-position-horizontal-relative:text;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1110 _x0000_s1125 _x0000_s1140" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1168" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1258" style='position:absolute;left:0;text-align:left;z-index:251757056;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,12.45pt" to="291.65pt,12.5pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251757056;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1258" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang mengandung Cl , atau NH4Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1194"
style='position:absolute;left:0;text-align:left;margin-left:61.2pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251691520;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1206"
style='position:absolute;left:0;text-align:left;margin-left:234pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251703808;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="15" width="80"></td>
<td width="80"></td>
<td width="151"></td>
<td width="79"></td>
</tr>
<tr>
<td height="80"></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image050.gif" v:shapes="_x0000_s1194" width="80" /></td>
<td></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1206" width="79" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1216"
style='position:absolute;left:0;text-align:left;margin-left:75.6pt;
margin-top:0;width:201.65pt;height:7.25pt;z-index:251714048;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1227"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251725312;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="162pt,7.2pt" to="176.45pt,28.85pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1236" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251714048;"><span style="height: 41px; left: 0px; left: 100px; position: absolute; top: -1px; width: 271px;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image052.gif" v:shapes="_x0000_s1216 _x0000_s1227 _x0000_s1236" width="271" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1248" style='position:absolute;left:0;text-align:left;z-index:251746816;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="162pt,.85pt" to="183.65pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="215"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image053.gif" v:shapes="_x0000_s1248" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ditandai dengan peningkatan
primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hiperkapnea), sehingga
terjadi penurunan PH; PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> >
45 mmHg dan PH . 7,35.<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:line
id="_x0000_s1058" style='position:absolute;left:0;text-align:left;z-index:251552256;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="255.6pt,4.85pt" to="262.85pt,4.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 340px; margin-top: 5px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251552256;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1058" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kompensasi ginjal mengakibatkan peningkatan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum. Asidosis respirasi dapat timbul secara
akut maupun kronik. Hipoksemia (PaO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> rendah) selalu menyertai asidosis respiratorik. Jika pasien bernafas
dalam udara ruangan.<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat pernafasan di medula oblongata<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obat-obatan : Kelebihan
dosis opiat, sedatif, anestetik (akut)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Terapi oksigen pada
hiperkapnea kronik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti jantung (akut)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apnea saat tidur <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyakit neuromuskuler :
miastenia gravis, sindrom guillain-Barre, poliomielitis, sklerosis lateral
amiotropik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deformitas rongga dada :
kifoskoliosis<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obesitas yang berlebihan :
sindrom pickwikian<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera dinding dada seperti
patah tulang-tulang iga <o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PPOM (emfisema dan
bronkitis)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tahap akhir penyakit paru
intrinsik yang difus<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumona atau asama yang
berat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Edema paru akut<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumotorak<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas yang akut <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Aspirasi benda asing atau
muntah<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laringospasme atau edema
laring, bronkospasme berat <o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum
Asidosis<o:p></o:p></span></div>
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<br /></div>
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<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image055.gif" v:shapes="_x0000_s1037" width="79" /></td>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 40px; z-index: 251578880;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image057.gif" v:shapes="_x0000_s1084" width="40" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru
menahan CO2<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 349px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251665920;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image060.gif" v:shapes="_x0000_s1169" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></div>
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<tbody>
<tr>
<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="22" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image063.gif" v:shapes="_x0000_s1182 _x0000_s1195 _x0000_s1207" width="21" /></td>
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<tr>
<td height="12"></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image064.gif" v:shapes="_x0000_s1155" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 261.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="5" width="71"></td>
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<td><img height="61" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image067.gif" v:shapes="_x0000_s1237 _x0000_s1249 _x0000_s1259 _x0000_s1266 _x0000_s1270 _x0000_s1274" width="319" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;z-index:251777536;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 215px; margin-top: 26px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251777536;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image068.gif" v:shapes="_x0000_s1278" width="21" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
2 Urin
menjadi asam<o:p></o:p></span></div>
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
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<tbody>
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<td height="1" width="61"></td>
<td width="89"></td>
<td width="161"></td>
<td width="89"></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image069.gif" v:shapes="_x0000_s1097" width="89" /></td>
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<br /></div>
<br clear="ALL" />
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="13" width="90"></td>
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<td></td>
<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image071.gif" v:shapes="_x0000_s1127 _x0000_s1142 _x0000_s1156 _x0000_s1170" width="290" /></td>
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</tbody></table>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td width="247"></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<tbody>
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<td height="6" width="138"></td>
</tr>
<tr>
<td></td>
<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image074.gif" v:shapes="_x0000_s1049 _x0000_s1060 _x0000_s1072" width="377" /></td>
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<tbody>
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</tr>
<tr>
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<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image075.gif" v:shapes="_x0000_s1085" width="50" /></td>
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<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="3" width="109"></td>
<td width="89"></td>
<td width="257"></td>
<td width="108"></td>
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<tr>
<td height="10"></td>
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<tr>
<td height="79"></td>
<td></td>
<td align="left" rowspan="2" valign="top"><img height="117" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image076.gif" v:shapes="_x0000_s1113" width="108" /></td>
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<tr>
<td height="38"></td>
</tr>
</tbody></table>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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</v:line><v:line id="_x0000_s1143" style='position:absolute;left:0;
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 522px; margin-top: 21px; mso-ignore: vglayout; position: absolute; width: 2px; z-index: 251693568;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image078.gif" v:shapes="_x0000_s1196" width="2" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1171"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 320px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251667968;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image079.gif" v:shapes="_x0000_s1171" width="22" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1157"
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from="226.8pt,8.55pt" to="241.25pt,30.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251653632;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image080.gif" v:shapes="_x0000_s1157" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1184"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251681280;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image081.gif" v:shapes="_x0000_s1184" width="41" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="100"></td>
<td width="88"></td>
<td width="219"></td>
<td width="108"></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image082.gif" v:shapes="_x0000_s1039" width="88" /></td>
<td></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image083.gif" v:shapes="_x0000_s1050" width="108" /></td>
</tr>
<tr>
<td height="19"></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1061"
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</v:line><v:line id="_x0000_s1073" style='position:absolute;left:0;
text-align:left;z-index:251567616;mso-position-horizontal-relative:text;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1086" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="7" width="128"></td>
</tr>
<tr>
<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image084.gif" v:shapes="_x0000_s1061 _x0000_s1073 _x0000_s1086" width="339" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 263px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251609600;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image086.gif" v:shapes="_x0000_s1114" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1099"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251594240;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1099" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="263"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1144" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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id="_x0000_s1158" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:18.2pt;width:64.85pt;height:64.85pt;z-index:251654656;
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1172"
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margin-top:3.55pt;width:79.25pt;height:79.25pt;z-index:251668992;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image090.gif" v:shapes="_x0000_s1158" width="89" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 293.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251716096;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1218" width="41" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
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<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
</td>
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<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1029" style='position:absolute;left:0;text-align:left;z-index:251522560;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251522560;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1029" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1030" style='position:absolute;left:0;text-align:left;z-index:251523584;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251523584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1030" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1040" style='position:absolute;left:0;text-align:left;z-index:251533824;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,14.65pt" to="133.25pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251533824;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1040" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Respiratorik
</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 103.5pt;" valign="top" width="138">
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 + :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH $ :<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.3pt;" valign="top" width="142">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">24,0
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">20
: 1<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">40,0
mmIg<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ` <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunen eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 ` 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Respiratorik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">FIK UI B’
95</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
</tr>
<!--[if !supportMisalignedColumns]-->
<tr height="0">
<td style="border: none;" width="169"></td>
<td style="border: none;" width="138"></td>
<td style="border: none;" width="142"></td>
<td style="border: none;" width="165"></td>
</tr>
<!--[endif]-->
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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<b><u><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">DAFTAR KEPUSTAKAAN</span></u></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Guyton, Arthur C, Fisiologi Manusia dan Mekanisme
Penyakit, EGC Penerbitan Buku Kedokteran, Jakarta, 1987.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Price Sylvia Anderson; Wilson Mc. Carty,
Pathofisiologi Konsep Klinik Proses-proses Penyakit, EGC Penerbit Buku
Kedokteran, Jakarta, 1993.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Soeparman, Ilmu Penyakit Dalam, UI Press, Jakarta,
1991.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">-------, Dasar-dasar
Keperawatan Kardiotorasik, Rumah Sakit Jantung “Harapan Kita”, Jakarta, 1989<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">Gangguan
Keseimbangan Asam Basa<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">A. Penilaian
Ketidakseimbangan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Penilaian
Sistematik dan Penilaian gangguan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">_____________________________________________________<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">kecurigaan
klinis<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan tanda dan gejala
klinis yang mengarah kepada gangguan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Periksa hasil pemeriksaan
laboratorium untuk elektrolit dan data lainnya yang mengarah kepada proses
penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menilai
variabel-variabel asam basa untuk mengetahui tipe gangguan.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pertama, periksa PH darah
arteri untuk menentukan arah dan besarnya gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1087"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251581952;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1087" width="12" /></span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan
variabel pernafasan (PaCO2) dan metabolik HCO3
, yang berhubungan dengan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">PH untuk mencoba mengetahui
apakah gangguan primer bersifat
respiratorik, metabolik atau campuran.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perkirakan respon
kompensatorik yang bakal terjadi pada gangguan asam basa primer.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Buat penafsiran tahap akhir.<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO3 )<o:p></o:p></span></b></div>
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<br /></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui saluran cerna : <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></b></div>
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from="277.2pt,10.4pt" to="327.65pt,10.45pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 368px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 71px; z-index: 251766272;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image092.gif" v:shapes="_x0000_s1267" width="71" /></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida
(NH4Cl NH3 + HCl) <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan hiperalimentasi <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan secara cepat .<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan produksi asam :<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menelan substansi toksik.
Kegagalan ekskresi asam : tidak adanya
ekskresi NH4 ; retensi asam sulfat dan
asam fosfat (gagal ginjal akut dan kronik)<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi asidosis metabolik<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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20<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Keton dan peningkatan Cl
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></b></div>
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B <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
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id="_x0000_s1240" style='position:absolute;left:0;text-align:left;
margin-left:262.8pt;margin-top:6.75pt;width:57.65pt;height:57.65pt;z-index:251738624;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 349px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251738624;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1240" width="79" /></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
10 <o:p></o:p></span></b></div>
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<td height="8" width="138"></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,75<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru
mengeluarkan banyak CO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan Bikarbonat , mengeluarkan H+, dam anion lain urin asam. NaHCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, larutan laktat diberikan
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
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<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image031.gif" v:shapes="_x0000_s1286 _x0000_s1288 _x0000_s1290" width="281" /></td>
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</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1292"
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</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="6" width="244"></td>
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<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image032.gif" v:shapes="_x0000_s1292" width="40" /></td>
</tr>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi Alkalosis metabolik<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1101"
style='position:absolute;left:0;text-align:left;margin-left:75.6pt;
margin-top:5.1pt;width:50.45pt;height:50.45pt;z-index:251596288;
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1116"
style='position:absolute;left:0;text-align:left;margin-left:234pt;
margin-top:5.1pt;width:50.45pt;height:50.45pt;z-index:251611648;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
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<td height="6" width="100"></td>
<td width="69"></td>
<td width="142"></td>
<td width="69"></td>
</tr>
<tr>
<td height="69"></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image034.gif" v:shapes="_x0000_s1101" width="69" /></td>
<td></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image035.gif" v:shapes="_x0000_s1116" width="69" /></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<!--[if gte vml 1]><v:rect id="_x0000_s1132"
style='position:absolute;left:0;text-align:left;margin-left:97.2pt;
margin-top:13.5pt;width:165.65pt;height:7.25pt;z-index:251628032;
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1146"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251642368;
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from="169.2pt,21pt" to="176.45pt,35.45pt" o:allowincell="f" strokeweight="1pt">
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</v:line><v:line id="_x0000_s1160" style='position:absolute;left:0;
text-align:left;z-index:251656704;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="176.4pt,21pt" to="183.65pt,35.45pt"
o:allowincell="f" strokeweight="1pt">
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<td height="17" width="128"></td>
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<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image036.gif" v:shapes="_x0000_s1132 _x0000_s1146 _x0000_s1160" width="224" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1174"
style='position:absolute;left:0;text-align:left;z-index:251671040;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="169.2pt,7.15pt" to="183.65pt,7.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 224px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251671040;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image037.gif" v:shapes="_x0000_s1174" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1210" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:37.1pt;width:50.45pt;height:50.45pt;z-index:251707904;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251707904;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1210" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1199"
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strokeweight="1pt">
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251696640;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1199" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1186"
style='position:absolute;left:0;text-align:left;z-index:251683328;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="342pt,15.5pt" to="349.25pt,15.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251683328;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1186" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat
karena kehilangan Cl atau karena makan
banyak Na bikarbonat<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1220" style='position:absolute;left:0;text-align:left;
margin-left:241.2pt;margin-top:9.5pt;width:64.85pt;height:57.65pt;z-index:251718144;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 320px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251718144;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image039.gif" v:shapes="_x0000_s1220" width="89" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1230"
style='position:absolute;left:0;text-align:left;z-index:251728384;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 138px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251728384;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image040.gif" v:shapes="_x0000_s1230" width="242" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1252"
style='position:absolute;left:0;text-align:left;z-index:251750912;
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from="198pt,3.95pt" to="212.45pt,25.6pt" o:allowincell="f" strokeweight="1pt">
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 263px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251750912;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image041.gif" v:shapes="_x0000_s1252" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1241"
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from="176.4pt,3.95pt" to="190.85pt,25.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251739648;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1241" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></b></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1262"
style='position:absolute;left:0;text-align:left;z-index:251761152;
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from="176.4pt,11.5pt" to="212.45pt,11.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251761152;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1262" width="50" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1089" style='position:absolute;left:0;text-align:left;
margin-left:190.8pt;margin-top:58.05pt;width:72.05pt;height:64.85pt;
z-index:251584000;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251584000;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1089" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1075"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251569664;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251569664;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1075" width="79" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal
mengeluarkan ion bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi
basa<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
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id="_x0000_s1187" style='position:absolute;left:0;text-align:left;flip:y;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 71px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251684352;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1187" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1161"
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
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<tbody>
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<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1117 _x0000_s1133 _x0000_s1147" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1175" width="2" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah pengobatan<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
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id="_x0000_s1263" style='position:absolute;left:0;text-align:left;z-index:251762176;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251762176;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1263" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang
mengandung Cl , atau NH4Cl<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1211" width="79" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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<tbody>
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<td height="0" width="215"></td>
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<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image053.gif" v:shapes="_x0000_s1253" width="31" /></td>
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</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat
pernafasan di medula oblongata<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas
yang akut <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum Asidosis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image055.gif" v:shapes="_x0000_s1041" width="79" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru menahan CO2<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<td height="15" width="292"></td>
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<tr>
<td></td>
<td><img height="60" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image058.gif" v:shapes="_x0000_s1118" width="69" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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20<o:p></o:p></span></div>
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="22" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image063.gif" v:shapes="_x0000_s1188 _x0000_s1201 _x0000_s1212" width="21" /></td>
</tr>
<tr>
<td height="12"></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image064.gif" v:shapes="_x0000_s1162" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 261.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="13" width="52"></td>
<td width="98"></td>
<td width="151"></td>
<td width="89"></td>
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<td height="79"></td>
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<td height="19"></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<td height="5" width="71"></td>
</tr>
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<td></td>
<td><img height="61" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image067.gif" v:shapes="_x0000_s1243 _x0000_s1254 _x0000_s1264 _x0000_s1268 _x0000_s1272 _x0000_s1276" width="319" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 215px; margin-top: 26px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251779584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image068.gif" v:shapes="_x0000_s1280" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
Urin menjadi asam<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan
setelah pengobatan<o:p></o:p></span></b></div>
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
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<tbody>
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<td height="1" width="61"></td>
<td width="89"></td>
<td width="161"></td>
<td width="89"></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image069.gif" v:shapes="_x0000_s1104" width="89" /></td>
<td></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image070.gif" v:shapes="_x0000_s1119" width="89" /></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
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<td height="13" width="90"></td>
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<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image071.gif" v:shapes="_x0000_s1135 _x0000_s1149 _x0000_s1163 _x0000_s1177" width="290" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo17; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1 20<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
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20 <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251601408;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1106" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="263"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1151" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1179"
style='position:absolute;left:0;text-align:left;margin-left:320.4pt;
margin-top:3.55pt;width:79.25pt;height:79.25pt;z-index:251676160;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="4" width="119"></td>
<td width="89"></td>
<td width="218"></td>
<td width="108"></td>
</tr>
<tr>
<td height="19"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image089.gif" v:shapes="_x0000_s1179" width="108" /></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image090.gif" v:shapes="_x0000_s1165" width="89" /></td>
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</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1203"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="16" width="148"></td>
</tr>
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<td></td>
<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image091.gif" v:shapes="_x0000_s1191 _x0000_s1203 _x0000_s1213" width="348" /></td>
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</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 293.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1244" style='position:absolute;left:0;text-align:left;z-index:251742720;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="406.8pt,40.35pt" to="414.05pt,40.4pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 541px; margin-top: 53px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251742720;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1244" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1223"
style='position:absolute;left:0;text-align:left;z-index:251721216;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251721216;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1223" width="41" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
</td>
<td style="background: #CCCCCC; border-left: none; border: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1033" style='position:absolute;left:0;text-align:left;z-index:251526656;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251526656;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1033" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1034" style='position:absolute;left:0;text-align:left;z-index:251527680;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251527680;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1034" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1044" style='position:absolute;left:0;text-align:left;z-index:251537920;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,14.65pt" to="133.25pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251537920;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1044" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Respiratorik
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Metabolik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 198.0pt;" valign="top" width="264">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 +
24,0 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 20 : 1<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 11.8pt;" valign="top" width="16">
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Metabolik
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunan eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Respiratorik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-48525566219227316362012-11-07T18:13:00.005-08:002012-11-07T18:13:53.655-08:00GANGGUAN KETIDAKSEIMBANGAN ASAM BASA<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">GANGGUAN
KETIDAKSEIMBANGAN ASAM BASA</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penilaian Sistematik daam Penilaian gangguan asam
basa<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">___________________________________________________________________________<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Awali dengan kecurigaan klinis yang tinggi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ini membutuhkan pengetahuan tentang patogensis dari berbagai gangguan
asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contohnya, asidosis respiratorik mungkin dapat diperkirakan timbul pada
penderita penyakit paru obstruksi menahun.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan tanda dan gejala klinis yang mengarah
kepada gangguan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sayang sekali, banyak tanda dan gejala dari gangguan asam basa tidak
jelas dan non spesifik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, pernafasan kussmaul pada pasien
diabetes dapat merupakan tanda kompensasi pernafasan terhadap asidosis
metabolik.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Periksa hasil pemeriksaan laboratorium untuk
elektrolit dan data lainnya yang mengarah <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> kepada
proses penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, hipokalemia sering berkaitan dengan alkalosis metabolik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, peningkatan kadar kreatinin serum menunjukkan insufesiensi
ginjal dan insufesiensi serta gagal ginjal sering disertai asidosis metabolik.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menilai variabel-variabel asam basa untuk mengetahui
tipe gangguan.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Pertama, periksa PH darah arteri untuk menentukan
arah dan besarnya gangguan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika menurun, pasien mengalami asidemia dengan dua sebab yang mungkin :
asidosis metabolik atau asidosis respiratorik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika meningkat, pasien mengalami alkalemia dengan dua sebab yang
mungkin : alkalosis metabolik atau alkalosis respiratorik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1066"
style='position:absolute;left:0;text-align:left;z-index:251560448;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="140.4pt,34.8pt" to="147.65pt,34.85pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 186px; margin-top: 45px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251560448;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1066" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ingatlah bahwa kampensasi ginjal dan pernafasan
jarang memulihkan PH kembali normal sehingga jika ditemukan PH yang normal
meskipun ada perubahan dalam PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ,mungkin ada gangguan campuran ; contohnya
seorang pasien dengan asidosis respiratorik yang bercampur dengan alkalosis
metabolik mungkin akan mempunyai PH yang normal.<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1079"
style='position:absolute;left:0;text-align:left;z-index:251573760;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251573760;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1079" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan variabel pernafasan (PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">) dan metabolik HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , yang berhubungan dengan<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> PH untuk
mencoba mengetahui apakah gangguan primer bersifat respiratorik, metabolik <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> atau
campuran.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (40 mmHg), meningkat
atau menurun ?<o:p></o:p></span></div>
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</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1045"
style='position:absolute;left:0;text-align:left;z-index:251538944;
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from="126pt,.85pt" to="133.25pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251538944;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1045" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (24 mEq/L), meningkat
atau menurun ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tambahan : apakah ada kelebihan atau kekurangan basa ?<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1055"
style='position:absolute;left:0;text-align:left;z-index:251549184;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="320.4pt,-.4pt" to="327.65pt,-.35pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251549184;"><span style="height: 3px; left: 0px; left: 426px; position: absolute; top: -2px; width: 12px;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1055" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pada gangguan asam basa sederhana, PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> selalu berubah dalam arah yang sama.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1035"
style='position:absolute;left:0;text-align:left;z-index:251528704;
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from="234pt,0" to="241.25pt,.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251528704;"><span style="height: 2px; left: 0px; left: 311px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1035" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyimpangan dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dalam darah yang berlawanan
menunjukkan adanya gangguan asam basa campuran.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cobalah untuk menduga campuran primer dengan menghubungkan hasil
pemeriksaan yang ditemukan dengan keadaan klinis.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Perkirakan respon kompensatorik yang bakal
terjadi pada gangguan asam basa primer.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika respon kompensatorik
lebih berat atau ringan dari pada yang diperkirakan, mungkin ada gangguan asam
basa campuran (normogram asam basa juga dapat digunakan untuk mengetahui
gangguan asan basa campuran) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hitung selisih (gap) anion
plasma.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika
meningkat ( >16 mEq/l ), mungkin sekali terjadi acidosis metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt;"> </span></span><!--[endif]--><!--[if gte vml 1]><v:line
id="_x0000_s1046" style='position:absolute;left:0;text-align:left;z-index:251539968;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="241.2pt,2.45pt" to="248.45pt,2.5pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 320px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251539968;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1046" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bandingkan besarnya penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> plasma dengan peningkatan selisih anion :
seharusnya sama besar.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1067"
style='position:absolute;left:0;text-align:left;z-index:251561472;
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 484px; margin-top: 22px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251561472;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1067" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1056"
style='position:absolute;left:0;text-align:left;z-index:251550208;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="349.2pt,3.25pt" to="356.45pt,3.3pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 464px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251550208;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1056" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan
< dari selisih anion penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , mungkin komponen dari
acidosis metabolik disebabkan oleh kehilangan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1080"
style='position:absolute;left:0;text-align:left;z-index:251574784;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="450pt,3.05pt" to="457.25pt,3.1pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 599px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251574784;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1080" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan selisih dari anion jauh lebih besar
dari penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> berarti ada alkalosis metabolik yang
menyertainya.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Buat penafsiran tahap akhir.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">gangguan asam-basa sederhana<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Akut (tidak terkompensasi)
atau<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kronik (sebagian atau
sepenuhnya terkompensasi )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam-basa campuran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik dengan selisih anion normal atau lebar.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1122"
style='position:absolute;left:0;text-align:left;z-index:251617792;
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from="284.4pt,10.75pt" to="291.65pt,10.8pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="13" width="378"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1122" width="12" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> )<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1107" style='position:absolute;left:0;text-align:left;z-index:251602432;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="75.6pt,14.65pt" to="82.85pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 100px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251602432;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1107" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer kadar bikarbonat sehingga terjadi
penurunan PH ( peningkatan ion H) . HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF =22 mEq/L
dan PH =7,35. Kompensasi pernafasan segera dimulai untuk menurunkan PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> melalui hiperventilasi
sehinga asidosis metabolik jarang terjadi secara akut.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui
saluran cerna : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Diare<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Ilieotomi ; fistula
pankreas, kantong empedu atau usus halus.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Ureterosigmoidostomi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Asidosis tubulus
proksimal ginjal (RTA)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Inhibitor Karbonik
Anhidrase (Asetazolamid)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Hipoaldosteronisme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1026" style='position:absolute;left:0;text-align:left;z-index:251519488;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="212.4pt,10.55pt" to="241.25pt,10.6pt" o:allowincell="f" strokecolor="blue"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrow="open"
endarrowwidth="narrow" endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 282px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 42px; z-index: 251519488;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image007.gif" v:shapes="_x0000_s1026" width="42" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida (NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cl
NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> + HCl <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan
hiperalimentasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan
secara cepat .<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Peningkatan produksi asam
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat : laktat (perfusi jaringan atau aksigenasi yang tidak
memadai seperti pada syok atau henti kardiopulmonar)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ketoasidosis diabetik : Beta-hidroksibutirat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelaparan: peningkatan asam - asam keto<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi alkohol : peningkatan asam-asam keto<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Menelan substansi toksik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kelebihan dosis salisilat
: Salisilat, laktat, keton<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Metanol atau formaldehid
: formad<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Etilglikol (antibeku) :
oksilat, glikolat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Kegagalan ekskresi asam
: tidak adanya ekskresi NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ; retensi asam sulfat dan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> asam fosfat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. gagal ginjal akut dan
kronik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi
asidosis metabolik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
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" Keton dan
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
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style='position:absolute;left:0;text-align:left;flip:y;z-index:251744768;
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from="118.8pt,10.35pt" to="298.85pt,46.4pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 157px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 243px; z-index: 251744768;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image027.gif" v:shapes="_x0000_s1246" width="243" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
10 ` <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">M</span></b><!--[if gte vml 1]><v:line
id="_x0000_s1295" style='position:absolute;left:0;text-align:left;flip:x;
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o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 138px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251794944;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1295" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ( 0,75<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkao banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan Bikarbonat , mengeluarkan H+, dam
anion lain urin asam. NaHCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">,
larutan lak|at diberikan I V. <o:p></o:p></span></div>
</td>
</tr>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></div>
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<br /></div>
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<td></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image030.gif" v:shapes="_x0000_s1283" width="79" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image032.gif" v:shapes="_x0000_s1291" width="40" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1036" style='position:absolute;left:0;text-align:left;z-index:251529728;
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from="147.6pt,19.4pt" to="154.85pt,19.45pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251529728;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1036" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">peningkatan primer kadar bikarbonat plasma, sehingga
terjadi peningkatan Ph (penurunan H ).
HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF = 2,6 mEq/l dan PH = 7,45. Kompensasi pernapasan berupa
peningkatan Pa CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dengan hipoventilasi ; akan
tetapi tingkat hipoventilasi adalah terbatas karena parnapasan terus berjalan
karena dorongan hipoxia/<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan mela|}i
saluran cerna (berkurangnya volume ECF)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Muntah atau penyedotan
nasogastrik <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Diare dengan kehilangan
klorida<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kehilangan melalui ginjal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Diuretik simpai atau
tiazid (pembatasan NaCl + berkurangnya ECF)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kelebihan
mineralokortikoid<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1). Hiperaldosteronisme<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2). Syndvom cushing ;
tgrapi kortikosteroid eksogen )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3). Makan licorice
berlebihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Karbenisillin atqu
penicillio dosis tinggi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1069" style='position:absolute;left:0;text-align:left;z-index:251563520;
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from="111.6pt,.85pt" to="126.05pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 148px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251563520;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image033.gif" v:shapes="_x0000_s1069" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian Natrium Bikarbonat
berlebihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sundrom susu alkali
(antasid, susu, natrium bkkarbonat)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Darah simpan (sitrat) yang
banyak (>8unit)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik
hiperkapnia (setelah koreksi pada asidosiw respiratorik kronik)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ventinasi mekanis: penurunan yang cepat dari PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> tapi HCO tetap tinggi
sampai0kinjal mengeksekresi kelebihannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya disertai penurunan ECF<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mun|ah atau penyeditan Nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasca-hiperkapnea<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:line
id="_x0000_s1082" style='position:absolute;left:0;text-align:left;z-index:251576832;
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<tbody>
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<td height="13" width="397"></td>
</tr>
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<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1082" width="12" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya tidak dirsertai penurunan Volume
ECF <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelebihan mineralokortikoid<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Edematosa (gagal jantung kongestif, sirosis, sindrom nefrotik).<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
Alkalosis metabolik<o:p></o:p></span></div>
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<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image035.gif" v:shapes="_x0000_s1109" width="69" /></td>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
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20<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></div>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251702784;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1205" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1193"
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from="342pt,15.5pt" to="349.25pt,15.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251677184;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1180" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat karena kehilangan Cl atau karena makan banyak Na bikarbonat<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></div>
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B<o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 263px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251745792;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image041.gif" v:shapes="_x0000_s1247" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1235"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251733504;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1235" width="22" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251756032;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1257" width="50" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></div>
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<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
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id="_x0000_s1083" style='position:absolute;left:0;text-align:left;
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strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251577856;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1083" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1070"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251564544;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251564544;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1070" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal mengeluarkan ion
bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi basa<o:p></o:p></span></div>
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<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
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<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1110 _x0000_s1125 _x0000_s1140" width="41" /></td>
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<tr>
<td height="12"></td>
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<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1168" width="2" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
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<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1258" style='position:absolute;left:0;text-align:left;z-index:251757056;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,12.45pt" to="291.65pt,12.5pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251757056;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1258" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang mengandung Cl , atau NH4Cl<o:p></o:p></span></div>
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</tr>
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<br /></div>
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<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image050.gif" v:shapes="_x0000_s1194" width="80" /></td>
<td></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1206" width="79" /></td>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></div>
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<br /></div>
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<!--[if gte vml 1]><v:rect id="_x0000_s1216"
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251714048;"><span style="height: 41px; left: 0px; left: 100px; position: absolute; top: -1px; width: 271px;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image052.gif" v:shapes="_x0000_s1216 _x0000_s1227 _x0000_s1236" width="271" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></div>
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<td height="0" width="215"></td>
</tr>
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<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image053.gif" v:shapes="_x0000_s1248" width="31" /></td>
</tr>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ditandai dengan peningkatan
primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hiperkapnea), sehingga
terjadi penurunan PH; PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> >
45 mmHg dan PH . 7,35.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 340px; margin-top: 5px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251552256;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1058" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kompensasi ginjal mengakibatkan peningkatan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum. Asidosis respirasi dapat timbul secara
akut maupun kronik. Hipoksemia (PaO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> rendah) selalu menyertai asidosis respiratorik. Jika pasien bernafas
dalam udara ruangan.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat pernafasan di medula oblongata<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obat-obatan : Kelebihan
dosis opiat, sedatif, anestetik (akut)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Terapi oksigen pada
hiperkapnea kronik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti jantung (akut)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apnea saat tidur <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyakit neuromuskuler :
miastenia gravis, sindrom guillain-Barre, poliomielitis, sklerosis lateral
amiotropik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deformitas rongga dada :
kifoskoliosis<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obesitas yang berlebihan :
sindrom pickwikian<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera dinding dada seperti
patah tulang-tulang iga <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PPOM (emfisema dan
bronkitis)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tahap akhir penyakit paru
intrinsik yang difus<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumona atau asama yang
berat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Edema paru akut<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumotorak<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas yang akut <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Aspirasi benda asing atau
muntah<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laringospasme atau edema
laring, bronkospasme berat <o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum
Asidosis<o:p></o:p></span></div>
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<br /></div>
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B <o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 40px; z-index: 251578880;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image057.gif" v:shapes="_x0000_s1084" width="40" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru
menahan CO2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="15" width="292"></td>
</tr>
<tr>
<td></td>
<td><img height="60" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image058.gif" v:shapes="_x0000_s1111" width="69" /></td>
</tr>
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<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 52px; margin-top: 6px; mso-ignore: vglayout; position: absolute; width: 98px; z-index: 251591168;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image059.gif" v:shapes="_x0000_s1096" width="98" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251621888;"><span style="height: 51px; left: 0px; left: 90px; position: absolute; top: -2px; width: 271px;"><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image062.gif" v:shapes="_x0000_s1126" width="271" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 20<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="22" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image063.gif" v:shapes="_x0000_s1182 _x0000_s1195 _x0000_s1207" width="21" /></td>
</tr>
<tr>
<td height="12"></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image064.gif" v:shapes="_x0000_s1155" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 261.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1217"
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margin-top:10.4pt;width:72.05pt;height:72.05pt;z-index:251715072;
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<td width="98"></td>
<td width="151"></td>
<td width="89"></td>
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<td height="79"></td>
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<td height="19"></td>
</tr>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
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<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1237"
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o:allowincell="f" strokeweight="1pt">
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<tbody>
<tr>
<td height="5" width="71"></td>
</tr>
<tr>
<td></td>
<td><img height="61" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image067.gif" v:shapes="_x0000_s1237 _x0000_s1249 _x0000_s1259 _x0000_s1266 _x0000_s1270 _x0000_s1274" width="319" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1278"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 215px; margin-top: 26px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251777536;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image068.gif" v:shapes="_x0000_s1278" width="21" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
2 Urin
menjadi asam<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:oval id="_x0000_s1097"
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margin-top:1.65pt;width:64.85pt;height:64.85pt;z-index:251592192;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="1" width="61"></td>
<td width="89"></td>
<td width="161"></td>
<td width="89"></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image069.gif" v:shapes="_x0000_s1097" width="89" /></td>
<td></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image070.gif" v:shapes="_x0000_s1112" width="89" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1127"
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<tbody>
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<td height="13" width="90"></td>
</tr>
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<td></td>
<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image071.gif" v:shapes="_x0000_s1127 _x0000_s1142 _x0000_s1156 _x0000_s1170" width="290" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> B <o:p></o:p></span></b></div>
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20 <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image084.gif" v:shapes="_x0000_s1061 _x0000_s1073 _x0000_s1086" width="339" /></td>
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</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251594240;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1099" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="263"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1144" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1172"
style='position:absolute;left:0;text-align:left;margin-left:320.4pt;
margin-top:3.55pt;width:79.25pt;height:79.25pt;z-index:251668992;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="4" width="119"></td>
<td width="89"></td>
<td width="218"></td>
<td width="108"></td>
</tr>
<tr>
<td height="19"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image089.gif" v:shapes="_x0000_s1172" width="108" /></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image090.gif" v:shapes="_x0000_s1158" width="89" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="16" width="148"></td>
</tr>
<tr>
<td></td>
<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image091.gif" v:shapes="_x0000_s1185 _x0000_s1197 _x0000_s1208" width="348" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 293.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1238" style='position:absolute;left:0;text-align:left;z-index:251736576;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="406.8pt,40.35pt" to="414.05pt,40.4pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 541px; margin-top: 53px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251736576;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1238" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1218"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251716096;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1218" width="41" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
</td>
<td style="background: #CCCCCC; border-left: none; border: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1029" style='position:absolute;left:0;text-align:left;z-index:251522560;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251522560;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1029" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
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<br /></div>
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<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1030" style='position:absolute;left:0;text-align:left;z-index:251523584;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251523584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1030" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
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<br /></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1040" style='position:absolute;left:0;text-align:left;z-index:251533824;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,14.65pt" to="133.25pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251533824;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1040" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Respiratorik
</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 103.5pt;" valign="top" width="138">
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 + :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH $ :<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.3pt;" valign="top" width="142">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">24,0
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">20
: 1<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">40,0
mmIg<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ` <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunen eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 ` 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Respiratorik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">FIK UI B’
95</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
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<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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<br /></div>
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<br /></div>
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<b><u><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">DAFTAR KEPUSTAKAAN</span></u></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Guyton, Arthur C, Fisiologi Manusia dan Mekanisme
Penyakit, EGC Penerbitan Buku Kedokteran, Jakarta, 1987.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Price Sylvia Anderson; Wilson Mc. Carty,
Pathofisiologi Konsep Klinik Proses-proses Penyakit, EGC Penerbit Buku
Kedokteran, Jakarta, 1993.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Soeparman, Ilmu Penyakit Dalam, UI Press, Jakarta,
1991.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">-------, Dasar-dasar
Keperawatan Kardiotorasik, Rumah Sakit Jantung “Harapan Kita”, Jakarta, 1989<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">Gangguan
Keseimbangan Asam Basa<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">A. Penilaian
Ketidakseimbangan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Penilaian
Sistematik dan Penilaian gangguan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">_____________________________________________________<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">kecurigaan
klinis<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan tanda dan gejala
klinis yang mengarah kepada gangguan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Periksa hasil pemeriksaan
laboratorium untuk elektrolit dan data lainnya yang mengarah kepada proses
penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menilai
variabel-variabel asam basa untuk mengetahui tipe gangguan.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pertama, periksa PH darah
arteri untuk menentukan arah dan besarnya gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1087"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251581952;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1087" width="12" /></span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan
variabel pernafasan (PaCO2) dan metabolik HCO3
, yang berhubungan dengan<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">PH untuk mencoba mengetahui
apakah gangguan primer bersifat
respiratorik, metabolik atau campuran.<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perkirakan respon
kompensatorik yang bakal terjadi pada gangguan asam basa primer.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Buat penafsiran tahap akhir.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
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<td height="13" width="378"></td>
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<td></td>
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<!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO3 )<o:p></o:p></span></b></div>
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<br /></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui saluran cerna : <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal :<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></b></div>
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<!--[if gte vml 1]><v:line
id="_x0000_s1267" style='position:absolute;left:0;text-align:left;z-index:251766272;
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from="277.2pt,10.4pt" to="327.65pt,10.45pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrow="open"
endarrowwidth="narrow" endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 368px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 71px; z-index: 251766272;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image092.gif" v:shapes="_x0000_s1267" width="71" /></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida
(NH4Cl NH3 + HCl) <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan hiperalimentasi <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan secara cepat .<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan produksi asam :<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menelan substansi toksik.
Kegagalan ekskresi asam : tidak adanya
ekskresi NH4 ; retensi asam sulfat dan
asam fosfat (gagal ginjal akut dan kronik)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi asidosis metabolik<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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<td width="171"></td>
<td width="69"></td>
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<td></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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<td height="8" width="109"></td>
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<td><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image009.gif" v:shapes="_x0000_s1074" width="291" /></td>
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</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251595264;"><span style="height: 31px; left: 0px; left: 253px; position: absolute; top: -1px; width: 22px;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image010.gif" v:shapes="_x0000_s1100" width="22" /></span></span><!--[endif]--><!--[if gte vml 1]><v:line
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251582976;"><span style="height: 31px; left: 0px; left: 234px; position: absolute; top: -1px; width: 22px;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1088" width="22" /></span></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<tbody>
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<td height="9" width="234"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1115" width="41" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 324.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Keton dan peningkatan Cl
menggganti ion bikarbonat<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></b></div>
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<!--[if gte vml 1]><v:oval
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<tbody>
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<td height="1" width="320"></td>
</tr>
<tr>
<td></td>
<td><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image014.gif" v:shapes="_x0000_s1145" width="70" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
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<!--[if gte vml 1]><v:oval id="_x0000_s1131"
style='position:absolute;left:0;text-align:left;margin-left:68.4pt;
margin-top:8.95pt;width:64.85pt;height:64.85pt;z-index:251627008;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 90px; margin-top: 11px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251627008;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image015.gif" v:shapes="_x0000_s1131" width="89" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
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<br /></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 60px; left: 0px; margin-left: 128px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 252px; z-index: 251655680;"><img height="60" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image018.gif" v:shapes="_x0000_s1159" width="252" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
10 <o:p></o:p></span></b></div>
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<tbody>
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<td height="3" width="128"></td>
<td width="12"></td>
<td width="104"></td>
<td width="40"></td>
</tr>
<tr>
<td height="20"></td>
<td colspan="2"></td>
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<tr>
<td height="12"></td>
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<td height="1"></td>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1240" style='position:absolute;left:0;text-align:left;
margin-left:262.8pt;margin-top:6.75pt;width:57.65pt;height:57.65pt;z-index:251738624;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 349px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251738624;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1240" width="79" /></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
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<td height="2" width="109"></td>
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<td><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1229" width="79" /></td>
</tr>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 157px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 243px; z-index: 251749888;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image027.gif" v:shapes="_x0000_s1251" width="243" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
10 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="8" width="138"></td>
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<tr>
<td></td>
<td><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1296" width="12" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,75<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 306.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 153.9pt;" valign="top" width="205">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru
mengeluarkan banyak CO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan Bikarbonat , mengeluarkan H+, dam anion lain urin asam. NaHCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, larutan laktat diberikan
I V. <o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="2" width="100"></td>
<td width="79"></td>
<td width="180"></td>
<td width="79"></td>
</tr>
<tr>
<td height="79"></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image029.gif" v:shapes="_x0000_s1282" width="79" /></td>
<td></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image030.gif" v:shapes="_x0000_s1284" width="79" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1286"
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<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image031.gif" v:shapes="_x0000_s1286 _x0000_s1288 _x0000_s1290" width="281" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<tbody>
<tr>
<td height="6" width="244"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image032.gif" v:shapes="_x0000_s1292" width="40" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi Alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1101"
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<td height="6" width="100"></td>
<td width="69"></td>
<td width="142"></td>
<td width="69"></td>
</tr>
<tr>
<td height="69"></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image034.gif" v:shapes="_x0000_s1101" width="69" /></td>
<td></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image035.gif" v:shapes="_x0000_s1116" width="69" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image036.gif" v:shapes="_x0000_s1132 _x0000_s1146 _x0000_s1160" width="224" /></td>
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<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 224px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251671040;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image037.gif" v:shapes="_x0000_s1174" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1210" style='position:absolute;left:0;text-align:left;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251707904;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1210" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1199"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251696640;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1199" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1186"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251683328;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1186" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat
karena kehilangan Cl atau karena makan
banyak Na bikarbonat<o:p></o:p></span></b></div>
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</tr>
</tbody></table>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></b></div>
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<br /></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1230"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 138px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251728384;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image040.gif" v:shapes="_x0000_s1230" width="242" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251739648;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1241" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251761152;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1262" width="50" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
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mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251584000;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1089" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1075"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251569664;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251569664;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1075" width="79" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal
mengeluarkan ion bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi
basa<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 100px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 175px; z-index: 251657728;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image046.gif" v:shapes="_x0000_s1161" width="175" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1102"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 71px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251597312;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image047.gif" v:shapes="_x0000_s1102" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1133" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1147" style='position:absolute;left:0;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1117 _x0000_s1133 _x0000_s1147" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1175" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah pengobatan<o:p></o:p></span></b></div>
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<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1263" style='position:absolute;left:0;text-align:left;z-index:251762176;
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strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251762176;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1263" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang
mengandung Cl , atau NH4Cl<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251697664;
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1211"
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="15" width="80"></td>
<td width="80"></td>
<td width="151"></td>
<td width="79"></td>
</tr>
<tr>
<td height="80"></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image050.gif" v:shapes="_x0000_s1200" width="80" /></td>
<td></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1211" width="79" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1231"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251719168;"><span style="height: 41px; left: 0px; left: 100px; position: absolute; top: -1px; width: 271px;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image052.gif" v:shapes="_x0000_s1221 _x0000_s1231 _x0000_s1242" width="271" /></span></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1253" style='position:absolute;left:0;text-align:left;z-index:251751936;
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from="162pt,.85pt" to="183.65pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="215"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image053.gif" v:shapes="_x0000_s1253" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat
pernafasan di medula oblongata<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l16 level1 lfo15; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas
yang akut <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum Asidosis<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru menahan CO2<o:p></o:p></span></b></div>
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<table align="left" cellpadding="0" cellspacing="0">
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<td height="15" width="292"></td>
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<tr>
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<td><img height="60" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image058.gif" v:shapes="_x0000_s1118" width="69" /></td>
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<br clear="ALL" />
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<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251630080;"><span style="height: 51px; left: 0px; left: 90px; position: absolute; top: -2px; width: 271px;"><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image062.gif" v:shapes="_x0000_s1134" width="271" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
20<o:p></o:p></span></div>
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<tbody>
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<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="22" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image063.gif" v:shapes="_x0000_s1188 _x0000_s1201 _x0000_s1212" width="21" /></td>
</tr>
<tr>
<td height="12"></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image064.gif" v:shapes="_x0000_s1162" width="2" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 261.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="13" width="52"></td>
<td width="98"></td>
<td width="151"></td>
<td width="89"></td>
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<td height="79"></td>
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<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image066.gif" v:shapes="_x0000_s1232" width="89" /></td>
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<tr>
<td height="19"></td>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<tbody>
<tr>
<td height="5" width="71"></td>
</tr>
<tr>
<td></td>
<td><img height="61" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image067.gif" v:shapes="_x0000_s1243 _x0000_s1254 _x0000_s1264 _x0000_s1268 _x0000_s1272 _x0000_s1276" width="319" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;z-index:251779584;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 215px; margin-top: 26px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251779584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image068.gif" v:shapes="_x0000_s1280" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
Urin menjadi asam<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan
setelah pengobatan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="1" width="61"></td>
<td width="89"></td>
<td width="161"></td>
<td width="89"></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image069.gif" v:shapes="_x0000_s1104" width="89" /></td>
<td></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image070.gif" v:shapes="_x0000_s1119" width="89" /></td>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l3 level1 lfo17; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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B <o:p></o:p></span></b></div>
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20 <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
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<br /></div>
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<td width="88"></td>
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<td width="108"></td>
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<td></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 263px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251616768;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image086.gif" v:shapes="_x0000_s1121" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1106"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251601408;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1106" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
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<tbody>
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<td height="10" width="263"></td>
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<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1151" width="31" /></td>
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<tbody>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1179"
style='position:absolute;left:0;text-align:left;margin-left:320.4pt;
margin-top:3.55pt;width:79.25pt;height:79.25pt;z-index:251676160;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="4" width="119"></td>
<td width="89"></td>
<td width="218"></td>
<td width="108"></td>
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<td height="19"></td>
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<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image089.gif" v:shapes="_x0000_s1179" width="108" /></td>
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<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image090.gif" v:shapes="_x0000_s1165" width="89" /></td>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<br /></div>
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<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image091.gif" v:shapes="_x0000_s1191 _x0000_s1203 _x0000_s1213" width="348" /></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
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<tbody>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
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strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 541px; margin-top: 53px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251742720;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1244" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1223"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251721216;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1223" width="41" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
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<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
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<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
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<td style="background: #CCCCCC; border-left: none; border: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
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<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1033" style='position:absolute;left:0;text-align:left;z-index:251526656;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251526656;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1033" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1034" style='position:absolute;left:0;text-align:left;z-index:251527680;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251527680;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1034" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1044" style='position:absolute;left:0;text-align:left;z-index:251537920;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,14.65pt" to="133.25pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251537920;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1044" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Respiratorik
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Metabolik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 198.0pt;" valign="top" width="264">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 +
24,0 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 20 : 1<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,4<o:p></o:p></span></div>
</td>
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<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Metabolik
<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunan eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Respiratorik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
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<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-60117463950083019052012-11-07T18:13:00.003-08:002012-11-07T18:13:47.068-08:00GANGGUAN KETIDAKSEIMBANGAN ASAM BASA<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">GANGGUAN
KETIDAKSEIMBANGAN ASAM BASA</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penilaian Sistematik daam Penilaian gangguan asam
basa<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">___________________________________________________________________________<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Awali dengan kecurigaan klinis yang tinggi <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ini membutuhkan pengetahuan tentang patogensis dari berbagai gangguan
asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contohnya, asidosis respiratorik mungkin dapat diperkirakan timbul pada
penderita penyakit paru obstruksi menahun.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan tanda dan gejala klinis yang mengarah
kepada gangguan asam basa.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sayang sekali, banyak tanda dan gejala dari gangguan asam basa tidak
jelas dan non spesifik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, pernafasan kussmaul pada pasien
diabetes dapat merupakan tanda kompensasi pernafasan terhadap asidosis
metabolik.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Periksa hasil pemeriksaan laboratorium untuk
elektrolit dan data lainnya yang mengarah <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> kepada
proses penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, hipokalemia sering berkaitan dengan alkalosis metabolik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh, peningkatan kadar kreatinin serum menunjukkan insufesiensi
ginjal dan insufesiensi serta gagal ginjal sering disertai asidosis metabolik.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menilai variabel-variabel asam basa untuk mengetahui
tipe gangguan.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Pertama, periksa PH darah arteri untuk menentukan
arah dan besarnya gangguan asam basa.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika menurun, pasien mengalami asidemia dengan dua sebab yang mungkin :
asidosis metabolik atau asidosis respiratorik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika meningkat, pasien mengalami alkalemia dengan dua sebab yang
mungkin : alkalosis metabolik atau alkalosis respiratorik.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1066"
style='position:absolute;left:0;text-align:left;z-index:251560448;
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from="140.4pt,34.8pt" to="147.65pt,34.85pt" o:allowincell="f" strokeweight="1pt">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 186px; margin-top: 45px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251560448;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1066" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ingatlah bahwa kampensasi ginjal dan pernafasan
jarang memulihkan PH kembali normal sehingga jika ditemukan PH yang normal
meskipun ada perubahan dalam PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ,mungkin ada gangguan campuran ; contohnya
seorang pasien dengan asidosis respiratorik yang bercampur dengan alkalosis
metabolik mungkin akan mempunyai PH yang normal.<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1079"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251573760;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1079" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Perhatikan variabel pernafasan (PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">) dan metabolik HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , yang berhubungan dengan<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> PH untuk
mencoba mengetahui apakah gangguan primer bersifat respiratorik, metabolik <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> atau
campuran.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (40 mmHg), meningkat
atau menurun ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1045"
style='position:absolute;left:0;text-align:left;z-index:251538944;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,.85pt" to="133.25pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251538944;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1045" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apakah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> normal (24 mEq/L), meningkat
atau menurun ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tambahan : apakah ada kelebihan atau kekurangan basa ?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1055"
style='position:absolute;left:0;text-align:left;z-index:251549184;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="320.4pt,-.4pt" to="327.65pt,-.35pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251549184;"><span style="height: 3px; left: 0px; left: 426px; position: absolute; top: -2px; width: 12px;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1055" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pada gangguan asam basa sederhana, PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> selalu berubah dalam arah yang sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1035"
style='position:absolute;left:0;text-align:left;z-index:251528704;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="234pt,0" to="241.25pt,.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251528704;"><span style="height: 2px; left: 0px; left: 311px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" v:shapes="_x0000_s1035" width="12" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyimpangan dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dalam darah yang berlawanan
menunjukkan adanya gangguan asam basa campuran.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cobalah untuk menduga campuran primer dengan menghubungkan hasil
pemeriksaan yang ditemukan dengan keadaan klinis.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Perkirakan respon kompensatorik yang bakal
terjadi pada gangguan asam basa primer.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika respon kompensatorik
lebih berat atau ringan dari pada yang diperkirakan, mungkin ada gangguan asam
basa campuran (normogram asam basa juga dapat digunakan untuk mengetahui
gangguan asan basa campuran) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hitung selisih (gap) anion
plasma.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika
meningkat ( >16 mEq/l ), mungkin sekali terjadi acidosis metabolik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l8 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c.<span style="font-size: 7pt;"> </span></span><!--[endif]--><!--[if gte vml 1]><v:line
id="_x0000_s1046" style='position:absolute;left:0;text-align:left;z-index:251539968;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="241.2pt,2.45pt" to="248.45pt,2.5pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 320px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251539968;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1046" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bandingkan besarnya penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> plasma dengan peningkatan selisih anion :
seharusnya sama besar.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1067"
style='position:absolute;left:0;text-align:left;z-index:251561472;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="363.6pt,17.65pt" to="370.85pt,17.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 484px; margin-top: 22px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251561472;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1067" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1056"
style='position:absolute;left:0;text-align:left;z-index:251550208;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="349.2pt,3.25pt" to="356.45pt,3.3pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 464px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251550208;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image006.gif" v:shapes="_x0000_s1056" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan
< dari selisih anion penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> , mungkin komponen dari
acidosis metabolik disebabkan oleh kehilangan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1080"
style='position:absolute;left:0;text-align:left;z-index:251574784;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="450pt,3.05pt" to="457.25pt,3.1pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 599px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251574784;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1080" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika peningkatan selisih dari anion jauh lebih besar
dari penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> berarti ada alkalosis metabolik yang
menyertainya.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Buat penafsiran tahap akhir.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">gangguan asam-basa sederhana<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Akut (tidak terkompensasi)
atau<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l14 level1 lfo4; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kronik (sebagian atau
sepenuhnya terkompensasi )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam-basa campuran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik dengan selisih anion normal atau lebar.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1122"
style='position:absolute;left:0;text-align:left;z-index:251617792;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,10.75pt" to="291.65pt,10.8pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="13" width="378"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1122" width="12" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> )<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1107" style='position:absolute;left:0;text-align:left;z-index:251602432;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="75.6pt,14.65pt" to="82.85pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 100px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251602432;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1107" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer kadar bikarbonat sehingga terjadi
penurunan PH ( peningkatan ion H) . HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF =22 mEq/L
dan PH =7,35. Kompensasi pernafasan segera dimulai untuk menurunkan PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> melalui hiperventilasi
sehinga asidosis metabolik jarang terjadi secara akut.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui
saluran cerna : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Diare<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Ilieotomi ; fistula
pankreas, kantong empedu atau usus halus.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Ureterosigmoidostomi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1) Asidosis tubulus
proksimal ginjal (RTA)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2) Inhibitor Karbonik
Anhidrase (Asetazolamid)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3) Hipoaldosteronisme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
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from="212.4pt,10.55pt" to="241.25pt,10.6pt" o:allowincell="f" strokecolor="blue"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrow="open"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 282px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 42px; z-index: 251519488;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image007.gif" v:shapes="_x0000_s1026" width="42" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida (NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cl
NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> + HCl <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan
hiperalimentasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan
secara cepat .<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Peningkatan produksi asam
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat : laktat (perfusi jaringan atau aksigenasi yang tidak
memadai seperti pada syok atau henti kardiopulmonar)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ketoasidosis diabetik : Beta-hidroksibutirat.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelaparan: peningkatan asam - asam keto<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi alkohol : peningkatan asam-asam keto<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Menelan substansi toksik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Kelebihan dosis salisilat
: Salisilat, laktat, keton<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Metanol atau formaldehid
: formad<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Etilglikol (antibeku) :
oksilat, glikolat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Kegagalan ekskresi asam
: tidak adanya ekskresi NH</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">4</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ; retensi asam sulfat dan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> asam fosfat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. gagal ginjal akut dan
kronik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi
asidosis metabolik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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<td width="69"></td>
</tr>
<tr>
<td height="70"></td>
<td align="left" valign="top"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image008.gif" v:shapes="_x0000_s1047" width="69" /></td>
<td></td>
<td align="left" valign="top"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image008.gif" v:shapes="_x0000_s1057" width="69" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<br clear="ALL" />
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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<td><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image009.gif" v:shapes="_x0000_s1068" width="291" /></td>
</tr>
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<br clear="ALL" />
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1
20<o:p></o:p></span></div>
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<br clear="ALL" />
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" Keton dan
peningkatan Cl
! a menggganti ion bikarbonat<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></div>
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<td><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image014.gif" v:shapes="_x0000_s1138" width="70" /></td>
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<br clear="ALL" />
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK `
!
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<td align="left" rowspan="2" valign="top"><img height="32" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image019.gif" v:shapes="_x0000_s1192 _x0000_s1204 _x0000_s1214" width="40" /></td>
</tr>
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<td align="left" rowspan="2" valign="top"><img height="13" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image020.gif" v:shapes="_x0000_s1166 _x0000_s1245" width="12" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1234" style='position:absolute;left:0;text-align:left;
margin-left:262.8pt;margin-top:6.75pt;width:57.65pt;height:57.65pt;z-index:251732480;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 349px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251732480;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1234" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ! ` ! B <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1225"
style='position:absolute;left:0;text-align:left;margin-left:82.8pt;
margin-top:2.25pt;width:57.65pt;height:57.65pt;z-index:251723264;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
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<td height="2" width="109"></td>
</tr>
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<td></td>
<td><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1225" width="79" /></td>
</tr>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 272px; margin-top: 70px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251776512;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image023.gif" v:shapes="_x0000_s1277" width="41" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1273"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 32px; left: 0px; margin-left: 292px; margin-top: 41px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251768320;"><img height="32" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image025.gif" v:shapes="_x0000_s1269" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1256"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 60px; left: 0px; margin-left: 138px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 290px; z-index: 251755008;"><img height="60" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image026.gif" v:shapes="_x0000_s1256" width="290" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1246"
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from="118.8pt,10.35pt" to="298.85pt,46.4pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 157px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 243px; z-index: 251744768;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image027.gif" v:shapes="_x0000_s1246" width="243" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
10 ` <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">M</span></b><!--[if gte vml 1]><v:line
id="_x0000_s1295" style='position:absolute;left:0;text-align:left;flip:x;
z-index:251794944;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="104.4pt,6.75pt" to="111.65pt,14pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 138px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251794944;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1295" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ( 0,75<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 306.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 153.9pt;" valign="top" width="205">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkao banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan Bikarbonat , mengeluarkan H+, dam
anion lain urin asam. NaHCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">,
larutan lak|at diberikan I V. <o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1281"
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1283"
style='position:absolute;left:0;text-align:left;margin-left:270pt;
margin-top:2.15pt;width:57.65pt;height:57.65pt;z-index:251782656;
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
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<tbody>
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<td height="2" width="100"></td>
<td width="79"></td>
<td width="180"></td>
<td width="79"></td>
</tr>
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<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image029.gif" v:shapes="_x0000_s1281" width="79" /></td>
<td></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image030.gif" v:shapes="_x0000_s1283" width="79" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1285"
style='position:absolute;left:0;text-align:left;margin-left:97.2pt;
margin-top:3.75pt;width:208.85pt;height:7.25pt;z-index:251784704;
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o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1287"
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endarrowlength="long"/>
</v:line><v:line id="_x0000_s1289" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
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<td height="4" width="128"></td>
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<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image031.gif" v:shapes="_x0000_s1285 _x0000_s1287 _x0000_s1289" width="281" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1291"
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from="183.6pt,5pt" to="212.45pt,5.05pt" o:allowincell="f" strokeweight="1pt">
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="6" width="244"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image032.gif" v:shapes="_x0000_s1291" width="40" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1036" style='position:absolute;left:0;text-align:left;z-index:251529728;
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from="147.6pt,19.4pt" to="154.85pt,19.45pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 25px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251529728;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1036" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">peningkatan primer kadar bikarbonat plasma, sehingga
terjadi peningkatan Ph (penurunan H ).
HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> di ECF = 2,6 mEq/l dan PH = 7,45. Kompensasi pernapasan berupa
peningkatan Pa CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> dengan hipoventilasi ; akan
tetapi tingkat hipoventilasi adalah terbatas karena parnapasan terus berjalan
karena dorongan hipoxia/<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan mela|}i
saluran cerna (berkurangnya volume ECF)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Muntah atau penyedotan
nasogastrik <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Diare dengan kehilangan
klorida<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kehilangan melalui ginjal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">a. Diuretik simpai atau
tiazid (pembatasan NaCl + berkurangnya ECF)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">b. Kelebihan
mineralokortikoid<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(1). Hiperaldosteronisme<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(2). Syndvom cushing ;
tgrapi kortikosteroid eksogen )<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">(3). Makan licorice
berlebihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">c. Karbenisillin atqu
penicillio dosis tinggi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1069" style='position:absolute;left:0;text-align:left;z-index:251563520;
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from="111.6pt,.85pt" to="126.05pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 148px; margin-top: 0px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251563520;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image033.gif" v:shapes="_x0000_s1069" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian Natrium Bikarbonat
berlebihan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sundrom susu alkali
(antasid, susu, natrium bkkarbonat)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Darah simpan (sitrat) yang
banyak (>8unit)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l15 level1 lfo5; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik
hiperkapnia (setelah koreksi pada asidosiw respiratorik kronik)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 108.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ventinasi mekanis: penurunan yang cepat dari PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> tapi HCO tetap tinggi
sampai0kinjal mengeksekresi kelebihannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya disertai penurunan ECF<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mun|ah atau penyeditan Nasogastrik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deuretik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasca-hiperkapnea<o:p></o:p></span></div>
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<td height="13" width="397"></td>
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<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1082" width="12" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Biasanya tidak dirsertai penurunan Volume
ECF <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kelebihan mineralokortikoid<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Edematosa (gagal jantung kongestif, sirosis, sindrom nefrotik).<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
Alkalosis metabolik<o:p></o:p></span></div>
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<br /></div>
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
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<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image034.gif" v:shapes="_x0000_s1094" width="69" /></td>
<td></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image035.gif" v:shapes="_x0000_s1109" width="69" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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style='position:absolute;left:0;text-align:left;margin-left:97.2pt;
margin-top:13.5pt;width:165.65pt;height:7.25pt;z-index:251619840;
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<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image036.gif" v:shapes="_x0000_s1124 _x0000_s1139 _x0000_s1153" width="224" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<br /></div>
<br clear="ALL" />
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<!--[if gte vml 1]><v:line id="_x0000_s1167"
style='position:absolute;left:0;text-align:left;z-index:251663872;
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from="169.2pt,7.15pt" to="183.65pt,7.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 224px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251663872;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image037.gif" v:shapes="_x0000_s1167" width="22" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
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o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251702784;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1205" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1193"
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strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251690496;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1193" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1180"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251677184;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1180" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat karena kehilangan Cl atau karena makan banyak Na bikarbonat<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></div>
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<br /></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1226"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 138px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251724288;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image040.gif" v:shapes="_x0000_s1226" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 263px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251745792;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image041.gif" v:shapes="_x0000_s1247" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1235"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251733504;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1235" width="22" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251756032;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1257" width="50" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></div>
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<tbody>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1083" style='position:absolute;left:0;text-align:left;
margin-left:190.8pt;margin-top:58.05pt;width:72.05pt;height:64.85pt;
z-index:251577856;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251577856;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1083" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1070"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251564544;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251564544;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1070" width="79" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal mengeluarkan ion
bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi basa<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 100px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 175px; z-index: 251650560;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image046.gif" v:shapes="_x0000_s1154" width="175" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1095"
style='position:absolute;left:0;text-align:left;z-index:251590144;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 71px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251590144;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image047.gif" v:shapes="_x0000_s1095" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
1<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1110"
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1125" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251620864;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="126pt,3.2pt" to="140.45pt,32.05pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1140" style='position:absolute;left:0;
text-align:left;z-index:251636224;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="140.4pt,3.2pt" to="154.85pt,32.05pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1168" style='position:absolute;left:0;
text-align:left;z-index:251664896;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="234pt,25.05pt" to="234.05pt,32.3pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1110 _x0000_s1125 _x0000_s1140" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1168" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1258" style='position:absolute;left:0;text-align:left;z-index:251757056;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,12.45pt" to="291.65pt,12.5pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251757056;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1258" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang mengandung Cl , atau NH4Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1194"
style='position:absolute;left:0;text-align:left;margin-left:61.2pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251691520;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1206"
style='position:absolute;left:0;text-align:left;margin-left:234pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251703808;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="15" width="80"></td>
<td width="80"></td>
<td width="151"></td>
<td width="79"></td>
</tr>
<tr>
<td height="80"></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image050.gif" v:shapes="_x0000_s1194" width="80" /></td>
<td></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1206" width="79" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1216"
style='position:absolute;left:0;text-align:left;margin-left:75.6pt;
margin-top:0;width:201.65pt;height:7.25pt;z-index:251714048;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1227"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251725312;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="162pt,7.2pt" to="176.45pt,28.85pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1236" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251714048;"><span style="height: 41px; left: 0px; left: 100px; position: absolute; top: -1px; width: 271px;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image052.gif" v:shapes="_x0000_s1216 _x0000_s1227 _x0000_s1236" width="271" /></span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1248" style='position:absolute;left:0;text-align:left;z-index:251746816;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="162pt,.85pt" to="183.65pt,.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="0" width="215"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image053.gif" v:shapes="_x0000_s1248" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ditandai dengan peningkatan
primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hiperkapnea), sehingga
terjadi penurunan PH; PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> >
45 mmHg dan PH . 7,35.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1058" style='position:absolute;left:0;text-align:left;z-index:251552256;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="255.6pt,4.85pt" to="262.85pt,4.9pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 340px; margin-top: 5px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251552256;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image005.gif" v:shapes="_x0000_s1058" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kompensasi ginjal mengakibatkan peningkatan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum. Asidosis respirasi dapat timbul secara
akut maupun kronik. Hipoksemia (PaO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> rendah) selalu menyertai asidosis respiratorik. Jika pasien bernafas
dalam udara ruangan.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat pernafasan di medula oblongata<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obat-obatan : Kelebihan
dosis opiat, sedatif, anestetik (akut)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Terapi oksigen pada
hiperkapnea kronik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti jantung (akut)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l1 level1 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Apnea saat tidur <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyakit neuromuskuler :
miastenia gravis, sindrom guillain-Barre, poliomielitis, sklerosis lateral
amiotropik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Deformitas rongga dada :
kifoskoliosis<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obesitas yang berlebihan :
sindrom pickwikian<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l4 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera dinding dada seperti
patah tulang-tulang iga <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PPOM (emfisema dan
bronkitis)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tahap akhir penyakit paru
intrinsik yang difus<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumona atau asama yang
berat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Edema paru akut<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l12 level1 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumotorak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas yang akut <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l13 level1 lfo9; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Aspirasi benda asing atau
muntah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 72.0pt; mso-list: l13 level1 lfo9; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laringospasme atau edema
laring, bronkospasme berat <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum
Asidosis<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<br clear="ALL" />
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
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<br /></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 196px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 40px; z-index: 251578880;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image057.gif" v:shapes="_x0000_s1084" width="40" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru
menahan CO2<o:p></o:p></span></div>
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<td height="15" width="292"></td>
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<td></td>
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</tr>
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<br clear="ALL" />
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<!--[if gte vml 1]><v:oval
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></div>
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id="_x0000_s1169" style='position:absolute;left:0;text-align:left;z-index:251665920;
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<tbody>
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<td height="8" width="90"></td>
<td width="2"></td>
<td width="123"></td>
<td width="21"></td>
</tr>
<tr>
<td height="10"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="22" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image063.gif" v:shapes="_x0000_s1182 _x0000_s1195 _x0000_s1207" width="21" /></td>
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<tr>
<td height="12"></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image064.gif" v:shapes="_x0000_s1155" width="2" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></div>
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<tbody>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 198.9pt;" valign="top" width="265">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></div>
</td>
</tr>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></div>
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30<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
2 Urin
menjadi asam<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
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<br /></div>
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<div class="MsoNormal" style="text-align: justify;">
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<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l10 level1 lfo10; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l7 level1 lfo11; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
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20<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> B <o:p></o:p></span></b></div>
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251623936;"><span style="height: 51px; left: 0px; left: 128px; position: absolute; top: -1px; width: 396px;"><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image077.gif" v:shapes="_x0000_s1128 _x0000_s1143 _x0000_s1183" width="396" /></span></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 320px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251667968;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image079.gif" v:shapes="_x0000_s1171" width="22" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1157"
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from="226.8pt,8.55pt" to="241.25pt,30.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251653632;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image080.gif" v:shapes="_x0000_s1157" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1184"
style='position:absolute;left:0;text-align:left;z-index:251681280;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="226.8pt,3.15pt" to="255.65pt,3.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 3px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251681280;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image081.gif" v:shapes="_x0000_s1184" width="41" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;margin-left:75.6pt;
margin-top:8.55pt;width:64.85pt;height:64.85pt;z-index:251532800;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1050"
style='position:absolute;left:0;text-align:left;margin-left:306pt;
margin-top:8.55pt;width:79.25pt;height:79.25pt;z-index:251544064;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="100"></td>
<td width="88"></td>
<td width="219"></td>
<td width="108"></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image082.gif" v:shapes="_x0000_s1039" width="88" /></td>
<td></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image083.gif" v:shapes="_x0000_s1050" width="108" /></td>
</tr>
<tr>
<td height="19"></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1061"
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</v:line><v:line id="_x0000_s1073" style='position:absolute;left:0;
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o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><v:line id="_x0000_s1086" style='position:absolute;left:0;
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="7" width="128"></td>
</tr>
<tr>
<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image084.gif" v:shapes="_x0000_s1061 _x0000_s1073 _x0000_s1086" width="339" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 282px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251624960;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image085.gif" v:shapes="_x0000_s1129" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1114"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251609600;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="198pt,6.75pt" to="212.45pt,35.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 41px; left: 0px; margin-left: 263px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251609600;"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image086.gif" v:shapes="_x0000_s1114" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1099"
style='position:absolute;left:0;text-align:left;z-index:251594240;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="349.2pt,6.75pt" to="349.25pt,14pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 464px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 3px; z-index: 251594240;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image087.gif" v:shapes="_x0000_s1099" width="3" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1144"
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mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="10" width="263"></td>
</tr>
<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1144" width="31" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1158" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:18.2pt;width:64.85pt;height:64.85pt;z-index:251654656;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1172"
style='position:absolute;left:0;text-align:left;margin-left:320.4pt;
margin-top:3.55pt;width:79.25pt;height:79.25pt;z-index:251668992;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="4" width="119"></td>
<td width="89"></td>
<td width="218"></td>
<td width="108"></td>
</tr>
<tr>
<td height="19"></td>
<td colspan="2"></td>
<td align="left" rowspan="2" valign="top"><img height="108" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image089.gif" v:shapes="_x0000_s1172" width="108" /></td>
</tr>
<tr>
<td height="89"></td>
<td align="left" valign="top"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image090.gif" v:shapes="_x0000_s1158" width="89" /></td>
</tr>
</tbody></table>
<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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style='position:absolute;left:0;text-align:left;margin-left:111.6pt;
margin-top:12.7pt;width:259.25pt;height:7.25pt;z-index:251682304;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:line id="_x0000_s1197"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251694592;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="16" width="148"></td>
</tr>
<tr>
<td></td>
<td><img height="51" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image091.gif" v:shapes="_x0000_s1185 _x0000_s1197 _x0000_s1208" width="348" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
10,5 <o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 293.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1238" style='position:absolute;left:0;text-align:left;z-index:251736576;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="406.8pt,40.35pt" to="414.05pt,40.4pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 541px; margin-top: 53px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251736576;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1238" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1218"
style='position:absolute;left:0;text-align:left;z-index:251716096;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="226.8pt,8.2pt" to="255.65pt,8.25pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 41px; z-index: 251716096;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image012.gif" v:shapes="_x0000_s1218" width="41" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #CCCCCC; border-right: solid windowtext 1.0pt; border: solid windowtext 1.5pt; mso-border-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
</td>
<td style="background: #CCCCCC; border-left: none; border: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext .75pt; mso-pattern: gray-20 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
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<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
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<br /></div>
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<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1029" style='position:absolute;left:0;text-align:left;z-index:251522560;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251522560;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1029" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
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<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
</td>
</tr>
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<td style="border-left: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1030" style='position:absolute;left:0;text-align:left;z-index:251523584;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 167px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251523584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1030" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik + Alkalosis respiratorik PCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH mendekati normal<o:p></o:p></span></div>
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<td style="border-right: solid windowtext 1.5pt; border: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
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<br /></div>
</td>
</tr>
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<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: none; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1040" style='position:absolute;left:0;text-align:left;z-index:251533824;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,14.65pt" to="133.25pt,14.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 167px; margin-top: 18px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251533824;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1040" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH
mendekati normal<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<br /></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td colspan="2" style="border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Respiratorik
</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 103.5pt;" valign="top" width="138">
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 + :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH $ :<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 106.3pt;" valign="top" width="142">
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">24,0
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">20
: 1<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">40,0
mmIg<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Metabolik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> ` <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunen eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 ` 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis
Respiratorik</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">FIK UI B’
95</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
</td>
</tr>
<!--[if !supportMisalignedColumns]-->
<tr height="0">
<td style="border: none;" width="169"></td>
<td style="border: none;" width="138"></td>
<td style="border: none;" width="142"></td>
<td style="border: none;" width="165"></td>
</tr>
<!--[endif]-->
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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<br /></div>
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<br /></div>
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<b><u><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">DAFTAR KEPUSTAKAAN</span></u></b><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Guyton, Arthur C, Fisiologi Manusia dan Mekanisme
Penyakit, EGC Penerbitan Buku Kedokteran, Jakarta, 1987.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Price Sylvia Anderson; Wilson Mc. Carty,
Pathofisiologi Konsep Klinik Proses-proses Penyakit, EGC Penerbit Buku
Kedokteran, Jakarta, 1993.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Soeparman, Ilmu Penyakit Dalam, UI Press, Jakarta,
1991.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">-------, Dasar-dasar
Keperawatan Kardiotorasik, Rumah Sakit Jantung “Harapan Kita”, Jakarta, 1989<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">Gangguan
Keseimbangan Asam Basa<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">A. Penilaian
Ketidakseimbangan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Penilaian
Sistematik dan Penilaian gangguan asam basa<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">_____________________________________________________<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">kecurigaan
klinis<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Teliti riwayat klinis dari perjalanan penyakit yang dapat mengakibatkan
ketidakseimbangan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan tanda dan gejala
klinis yang mengarah kepada gangguan asam basa.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Periksa hasil pemeriksaan
laboratorium untuk elektrolit dan data lainnya yang mengarah kepada proses
penyakit yang berkaitan dengan gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menilai
variabel-variabel asam basa untuk mengetahui tipe gangguan.<o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pertama, periksa PH darah
arteri untuk menentukan arah dan besarnya gangguan asam basa.<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1087"
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<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251581952;"><span style="height: 2px; left: 0px; left: 407px; position: absolute; top: -1px; width: 12px;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" v:shapes="_x0000_s1087" width="12" /></span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perhatikan
variabel pernafasan (PaCO2) dan metabolik HCO3
, yang berhubungan dengan<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">PH untuk mencoba mengetahui
apakah gangguan primer bersifat
respiratorik, metabolik atau campuran.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Perkirakan respon
kompensatorik yang bakal terjadi pada gangguan asam basa primer.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l11 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Buat penafsiran tahap akhir.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 18.0pt; mso-bidi-font-size: 10.0pt;">B. Kelainan
yang berhubungan dengan keseimbangan asam basa<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
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<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1130" width="12" /></td>
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<br clear="ALL" />
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> 1. Asidosis Metabolik (kekurangan
bikarbonat =HCO3 )<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab Asidosis Metabolik.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion normal (hiperkloremik)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1. Kehilangan bikarbonat<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Kehilangan melalui saluran cerna : <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Kehilangan melalui ginjal :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Peningkatan beban asam<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
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</v:line><![endif]--><!--[if !vml]--><span style="height: 14px; left: 0px; margin-left: 368px; margin-top: 7px; mso-ignore: vglayout; position: absolute; width: 71px; z-index: 251766272;"><img height="14" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image092.gif" v:shapes="_x0000_s1267" width="71" /></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">a. Amonium klorida
(NH4Cl NH3 + HCl) <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">b. Cairan-cairan hiperalimentasi <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Lain-lain<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 72.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Pemberian IV larutan garan secara cepat .<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Selisih anion meningkat <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan produksi asam :<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l2 level1 lfo14; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Menelan substansi toksik.
Kegagalan ekskresi asam : tidak adanya
ekskresi NH4 ; retensi asam sulfat dan
asam fosfat (gagal ginjal akut dan kronik)<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sebelum terjadi asidosis metabolik<o:p></o:p></span></b></div>
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<br /></div>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
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</v:line><![endif]--><!--[if !vml]--><span style="mso-ignore: vglayout; position: relative; z-index: 251582976;"><span style="height: 31px; left: 0px; left: 234px; position: absolute; top: -1px; width: 22px;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image011.gif" v:shapes="_x0000_s1088" width="22" /></span></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Keton dan peningkatan Cl
menggganti ion bikarbonat<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan asidosis metabolik<o:p></o:p></span></b></div>
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<td height="1" width="320"></td>
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<td><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image014.gif" v:shapes="_x0000_s1145" width="70" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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B <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
10 <o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
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<br /></div>
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<br /></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B <o:p></o:p></span></b></div>
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="2" width="109"></td>
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<tr>
<td></td>
<td><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image021.gif" v:shapes="_x0000_s1229" width="79" /></td>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 157px; margin-top: 13px; mso-ignore: vglayout; position: absolute; width: 243px; z-index: 251749888;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image027.gif" v:shapes="_x0000_s1251" width="243" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
10 <o:p></o:p></span></b></div>
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<br /></div>
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<!--[if gte vml 1]><v:line id="_x0000_s1296"
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="8" width="138"></td>
</tr>
<tr>
<td></td>
<td><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1296" width="12" /></td>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,75<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 306.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 153.9pt;" valign="top" width="205">
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru
mengeluarkan banyak CO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> .<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan Bikarbonat , mengeluarkan H+, dam anion lain urin asam. NaHCO</span></b><b><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span></b><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, larutan laktat diberikan
I V. <o:p></o:p></span></b></div>
</td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan sesudah pengobatan<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if gte vml 1]><v:oval id="_x0000_s1282"
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<td height="2" width="100"></td>
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<td width="79"></td>
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<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image029.gif" v:shapes="_x0000_s1282" width="79" /></td>
<td></td>
<td align="left" valign="top"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image030.gif" v:shapes="_x0000_s1284" width="79" /></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:rect id="_x0000_s1286"
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<td height="4" width="128"></td>
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<td><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image031.gif" v:shapes="_x0000_s1286 _x0000_s1288 _x0000_s1290" width="281" /></td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="6" width="244"></td>
</tr>
<tr>
<td></td>
<td><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image032.gif" v:shapes="_x0000_s1292" width="40" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">2. Alkalosis
metabolik (kelebihan bikarbonat)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab alkalosis metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Kehilangan H dari ECF.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Retensi HCO3<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 126.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabilok yang responsif terhadap Klorida (Cl Kemih 10 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 16.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Asidosis metabolik yang resisten terhadap klorida(Cl kemih 20 mEq/l)<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi Alkalosis metabolik<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<td height="6" width="100"></td>
<td width="69"></td>
<td width="142"></td>
<td width="69"></td>
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<td height="69"></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image034.gif" v:shapes="_x0000_s1101" width="69" /></td>
<td></td>
<td align="left" valign="top"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image035.gif" v:shapes="_x0000_s1116" width="69" /></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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text-align:left;z-index:251656704;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="176.4pt,21pt" to="183.65pt,35.45pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="17" width="128"></td>
</tr>
<tr>
<td></td>
<td><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image036.gif" v:shapes="_x0000_s1132 _x0000_s1146 _x0000_s1160" width="224" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1174"
style='position:absolute;left:0;text-align:left;z-index:251671040;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="169.2pt,7.15pt" to="183.65pt,7.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 224px; margin-top: 8px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251671040;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image037.gif" v:shapes="_x0000_s1174" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Alkalosis Metabolik<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1210" style='position:absolute;left:0;text-align:left;
margin-left:90pt;margin-top:37.1pt;width:50.45pt;height:50.45pt;z-index:251707904;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 70px; left: 0px; margin-left: 119px; margin-top: 48px; mso-ignore: vglayout; position: absolute; width: 69px; z-index: 251707904;"><img height="70" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image038.gif" v:shapes="_x0000_s1210" width="69" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1199"
style='position:absolute;left:0;text-align:left;z-index:251696640;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="320.4pt,29.9pt" to="327.65pt,29.95pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 426px; margin-top: 39px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251696640;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1199" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1186"
style='position:absolute;left:0;text-align:left;z-index:251683328;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="342pt,15.5pt" to="349.25pt,15.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 455px; margin-top: 20px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251683328;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image013.gif" v:shapes="_x0000_s1186" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bikarbinat meningkat
karena kehilangan Cl atau karena makan
banyak Na bikarbonat<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1220" style='position:absolute;left:0;text-align:left;
margin-left:241.2pt;margin-top:9.5pt;width:64.85pt;height:57.65pt;z-index:251718144;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 79px; left: 0px; margin-left: 320px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 89px; z-index: 251718144;"><img height="79" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image039.gif" v:shapes="_x0000_s1220" width="89" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1230"
style='position:absolute;left:0;text-align:left;z-index:251728384;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="104.4pt,3.55pt" to="284.45pt,25.2pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 138px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251728384;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image040.gif" v:shapes="_x0000_s1230" width="242" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1252"
style='position:absolute;left:0;text-align:left;z-index:251750912;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="198pt,3.95pt" to="212.45pt,25.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 263px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251750912;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image041.gif" v:shapes="_x0000_s1252" width="21" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1241"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251739648;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="176.4pt,3.95pt" to="190.85pt,25.6pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 234px; margin-top: 4px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251739648;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image042.gif" v:shapes="_x0000_s1241" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1,25<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1262"
style='position:absolute;left:0;text-align:left;z-index:251761152;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="176.4pt,11.5pt" to="212.45pt,11.55pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 234px; margin-top: 14px; mso-ignore: vglayout; position: absolute; width: 50px; z-index: 251761152;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image043.gif" v:shapes="_x0000_s1262" width="50" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval
id="_x0000_s1089" style='position:absolute;left:0;text-align:left;
margin-left:190.8pt;margin-top:58.05pt;width:72.05pt;height:64.85pt;
z-index:251584000;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' o:allowincell="f" filled="f"
strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 89px; left: 0px; margin-left: 253px; margin-top: 76px; mso-ignore: vglayout; position: absolute; width: 99px; z-index: 251584000;"><img height="89" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image044.gif" v:shapes="_x0000_s1089" width="99" /></span><!--[endif]--><!--[if gte vml 1]><v:oval id="_x0000_s1075"
style='position:absolute;left:0;text-align:left;margin-left:46.8pt;
margin-top:29.25pt;width:57.65pt;height:50.45pt;z-index:251569664;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 61px; margin-top: 38px; mso-ignore: vglayout; position: absolute; width: 79px; z-index: 251569664;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image045.gif" v:shapes="_x0000_s1075" width="79" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru menahan CO2 ginjal
mengeluarkan ion bikarbonat dan menahan ion H + dan ion-ion lain.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Urin menjadi
basa<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1187" style='position:absolute;left:0;text-align:left;flip:y;
z-index:251684352;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="54pt,2.45pt" to="61.25pt,9.7pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 12px; left: 0px; margin-left: 71px; margin-top: 2px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251684352;"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image028.gif" v:shapes="_x0000_s1187" width="12" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1161"
style='position:absolute;left:0;text-align:left;z-index:251657728;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="75.6pt,9.65pt" to="205.25pt,45.7pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 50px; left: 0px; margin-left: 100px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 175px; z-index: 251657728;"><img height="50" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image046.gif" v:shapes="_x0000_s1161" width="175" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1102"
style='position:absolute;left:0;text-align:left;z-index:251597312;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="54pt,9.65pt" to="234.05pt,60.1pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 69px; left: 0px; margin-left: 71px; margin-top: 12px; mso-ignore: vglayout; position: absolute; width: 242px; z-index: 251597312;"><img height="69" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image047.gif" v:shapes="_x0000_s1102" width="242" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1117"
style='position:absolute;left:0;text-align:left;flip:x;z-index:251612672;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="126pt,32pt" to="154.85pt,32.05pt" o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1133" style='position:absolute;left:0;
text-align:left;flip:x;z-index:251629056;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="126pt,3.2pt" to="140.45pt,32.05pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1147" style='position:absolute;left:0;
text-align:left;z-index:251643392;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="140.4pt,3.2pt" to="154.85pt,32.05pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><v:line id="_x0000_s1175" style='position:absolute;left:0;
text-align:left;z-index:251672064;mso-position-horizontal-relative:text;
mso-position-vertical-relative:text' from="234pt,25.05pt" to="234.05pt,32.3pt"
o:allowincell="f" strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="3" width="167"></td>
<td width="41"></td>
<td width="103"></td>
<td width="2"></td>
</tr>
<tr>
<td height="29"></td>
<td align="left" rowspan="2" valign="top"><img height="41" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image048.gif" v:shapes="_x0000_s1117 _x0000_s1133 _x0000_s1147" width="41" /></td>
</tr>
<tr>
<td height="12"></td>
<td></td>
<td align="left" valign="top"><img height="12" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image049.gif" v:shapes="_x0000_s1175" width="2" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
40<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah pengobatan<o:p></o:p></span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 270.9pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 189.9pt;" valign="top" width="253">
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line
id="_x0000_s1263" style='position:absolute;left:0;text-align:left;z-index:251762176;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
from="284.4pt,12.45pt" to="291.65pt,12.5pt" o:allowincell="f"
strokeweight="1pt">
<v:stroke startarrowwidth="narrow" startarrowlength="long" endarrowwidth="narrow"
endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 3px; left: 0px; margin-left: 378px; margin-top: 15px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251762176;"><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" v:shapes="_x0000_s1263" width="12" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pemberian larutan yang
mengandung Cl , atau NH4Cl<o:p></o:p></span></b></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:oval id="_x0000_s1200"
style='position:absolute;left:0;text-align:left;margin-left:61.2pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251697664;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><v:oval id="_x0000_s1211"
style='position:absolute;left:0;text-align:left;margin-left:234pt;
margin-top:12.45pt;width:57.65pt;height:57.65pt;z-index:251708928;
mso-position-horizontal-relative:text;mso-position-vertical-relative:text'
o:allowincell="f" filled="f" strokeweight="1pt"/><![endif]--><!--[if !vml]-->
<table align="left" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td height="15" width="80"></td>
<td width="80"></td>
<td width="151"></td>
<td width="79"></td>
</tr>
<tr>
<td height="80"></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image050.gif" v:shapes="_x0000_s1200" width="80" /></td>
<td></td>
<td align="left" valign="top"><img height="80" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image051.gif" v:shapes="_x0000_s1211" width="79" /></td>
</tr>
</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ak
B<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 1
20 <o:p></o:p></span></b></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">3. Asidosis
Respiratorik (Kelebihan asam karbonat)<o:p></o:p></span></b></div>
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<br /></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab asidosis respiratorik (sebab dasar = Hipoventilasi)</span></b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Hambatan pada pusat
pernafasan di medula oblongata<o:p></o:p></span></b></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan otot-otot</span></b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;"> <b>pernafasan dan dinding dada<o:p></o:p></b></span></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Gangguan pertukaran gas <o:p></o:p></span></b></div>
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<br /></div>
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<!--[if !supportLists]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">Obstruksi saluran nafas atas
yang akut <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan Sebelum Asidosis<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B <o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keadaan Asidosis Paru menahan CO2<o:p></o:p></span></b></div>
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B<o:p></o:p></span></div>
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20<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha Kompensasi tubuh <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal
menahan bikarbonat
mengeluarkan H+ dan Anion lain <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK B <o:p></o:p></span></b></div>
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<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 215px; margin-top: 26px; mso-ignore: vglayout; position: absolute; width: 21px; z-index: 251779584;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image068.gif" v:shapes="_x0000_s1280" width="21" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
30<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
Urin menjadi asam<o:p></o:p></span></b></div>
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<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan
setelah pengobatan<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 2
40 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4. Alkalosis
respiratorik (kekurangan asam karbonat)<o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan primer dari PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> (hipokapnea) sehinggan
terjadi penurunan PH. PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <
35 mmHG > 7,45. Kompensasi ginjal berupa penurunan ekskresi H+ dengan akibat lebih sedikit absorbsi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">. Penurunan HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> serum berbeda-beda, tergantung apakah
keadaanya akut atau kronik.<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Sebab-sebab alkalosis Respiratorik (sebab
dasar =hiperventilasi)<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Perangsangan sentral terhadap pernafasan <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hiperventilasi psikogenik
yang disebabkan oleh stres emosional <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan hipermetabolik :
demam, tirotoksikosis <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l9 level1 lfo16; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan SSP<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cedera kepala atau gangguan
pembuluh darah otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tumor otak<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat (awal)
<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Hipoksia <o:p></o:p></span></b></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pneumonia, asma, edema paru<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal jantung kongestif<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tinggal ditempat yang tinggi
<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Ventilasi mekanik yang berlebihan <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Mekanisme yang belum jelas <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan sebelum terjadi
alkalosis respiratorik<b><o:p></o:p></b></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></b></div>
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<br /></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keadaan alkalosis
respiratorik<o:p></o:p></span></div>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Paru mengeluarkan banyak CO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">, pernafasan hiperaktif.<o:p></o:p></span></div>
</td>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 320px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251675136;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image079.gif" v:shapes="_x0000_s1178" width="22" /></span><!--[endif]--><!--[if gte vml 1]><v:line id="_x0000_s1164"
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endarrowlength="long"/>
</v:line><![endif]--><!--[if !vml]--><span style="height: 31px; left: 0px; margin-left: 301px; margin-top: 10px; mso-ignore: vglayout; position: absolute; width: 22px; z-index: 251660800;"><img height="31" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image080.gif" v:shapes="_x0000_s1164" width="22" /></span><!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,5<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte vml 1]><v:line id="_x0000_s1190"
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20 <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Usaha kompensasi tubuh :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
B<o:p></o:p></span></b></div>
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<td height="7" width="128"></td>
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
15 <o:p></o:p></span></b></div>
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<table align="left" cellpadding="0" cellspacing="0">
<tbody>
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<td height="10" width="263"></td>
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<tr>
<td></td>
<td><img height="3" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image088.gif" v:shapes="_x0000_s1151" width="31" /></td>
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</tbody></table>
<!--[endif]--><b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></b></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 221.4pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 239.4pt;" valign="top" width="319">
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ginjal mengeluarkan ion bikarbonat, menahan H+ dan
anion lain, urin basa.<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Keseimbangan setelah
pengobatan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<td height="19"></td>
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<!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> </span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<br /></div>
<br clear="ALL" />
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> AK
B<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">
0,5
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<tbody>
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<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 167.4pt;" valign="top" width="223">
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<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Larutan mengandung Cl<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Gangguan
asam basa campuran <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan asam basa campuran
adalah keadaan dimana terdapat satu atau lebih gangguan asam basa sederhana
yang terjadi bersama-sama.<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gangguan ganda<o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sebab-sebab yang sering <o:p></o:p></span></b></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek aditif
pada perubahan PH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosi metabolik + asidosis respiratorik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah pH sangat rendah<o:p></o:p></span></div>
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<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Henti kardiopulmonar <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mengalami syok<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gagal ginjal kronik dengan kelebihan volume dan edema paru<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien dengan ketoasidosis diabetik yang mendapat narkotik kuat atau
barbiturat.<o:p></o:p></span></div>
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<!--[if gte vml 1]><v:line
id="_x0000_s1033" style='position:absolute;left:0;text-align:left;z-index:251526656;
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from="133.2pt,15.1pt" to="140.45pt,15.15pt" o:allowincell="f"
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</v:line><![endif]--><!--[if !vml]--><span style="height: 2px; left: 0px; margin-left: 176px; margin-top: 19px; mso-ignore: vglayout; position: absolute; width: 12px; z-index: 251526656;"><img height="2" src="file:///C:/Users/ag/AppData/Local/Temp/msohtmlclip1/01/clip_image004.gif" v:shapes="_x0000_s1033" width="12" /></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis metabolik + Alkalosis respiratirik PaCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">2</span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu rendah HCO</span><span style="font-size: 8.0pt; mso-bidi-font-size: 10.0pt;">3 </span><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> terlalu tinggi pH sangat tinggi<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang mendapat ventilasi berlebuhan lewat respirator
mekanik<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien hiperventilasi dengan gagal jantung kongestif atau sirosis
hati yang munyah-muntah atau mendapat pengobatan dengan deuretik kuat atau
penyedotan nasogastrik<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien cidera kepala dengan hiper ventilasi yang mendapat deuretik<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Efek yang
mengukuti perubahan pH</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
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id="_x0000_s1034" style='position:absolute;left:0;text-align:left;z-index:251527680;
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from="126pt,15.65pt" to="133.25pt,15.7pt" o:allowincell="f" strokeweight="1pt">
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis laktat sebagai komplikasi syok septik<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom hepato renal<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Intoksikasi salisilat<o:p></o:p></span></div>
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mendekati normal<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pasien PPOM yang muntah atau yang menjalani penyedotan nasogastrik
atau deuretik kuat<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sindrom distres paru dewasa<o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tabel gangguan
keseimbangan asam basa <o:p></o:p></span></b></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis
Respiratorik
<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperventiasi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,7 mEq/L<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 8,8 : 1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 90,0 mmHg<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Meningkatkan respirasi, Amonia ginjal dan ekskresi asam meningkat, penahanan
ginjal ; dominasi buffer basa<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,1 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 2,5 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 15,2 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 80,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,3 <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Metabolik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Muntah, pengeluaran cairan lambung,
over dosis NaHCO3, terapi diuretik berlebihan dengan kehilangan asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
38,0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 31,6 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,6<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pernafasan lambat, dangkal , Peningkatan ekkresi
bikarbonat pada ginjal, penahanan asam ; dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
34,5 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,33 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25,9 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 45,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,5 <o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="169"><div class="MsoNormal">
<br /></div>
</td>
<td colspan="2" style="border-bottom: solid windowtext 1.0pt; border-left: solid windowtext 1.0pt; border-right: none; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 198.0pt;" valign="top" width="264">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">NORMAL<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">HCO3 +
24,0 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2 mEq/L<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 20 : 1<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,4<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 11.8pt;" valign="top" width="16">
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
<td style="border-bottom: solid windowtext 1.0pt; border: none; mso-cell-special: placeholder;" width="165"><div class="MsoNormal">
<br /></div>
</td>
</tr>
<tr>
<td colspan="2" style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: 1.5pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Asidosis Metabolik
<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : asidosis nefritis (penurunan eksresi metabolisme asam ), asidosis
diabetik (pengeluaran produksi metabolisme asam), diare, fistula pencernaan
(kehilangan bikarbonat utama)<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
15.0 mEq/L <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 1,2
mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 12,5 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 40,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,2<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Peningkatan respirasi, peningkatan amonia di
ginjal, peningkatan ekskresi asam, penahanan bikarbonat : dominasi buffer
asam <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil :
HCO3 17,2 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,9 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 19 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 30,3 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,38<o:p></o:p></span></div>
</td>
<td colspan="3" style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 230.4pt;" valign="top" width="307">
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Alkalosis Respiratorik<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penyebab : Hiperpnea , demam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
24,0 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,6 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 40 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 20,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,55<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Mekanisme kompensasi :<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Penurunan respirasi, peningkatan ekskresi
bikarbonat diginjal, penahanan asam : dominasi buffer asam<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Hasil : HCO3
20,0 mEq/l<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">H2CO3 0,8 mEq/L<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Rasio 25 : 1<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PCO2 25,0 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">PH 7,52 <o:p></o:p></span></div>
</td>
</tr>
<!--[if !supportMisalignedColumns]-->
<tr height="0">
<td style="border: none;" width="169"></td>
<td style="border: none;" width="138"></td>
<td style="border: none;" width="126"></td>
<td style="border: none;" width="16"></td>
<td style="border: none;" width="165"></td>
</tr>
<!--[endif]-->
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BAB III <o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">INTERVENSI
KEPERAWATAN<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">A. Asidosis
Metabolik <o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. Independen <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor tekanan darah, frekwensi nadi / ritme <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji tingkat kesadaran dan catat perubahan progresif, kondisi
neuromuskuler misalnya : kekuatan, tonus otot, pergerakan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila terjadi koma, lakukan : tempat tidur direndahkan, gunakan
penghalang tempat tidur, observasi yang sering.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Observasi respirasi mengenai
jumlah dan kedalamannya.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji temperatur kulit : warna dan perfusi jaringan<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi bunyi bising usus <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan setiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tes atau monitor PH urine<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kebersihan mulut dengan kumur cairan sodium bikarbona, lemon atau
boraks gliserin <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2. Kolaborasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi / mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum elektrolit dan potasium <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan cairan sesuai indikasi, tergantung pada etiologi antara lain
Dekst. 5 %/saline solution<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan sesuai dengan indikasi antara lain : <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat/laktat atau saline melalui intra vena (mengoreksi
defisit bikarbonat/mengoreksi asidosis dengan PH , 7,2)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida (defisit serum)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Phospat (kronik asidosis dengan hipophopatemia)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Calsium (fungsi neuro muskuler) <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Modifikasi diet sesuai dengan indikasi, contohnya : Diet rendah
protein, tinggi karbohidrat bila terdapat gagal ginjal atau diabetes.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Laksanakan terapi dralisil bila diindikasikan <o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">B. Alkalosis Metabolik </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, ritme dan kedalamannya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor intake dan out put serta berat badan tiap hari<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi intake oral dan kurangi stimulus lingkungan, lakukan suction
secara intermiten bila terpasang NGT, irigasi/bilas lambung dengan cairan
isotonik<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan intak cairan dan makanan tinggi potasium dan kalsium sedapat
mungkin (tergantung pada tingkat kalsium dan potasium dalam darah), contohnya :
buah anggur dan buah apel, pisang, Cauli flower (kembang kol), buah kering
(manisan), kolang-kaling, biji gandum.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Lanjutkan pemberian terapi diuretik secara teratur, contoh lasik,
etherynic acid.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Instruksikan pasien untuk mencegah hilangnya, sejumlah bikarbonat
(anjurkan pasien untuk minum susu) <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Analisa gas darah, serum elektrolit, BUN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat-obatan <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium clorida/cairan ringer laktat secara intra vena jika tidak ada
kontra indikasi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Amonium clorida atau arginin
hidroklorida untuk mencegah penurunan PH<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida untuk mengatsi hipokalemia<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 90.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Diamox<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Spironolakton <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cugah atau batasi pengguanan sedatif/penenang<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anjurkan/laksanakan pemberian cairan secara intra vena<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi dan obat-obatan respiratori untuk
mengatasi kondisi ventilasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan dralisis jika diperlukan <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">C. Asidosis Respiratori </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1.
Independen<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan kesulitan pasien bernafas
(cuping hidung)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Auskultasi suara nafas<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kaji penurunan tingkat kesadaran<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor denyut nadi dan ritmenya<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 54.0pt; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Catat warna kulit dan kelembabannya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Anurkan pasien untuk batuk dan nafas dalam, tempatkan pada posisi
semifowler, lakukan suction jika perlu, berikan nafas tambahan/oksigen sesuai
indikasi<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidntifikasi/mengobati sesuai penyebabnya<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah dan kadar serum elektrolit<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan oksigen sesuai indikasi melalui masker, kanule atau ventrilasi
mekanik/ventilator<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tingkatkan jumlah pernafasan atau tidal volume<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan obat sesuai indikasi antara lain :<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Naloxane hidroclorida (narcan) untuk menstimulasi fungsi pernafasan
dalam pasien menggunakan obat sedatif<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sodium bikarbonat<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cairan IV seperti RL atau 0,6 M cairan Na lactal<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Potasium clorida <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Batasi pengguanan obat penenang atau tranquillizer<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jaga kelembaban dengan menggunakan humidikasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan chist terapi dada termasuk didalamnya postural drainage<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan alat bantu ventilator jika perlu <o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">D. Alkalosis</span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> <b>Respiratori <o:p></o:p></b></span></div>
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<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1. </span></b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Independen <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor jumlah pernafasan, kedalaman dan usahanya/kesulitan pasien
bernafas (cuping hidung dll)<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Pastikan penyebab hiperventilasi jika mungkin seperti kecemasan, nyeri<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">kaji tingkat kesadaran dan catat status neuromuskuler<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ajarkan pasien cara bernafas yang benar dan bantu pasien jika
mengguanakan alat bantu pernafasan,
misalnya masker<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu Pasien untuk bersikap tenang <b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan pengaman bila perlu, misal tempat tidur direndahkan,
penghalang tempat tidur dan observasi
yang sering <b><o:p></o:p></b></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2.
Kolaborasi <b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bantu dengan mengidentifikasi/mengobati sesuai dengan penyebab<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor analisa gas darah<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Monitor serum potasium<b><o:p></o:p></b></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Berikan sedativ jika ada indikasi<b><o:p></o:p></b></span></div>
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</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gunakan alat bantu pernafasan masker untuk mempertahankan/mengembalikan
CO2. Kurangi frekwensi nafas/tidal volume dengan alat bantu ventilator <b><o:p></o:p></b></span></div>
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Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-39903132202591417132012-11-07T18:09:00.003-08:002012-11-07T18:09:53.937-08:00PATOFISIOLOGI SEL<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">PATOFISIOLOGI SEL<o:p></o:p></span></b></div>
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<h1>
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; mso-ansi-language: EN-US;">1<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; mso-ansi-language: EN-US;">Batasan<o:p></o:p></span></h1>
<h2 style="margin-left: 54.0pt; tab-stops: 36.0pt; text-align: justify;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;">1.1<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;">Patobiologi </span><span style="font-family: 'Times New Roman', serif; font-weight: normal;">adalah ilmu yang mempelajari
perubahan biologik yang menyimpang, mulai dari sistem sampai molkul, yang
disebut abnormal, yang menimbulkan penyakit (Hill, <st1:numconv6p0 sch="1" val="1980" w:st="on">1980</st1:numconv6p0>)</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;"><o:p></o:p></span></h2>
<h2 style="margin-left: 54.0pt; tab-stops: 36.0pt; text-align: justify;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;">1.2<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;">Patologi </span><span style="font-family: 'Times New Roman', serif; font-weight: normal;">adalah ilmu tentang penyakit yang
menekankan pad deskriptif perubahahn morfologik dari penyakit (Hill, <st1:numconv6p0 sch="1" val="1980" w:st="on">1980</st1:numconv6p0>)</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;"><o:p></o:p></span></h2>
<h2 style="margin-left: 54.0pt; tab-stops: 36.0pt; text-align: justify;">
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;">1.3<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;">Patofisiolog i</span><span style="font-family: 'Times New Roman', serif; font-weight: normal;">adalah ilmu yang mmpelajari
tentang penyimpangan atau kelainan fungsi (yang menimbulkan sign dan symptom
dari berbagai sindrom penyakit (Lange JD, <st1:numconv6p0 sch="1" val="1994" w:st="on">1994</st1:numconv6p0>)</span><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;"><o:p></o:p></span></h2>
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<i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Ada tiga reaksi tubuh terhadap jejas dalam rangka mempertahankan
homeostasis :<o:p></o:p></span></i></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Reaksi pertahanan aktif
(active resistence)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">2)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Rekasi kekalahan (submissive
reaction)<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Rekasi penyesuaian
(adaptation)<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; font-weight: normal; mso-ansi-language: EN-US; mso-font-kerning: 0pt;"> <a name='more'></a></span></h1>
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<st1:numconv6p0 sch="1" val="2" w:st="on"><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; font-weight: normal; mso-ansi-language: EN-US; mso-font-kerning: 0pt;">2</span></st1:numconv6p0><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; font-weight: normal; mso-ansi-language: EN-US; mso-font-kerning: 0pt;">. </span><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Etiologi Perubahan
“Reversibel” dan Irreversibel “ pada sel<o:p></o:p></span></h1>
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<!--[if !supportLists]-->a)<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->Hipoksia, biasanya disebabkan oleh :<o:p></o:p></h2>
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<!--[if !supportLists]-->b)<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->Jejas fisik<o:p></o:p></h2>
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<!--[if !supportLists]-->c)<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->Jejas bahan kimia<o:p></o:p></h2>
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<!--[if !supportLists]-->d)<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->Gangguan mekanismeimunologik<o:p></o:p></h2>
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<!--[if !supportLists]-->e)<span style="font-size: 7pt; font-weight: normal;"> </span><!--[endif]-->Gangguan nutrisi<o:p></o:p></h2>
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<!--[if !supportLists]--><span lang="IN">f)<span style="font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]-->Gangguan
genetik</h2>
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<!--[if !supportLists]--><span lang="IN">g)<span style="font-size: 7pt; font-weight: normal;">
</span></span><!--[endif]-->Proses
ketuaan (aging=senescene</h2>
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<st1:numconv6p0 sch="1" val="3" w:st="on"><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3</span></st1:numconv6p0><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">. Patofisiologi tingkat sel<o:p></o:p></span></h1>
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<st1:numconv6p6 sch="4" val="3.1" w:st="on">3.1</st1:numconv6p6> Adaptasi sel<o:p></o:p></h2>
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<st1:numconv6p0 sch="1" val="3" w:st="on"><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3</span></i></st1:numconv6p0><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">.<st1:numconv6p0 sch="1" val="1" w:st="on">1</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="1" w:st="on">1</st1:numconv6p0>
Atropi, </span></i><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; font-weight: normal; mso-ansi-language: EN-US; mso-bidi-font-weight: bold;">adalah
mengecilnya ukuran sel yang sudah pernah mencapai ukuran normal, oleh karena
respon penurunan atau pengkerutan ukuran sel dengan pengurangan substansi sel.<o:p></o:p></span></h3>
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<b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Etiologi</span></i></b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">, <o:p></o:p></span></i></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Disuse atropy, misalnya patah
tulang, imobilisasi<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">2)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Neurogenic atropy, misalnya
myolitis<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Vaskular atropi, misalnya
arterosklerosis pembuluh darah menyempit sehingga aliran darah ke jaringan
menurun dan terjadi atropi.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">4)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">nutrisi yang tidak cukup, <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">5)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Endokrin atropi)/penuaan,
misalnya post menopause oleh karena stimulus endokrine berhenti, gonad
mengalami atropi.<o:p></o:p></span></div>
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<st1:numconv6p0 sch="1" val="3" w:st="on">3</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="1" w:st="on">1</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0> Hipertropi, <span style="font-family: 'Times New Roman', serif; font-weight: normal;">adalah peningkatan ukuran sel sehingga organ atau jaringan yang
dibentuk membesar. <o:p></o:p></span></h2>
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<i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Etiologi,</span></i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> meningkatnya fungsi oleh
karena kenaikan beban dan adanya stimulasi hormon (peningkatan sintesis protein
pada sitoplasma, retikulum endoplasmik, mikrofilamin dan mitokondria) bukan
pada cairan sel.<o:p></o:p></span></div>
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<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Ada dua bentuk fisioogik dan patologik<o:p></o:p></span></div>
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<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Contoh, <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">pada kehamilan membesarnya
rahim disebabkan adanya hipertropi dan hiperplasia sel-sel otot rahim oleh
karena rangsangan hormon<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">2)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Menurut Kissane (<st1:numconv6p0 sch="1" val="1990" w:st="on">1990</st1:numconv6p0>), hipertropi otot jantung diwali
dengan pembesaran ukuran organ jantung yang disebabkan karena dilatasi bilik
jantung akibat beban berat yang diikuti sintesis protein dan sintesis DNA. Sel
otot jantung termasuk sel permanen, sehingga sel jantung yang sudah dewasa
tidak dapat mitosis (Contrans, <st1:numconv6p0 sch="1" val="1994" w:st="on">1994</st1:numconv6p0>).<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">pada otot skletal pekerja
berat, dan pada otot jantung penderita tekanan darah tinggi, oleh karena
meningkatnya beban, sel-sel otot menjadi hipertropi.<o:p></o:p></span></div>
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<st1:numconv6p0 sch="1" val="3" w:st="on">3</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="1" w:st="on">1</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="3" w:st="on">3</st1:numconv6p0> Hiperplasia, <span style="font-family: 'Times New Roman', serif; font-weight: normal;">adalah bertambahnya jumlah sel dalam jaringan/organ yang bisanya meningkatkan
volume/bearnya jaringan atau organ tersebut.Sebagian sel jaringan bila mendapat
jejeas akan bereaksi dengan jalan membelah diri (mitosis), sehingga jumlahnya
bertambah banyak. Hiperplasi dapat terjadi : <st1:numconv6p0 sch="1" val="1" w:st="on">1</st1:numconv6p0>) regenerasi, <st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0>) awal pertumbuhan neoplasma.</span><o:p></o:p></h2>
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<i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Rekasi
hiperplasia dibagi menjadi dua :<o:p></o:p></span></i></div>
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<st1:numconv6p0 sch="1" val="3" w:st="on"><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3</span></st1:numconv6p0><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">.<st1:numconv6p0 sch="1" val="1" w:st="on">1</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="3" w:st="on">3</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="1" w:st="on">1</st1:numconv6p0> Hiperplasia fisiologik, ada <st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0> bentuk :<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">hiperplasia hormonal, terutama terjadi pada estrogen dependent. Contoh
pembesaran payudara pada masa laktasi/pubertas , uterus pada saat hamil<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">hiperplasia kompensator, sebagai bentuk adaptasi kompensasi sari sel
melalui regenerasi, agar fungsi organ tetapi homestasis. Misalnya (partial
hepatectomi”, akan terjadi regenerasi dalam waktu <st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0> minggu..<o:p></o:p></span></div>
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<st1:numconv6p0 sch="1" val="3" w:st="on"><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3</span></st1:numconv6p0><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">.<st1:numconv6p0 sch="1" val="1" w:st="on">1</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="3" w:st="on">3</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0>. Hiperplasia patologik, </span><span style="font-size: 14pt;">terutama akibat stimulasi hormonal yang berlebihan/proliferasi sel yang
abnormal.<o:p></o:p></span></div>
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<b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Contoh :<o:p></o:p></span></i></b></div>
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<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Hiperplasia adematousa dari
endometrium (hiperplasi yang ganas)<o:p></o:p></span></div>
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<h2 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-align: justify; text-indent: 0cm;">
<st1:numconv6p0 sch="1" val="3" w:st="on">3</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="1" w:st="on">1</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="4" w:st="on">4</st1:numconv6p0> Metaplasia, <span style="font-family: 'Times New Roman', serif; font-weight: normal;">adalah perubahan yang reversibel dari satu jenis sel dewasa menjadi sel
dewasa yang lain.<o:p></o:p></span></h2>
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<b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Contoh, <o:p></o:p></span></i></b></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Epitel sistem respirasi pada perokok berat, epitel silinder pada trakea
dan bronkus akan mengalami metaplasia skuamosa<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Radang menahun pada bronki dan bronki kecil<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Batu pada pankreas dan kandung kencing<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">-<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Defisiensi vitamin A dapat menyebabkan metaplasia.<o:p></o:p></span></div>
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<b><i><span style="font-size: 16.0pt; mso-ansi-language: EN-US;">Perubahan-perubahan
sel yang bukan reaksi adaptasi :<o:p></o:p></span></i></b></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">a)<span style="font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Displasia,</span></b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> perubahan pada sel dewasa dengan vareasi dalam bentuk, ukuran dan
susunan dari sel-selnya atau kelainan pertumbuhan.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">b)<span style="font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Hipoplasia</span></b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">, gangguan pertumbuhan <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">c)<span style="font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Aplasia,</span></b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">
tingkat perkembangannya tidak sempurna.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">d)<span style="font-size: 7pt;"> </span></span><!--[endif]--><b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Agenesis,</span></b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> tidak terbentuknya suatu organ.<o:p></o:p></span></div>
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<st1:numconv6p0 sch="1" val="4" w:st="on"><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">4</span></st1:numconv6p0><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">. Perubahan-perubahan lain
(kalsifikasi)<o:p></o:p></span></h1>
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<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Kalsifikasi adalah pengendapan abnormal garam-garam
kalsium, bersama sedikit besi dan magnesium dan mineral-mineral yang lain<b>.<o:p></o:p></b></span></div>
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<i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Terjadi dalam<st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0> bentuk berbagai keadaan patologik :<o:p></o:p></span></i></div>
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<st1:numconv6p6 sch="4" val="4.1" w:st="on">4.1</st1:numconv6p6> Klasifikasi distropik, <span style="font-family: 'Times New Roman', serif; font-weight: normal;">bila deposisi terjadi pada jaringan yang mati atau hampir mati. Pada
bentuk ini tidak terdapat perubahan metabolisme kalsium, dan kadar kalsium
normal.<o:p></o:p></span></h2>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Misalnya : <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Pada nekrosis koagulasi, nekrosis perlunakan, nekrosis pengejuan dan
enzymatic fat nekrosis.<o:p></o:p></span></div>
<h2 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-align: justify; text-indent: 0cm;">
<st1:numconv6p6 sch="4" val="4.1" w:st="on">4.1</st1:numconv6p6> Kalsifikasi metatatik, <span style="font-family: 'Times New Roman', serif; font-weight: normal;">bila endapan pada jaringan normal menunjukkan perubahan metabolisme
kalsium dan kadar kalsium darah meningkat. <o:p></o:p></span></h2>
<div class="MsoNormal">
<br /></div>
<h1 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-indent: 0cm;">
<st1:numconv6p0 sch="1" val="5" w:st="on">5</st1:numconv6p0>. Pembentukan batu<o:p></o:p></h1>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Garam-garam kalsium dapat juga
diendapkan dalam bentuk batu atau kalkuli di dalam sistemsaluran dari berbagai
organ. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Kalukuli terbentuk akibat <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.75pt; mso-list: l11 level1 lfo9; tab-stops: list 36.75pt; text-align: justify; text-indent: -18.75pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">hancurnya debris nekrotik
dalam saluran, <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.75pt; mso-list: l11 level1 lfo9; tab-stops: list 36.75pt; text-align: justify; text-indent: -18.75pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">2)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">ketidakseimbangan unsur-unsur
sekresi, yang terjadi pada saluran empedu, pankreas, kelenjar saliva, prostat
dan sistem kemih<b>.</b><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">.<o:p></o:p></span></div>
<h1 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-indent: 0cm;">
<st1:numconv6p0 sch="1" val="6" w:st="on">6</st1:numconv6p0>. Kematian Sel<o:p></o:p></h1>
<div class="MsoNormal">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Secara
morfologi ada dua bentuk kematian sel yaitu (Contrans, <st1:numconv6p0 sch="1" val="1994" w:st="on">1994</st1:numconv6p0>) :<o:p></o:p></span></div>
<h2>
<!--[if !supportLists]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;">1.4<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;">Nekrosis<o:p></o:p></span></h2>
<div class="MsoNormal">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Pada
nekrosis ada dua perubahan yaitu pencernaan enzimatik (autolisis) dan
denaturasi protein. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Perubahan irreverisbel dari inti sel :<o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l5 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 14.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Pikonosis, inti sel mengkerut<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l5 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 14.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Karioraksis, inti
terpecah-pecah menjadi bagian kecil-kecil<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l5 level1 lfo7; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 14.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Kariolisis, pecahnya seluruh
inti karena metabolisme protein inti oleh DNA-se dan RNA-se.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal">
<st1:numconv6p6 sch="4" val="6.2" w:st="on"><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">6.2</span></i></b></st1:numconv6p6><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> Apoptosis<o:p></o:p></span></i></b></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Perubahan
morfologik yang terjadi adalah <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo10; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 14.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Pengkerutan sel<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo10; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 14.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Kondensasi kromatin<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo10; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 14.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Pembentukan blebs sitoplasma
dan apoptosis baodies<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l6 level1 lfo10; tab-stops: list 18.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 14.0pt; mso-ansi-language: EN-US; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">v<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Fagosistosis apoptosis bodies
oleh makrofage<o:p></o:p></span></div>
<h1 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-indent: 0cm;">
<st1:numconv6p0 sch="1" val="7" w:st="on">7</st1:numconv6p0>. Perubahan post mortem<o:p></o:p></h1>
<h1 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-indent: 0cm;">
<st1:numconv6p6 sch="4" val="7.1" w:st="on"><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">7.1</span></i></st1:numconv6p6><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> Kematian somatik<o:p></o:p></span></i></h1>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Kematian seluruh individu
disebut kematian somatik yang menyangkut
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">a) kegiatan sistem saraf pusat
(otak) berhenti. Jika otak mati maka
kegiata listrik berhenti dan elekroensepalogramnya datar/isoelektrik.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">b) walaupun paru, ajntung
masih dapat dijalankan secara buatan.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<st1:numconv6p6 sch="4" val="7.2" w:st="on"><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">7<b>.2</b></span></i></st1:numconv6p6><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> Perubahan-perubahan yang
terjadi setelah kematian :<o:p></o:p></span></i></b></div>
<h2 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-indent: 0cm;">
<st1:numconv6p6 sch="4" val="72.1" w:st="on">72.1</st1:numconv6p6> Rigor mortis, <span style="font-family: 'Times New Roman', serif; font-weight: normal;">kekakuan
otot<o:p></o:p></span></h2>
<h2 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-indent: 0cm;">
<st1:numconv6p0 sch="1" val="7" w:st="on">7</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0> Algor mortis <span style="font-family: 'Times New Roman', serif; font-weight: normal;">, dinginnya mayat karena suhu tubunya mendekati suhu lingkungan</span><o:p></o:p></h2>
<h2 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-align: justify; text-indent: 0cm;">
<st1:numconv6p0 sch="1" val="7" w:st="on">7</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="3" w:st="on">3</st1:numconv6p0> Livor mortis, <span style="font-family: 'Times New Roman', serif; font-weight: normal;">perubahan warna </span><span style="font-weight: normal;">.<o:p></o:p></span></h2>
<h1 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-indent: 0cm;">
<st1:numconv6p0 sch="1" val="8" w:st="on">8</st1:numconv6p0>. Sel Kanker<o:p></o:p></h1>
<h2 style="margin-left: 0cm; mso-list: none; tab-stops: 18.0pt; text-indent: 0cm;">
<st1:numconv6p6 sch="4" val="8.1" w:st="on"><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;">8.1</span></st1:numconv6p6><span style="font-family: "Times New Roman","serif"; mso-ansi-language: EN-US;"> Konsep patobiologik<o:p></o:p></span></h2>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo14; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">kanker berkembang dari satu
sel<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo14; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">2)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">pertumbuhan kelompok sel
kanker monoklonal<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo14; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">perubahahn gen yang heterogen<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo14; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">4)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">kelainan pengendalian proliferasi
dan diferensiasi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo14; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">5)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">dedifferensiasi dan
immortatility<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo14; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">6)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">etiologi multifaktor<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l9 level1 lfo14; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">7)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">proses multistep.<o:p></o:p></span></div>
<h1 style="margin-left: 63.0pt; mso-list: none; tab-stops: 36.0pt; text-indent: -63.0pt;">
<st1:numconv6p6 sch="4" val="8.2" w:st="on"><i><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; mso-ansi-language: EN-US;">8.2</span></i></st1:numconv6p6><i><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; mso-ansi-language: EN-US;"> Batasan sel kanker<o:p></o:p></span></i></h1>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l3 level1 lfo13; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Neoplasma, pertumbuhan masa
jaringan abnormal yang tumbuh berlebih dan tak terkoordinasi.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l3 level1 lfo13; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">2)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Tomor, inflamsi (pembengkakan)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l3 level1 lfo13; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Kanker, neoplasma ganas<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l3 level1 lfo13; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">4)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Karsinogen, bahan yang dapat
menimbulkan perubahan kanker ataui perubahan sel normal menjadi sel kanker.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l3 level1 lfo13; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">5)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Karsiongenik , sifat dari
karsinogen.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l3 level1 lfo13; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">6)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Karsinogenesis, proses
perubahan keadaan normal menjadi kanker<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l3 level1 lfo13; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">7)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Sel kanker,<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l3 level1 lfo13; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">8)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Metastasis, <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l3 level1 lfo13; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">9)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Heterogen, keanekaragaman
struktur dan perilaku dari sel yang menyusun suatu masa kanker.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l3 level1 lfo13; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">10)<span style="font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Imunne-surveilance,<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -63.0pt;">
<st1:numconv6p6 sch="4" val="8.3" w:st="on"><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">8.3</span></i></b></st1:numconv6p6><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> Perubahan molekul sel kanker<o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -63.0pt;">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Pada perkebangan sel kanker
dibagi dalam <st1:numconv6p0 sch="1" val="3" w:st="on">3</st1:numconv6p0> tahap
:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l0 level1 lfo12; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Inisiasi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l0 level1 lfo12; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">2)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Promosi <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l0 level1 lfo12; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Progresi<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -63.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -63.0pt;">
<st1:numconv6p6 sch="4" val="8.4" w:st="on"><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">8.4</span></i></b></st1:numconv6p6><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> Antigen kanker<o:p></o:p></span></i></b></div>
<div class="MsoNormal">
<b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Antigen a</span></b><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">dalah yang mampu merespon
imun. Sesuatu yang membangkitkan respon imun disebut <b>imunogen</b>. Antigen yang digunakan untuk menyebutkan bahan yang dapat
bereaksi disebut <b>antibodi.</b><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Ada
dua macam imunogen :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l7 level1 lfo11; tab-stops: list 36.0pt; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Tumor assosiated Antigen
(TAA), imunogen pada sel nomrla dalam
jumlah sedikit, yang emngikat sel kanker.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l7 level1 lfo11; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">2)<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Tumor spesific antigen (TSA),
imunogen yang hanya dijumpai pada sel kanker.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -63.0pt;">
<st1:numconv6p6 sch="4" val="8.5" w:st="on"><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">8.5</span></i></b></st1:numconv6p6><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> Perlawanan terhadap sel kanker<o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Perlawanan tubuh terhadap sel kanker dilakukan oleh
sel NK dan respon imun, terutama respon imun seluler yaitu sel NK( merupakan
inti terdepan pertahanan tubuh terjadap kanker) , makrofage ( respon awal imun
terhadap sel kanker) dan limfosit T. (sel ini mampu mengikat danmemproses
antigen tumor)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -63.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -63.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 63.0pt; text-indent: -63.0pt;">
<st1:numconv6p6 sch="4" val="8.6" w:st="on"><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">8.6</span></i></b></st1:numconv6p6><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> Proses invasif dan metastasis<o:p></o:p></span></i></b></div>
<h1 style="margin-left: 0cm; mso-list: none; tab-stops: 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 14.0pt; font-weight: normal; mso-ansi-language: EN-US; mso-bidi-font-weight: bold;">Faktor-faktor
yang mempengaruhi pertumbuhan sel tumor menjadi ganas tergantung :<o:p></o:p></span></h1>
<div class="MsoNormal" style="text-align: justify;">
<st1:numconv6p0 sch="1" val="1" w:st="on"><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1</span></st1:numconv6p0><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">) heterogenitas sel kanker, <st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0>) sifat imunogen sel kanker dan <st1:numconv6p0 sch="1" val="3" w:st="on">3</st1:numconv6p0>) pertahana tubuh terhadap kanker<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<st1:numconv6p0 sch="1" val="8" w:st="on"><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">8</span></i></b></st1:numconv6p0><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">.<st1:numconv6p0 sch="1" val="6" w:st="on">6</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="1" w:st="on">1</st1:numconv6p0>
Proses metastase terjadi melalui beberapa kejadian</span></i></b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;"> :<o:p></o:p></span></i></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level7 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Dimulai dengan proses invasi
dan infiltrasi sel kanker <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level7 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">sel kanker lepas ke vaskuler<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level7 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Sel kanker mempertahankan hidu
di vaskuler<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level7 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">4.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Sel kanker tersangkut di
anyaman kapiler pada organ dekat<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l4 level7 lfo8; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">5.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">penetrasi ke dinding pembuluh
getah bening dan pembuluh darah dan perkembangan metastase jauh.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<st1:numconv6p0 sch="1" val="8" w:st="on"><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">8</span></i></b></st1:numconv6p0><b><i><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">.<st1:numconv6p0 sch="1" val="6" w:st="on">6</st1:numconv6p0>.<st1:numconv6p0 sch="1" val="2" w:st="on">2</st1:numconv6p0>
Proses invasi ada beberapa tahap :<o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level7 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">1.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Peningkatan sel kanker pada
matriks sekitar, melalui ikatan reseptor do membrane sel kanker dengan
glikoprotein laminin dan fibronectin.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level7 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">2.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">Sel kanker mensekresi ensim
hidrolitik atau merangsang sel tubuh memproduksi enzim yang merusak matriks<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l13 level7 lfo6; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">3.<span style="font-size: 7pt;"> </span></span><!--[endif]--><span style="font-size: 14.0pt; mso-ansi-language: EN-US;">sel kanker bergerak ke daerah
matriks yang diubah oleh enzim proteolitik<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<br /></div>
</div>
Anonymoushttp://www.blogger.com/profile/04289779444843316440noreply@blogger.com0tag:blogger.com,1999:blog-4467973453329322066.post-84676267185994647122012-11-07T18:07:00.000-08:002012-11-07T18:07:18.379-08:00RUMUS HITUNG CAIRAN<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">RUMUS HITUNG CAIRAN</span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Keadaan
normal status cairan dan elektrolit<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: center;">
<b><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 14.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;"><br /></span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Air adalah komponen pembentuk
tubuh yang paling banyak jumlahnya. Pada orangdewasa kurang lebih 60 % dari
berat badan adalah air (air dan elektrolit), 2/3 bagian berada di intrasel, dan
1/3 bagian berada di ekstrasel. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">60 % berat badan tubuh adalah
: <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; mso-list: l1 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-family: "TektoMM_240 RG 850 EX"; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: "TektoMM_240 RG 850 EX";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Cairan intrasel (CIS) 40 % dari berat
badan <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; mso-list: l1 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-family: "TektoMM_240 RG 850 EX"; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: "TektoMM_240 RG 850 EX";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Cairan ekstrasel (CES) 20 % dari berat
badan yang terdiri dari cairan intravaskuler (plasma) 5 % dari berat badan, dan
cairan interstisil 15 % dari berat badan.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Elektrolit utama <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-family: "TektoMM_240 RG 850 EX"; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: "TektoMM_240 RG 850 EX";">a.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Dari CES : Natrium (N = 135 - 147
mEq/liter), Klorida (N = 100 - 106 mEq/liter)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 90.0pt; mso-list: l2 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-family: "TektoMM_240 RG 850 EX"; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: "TektoMM_240 RG 850 EX";">b.<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Dari CIS : Kalium (N = 3,5 - 5,5
mEq/liter), Phospat (N = 3 - 4,5 mg/liter)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "TektoMM_240 RG 850 EX","sans-serif"; font-size: 11.0pt; line-height: 150%; mso-bidi-font-size: 10.0pt;">Secara lebih terperinci
kandungan kadar elektrolit dalam tubuh adalah sebagai berikut :</span></div>
<a name='more'></a><o:p></o:p><br />
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<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; margin-left: 27.9pt; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #F2F2F2; border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; mso-pattern: gray-5 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 98.05pt;" valign="top" width="131">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">mEq<o:p></o:p></span></b></div>
</td>
<td style="background: #F2F2F2; border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: solid windowtext 1.5pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext 1.5pt; mso-pattern: gray-5 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.65pt;" valign="top" width="149">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Plasma<o:p></o:p></span></b></div>
</td>
<td style="background: #F2F2F2; border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: solid windowtext 1.5pt; mso-border-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-top-alt: solid windowtext 1.5pt; mso-pattern: gray-5 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.65pt;" valign="top" width="149">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Interstisial<o:p></o:p></span></b></div>
</td>
<td style="background: #F2F2F2; border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; mso-pattern: gray-5 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 88.15pt;" valign="top" width="118">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Seluler<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 98.05pt;" valign="top" width="131">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Na<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Cl<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">HCO3<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">K<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Ca<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Mg<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">PO4<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">SO4<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Protein<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.65pt;" valign="top" width="149">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">145<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">100<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">27<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">4<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">5<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">3<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">1<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">16<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 111.65pt;" valign="top" width="149">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">143<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">110<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">27<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">4<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">5<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">3<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">1<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid windowtext 1.5pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: none; mso-border-left-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 88.15pt;" valign="top" width="118">
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">14<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">-<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">10<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">150<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">-<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">26<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">113<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">-<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">74<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Konsentrasi
ion H pada suatu larutan atau tingkat keasaman dan kebasaan ditunjukkan sebagai
pH . <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Nilai
pH normal adalah 7,35 - 7,45 <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Air
murni merupakan larutan netral mempunyai pH 7<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Larutan
asam mempunyai pH < 7<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-family: "TektoMM_100 LT 850 EX","sans-serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Larutan
basa mempunyai pH > 7<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 27.8pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 16.0pt; mso-bidi-font-size: 10.0pt;">Rehidrasi <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Goldberger
(1980) melakukan beberapa cara
menghitung kebutuhan cairan dan elektrolit, yaitu :<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cara I <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika ada rasa haus dan tidak ada tanda-tanda klinis dehidrasi lainnya,
maka kehilangan cairan kira-kira 2 % dari BB pada waktu itu. Contoh: BB 50 kg
maka defisit cairan sekitar 1 liter. (1000 cc)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika seseorang bepergian 3-4 hari tanpa air dan ada rasa haus, mulut
kering, oliguria, maka defisit air sekitar 6 % atau 3000 cc pada orang dengan
BB 50 kg.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: l0 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Bila ada tanda di atas ditambah dengan kelemahan fisik nyata, perubahan
mental seperti bingung atau delirium, maka defisit cairan sekitar 7-14% atau
sekitar 3,5 sampai 7 liter pada orang dengan BB 50 kg.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cara II:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jika
penderita dapat ditimbang tiap hari, maka kehilangan BB 4 kg pada fase akut
cuma dengan defisit air 4 liter.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Cara III:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Dengan
suatu kenyataan bahwa kosentrasi natrium dalam plasma berbanding terbalik
denganvolume ekstrasel dengan pengertian bahwa kehilangan air tidak disertai
dengan perubahan kosentrasi natrium dalam plasma, maka dapat dihitung dengan
rumus:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Na2 x
BW2 = Na1
x BW1 dimana; <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Na1 = kadas Na plasma normal 142 mEq/liter<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BW1
= volume air badan normal sekitar 60 %
dari BB pria dan 50 % dari BB
wanita.<o:p></o:p></span></div>
<div class="MsoNormal" style="mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> Na2
= Kadar natrium plasma sekarang.<o:p></o:p></span></div>
<div class="MsoNormal" style="mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> BW2= Volume
air badan sekarang.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Daldiyono
(1973) mengemukakan salah satu cara menghitung kebutuhan cairan untuk rehidrasi
inisial pada gastro enteritis akut berdasarkan sistim score.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 18.0pt; mso-list: skip; text-align: justify; text-indent: -18.0pt;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Adapun
nilai/score gejala klinis dapat dilihat pada tabel dibawah ini<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-border-alt: solid windowtext 1.5pt; mso-border-insideh: .75pt solid windowtext; mso-border-insidev: .75pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;">
<tbody>
<tr>
<td style="background: #E5E5E5; border-bottom: 1.0pt; border-color: windowtext; border-left: 1.5pt; border-right: 1.0pt; border-style: solid; border-top: 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: 1.5pt; mso-border-right-alt: .75pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; mso-pattern: gray-10 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 347.4pt;" valign="top" width="463">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Gejala klinik<o:p></o:p></span></b></div>
</td>
<td style="background: #E5E5E5; border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.5pt; border-top: solid windowtext 1.5pt; mso-border-bottom-alt: .75pt; mso-border-color-alt: windowtext; mso-border-left-alt: .75pt; mso-border-left-alt: solid windowtext .75pt; mso-border-right-alt: 1.5pt; mso-border-style-alt: solid; mso-border-top-alt: 1.5pt; mso-pattern: gray-10 auto; mso-shading: windowtext; padding: 0cm 5.4pt 0cm 5.4pt; width: 4.0cm;" valign="top" width="151">
<div align="center" class="MsoNormal" style="text-align: center;">
<b><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Score<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-bottom: solid windowtext 1.5pt; border-left: solid windowtext 1.5pt; border-right: solid windowtext 1.0pt; border-top: none; mso-border-bottom-alt: solid windowtext 1.5pt; mso-border-left-alt: solid windowtext 1.5pt; mso-border-right-alt: solid windowtext .75pt; padding: 0cm 5.4pt 0cm 5.4pt; width: 347.4pt;" valign="top" width="463">
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Muntah<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Vox colerica (suara sesak)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kesadaran apatis<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Kesadaran somnolent sampai
dengan koma <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Tensi sistolik kurang atau
sama dengan 90 mmHg<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Nadi lebih atau sama
dengan 120 x/menit <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Napas kusmaul >
30x/menit<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Turgor kulit <<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Vacies colerica<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Ekstremitas dingin<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jari tangan keriput<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Sianosis<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Umur 50 atau lebih<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 36.0pt; text-align: justify;">
<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Umur 60 tahun atau lebih<o:p></o:p></span></div>
</td>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">2<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">-1<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">-2<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Semua score
ditulis lalu dijumlah. Jumlah cairan yang akan diberikan dalam 2 jam dapat
dihitung: <o:p></o:p></span></div>
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<u><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Score</span></u><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> x 10% x BB (Kg) x 1 liter <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 15<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Dengan
menggunakan rumus Margon-walten (dikutip dari Daldiyono) yaitu dengan mengukur
BJ Plasma:<o:p></o:p></span></div>
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<u><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">BJ plasma
-1,025</span></u><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> x BB
(Kg) x 4 ml<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,001 <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Contoh : Pria BB 40 Kg dengan BJ Plasama pada waktu
itu 1,030, maka kebutuhan cairan untuk rehidrasi inisial : <o:p></o:p></span></div>
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<u><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">1,030 -
1,025</span></u><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> x 40
x 4 ml = 800 ml<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> 0,001 <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Jumlah cairan
yang dibutuhkan adalah :<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menurut
Golderberg (1980) kebutuhan cairan berdasarkan gejala klinis adalah:<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">cara 1.
Kehilangan cairan sekitar 6% dari BB atau sekitar 3 liter.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menurut cara
III rumus :<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Na II x Bw 2
= Na I x Bw I<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">123 x X
= 142 x 22<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> X = 25,4 (tak sesuai)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">Menurut score
Daldiyono dari gejala klinis ditemukan score 6 , perhitungannya:<o:p></o:p></span></div>
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<u><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">6</span></u><span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;"> x 10% x 50 Kg x 1 liter = 2 liter (2000 ml)<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 10.0pt;">15 <o:p></o:p></span></div>
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