Asuhan Keperawatan Gawat Darurat Penurunan Kesadaran dan Kejang Post Craniotomy Et Causa Subdural Hematoma di IGD RS Panti Waluya Sawahan.

Pailaha, Aprianto Daniel and Ns. Bintari Ratih Kusumaningrum, S.Kep., M.Kep. (2022) Asuhan Keperawatan Gawat Darurat Penurunan Kesadaran dan Kejang Post Craniotomy Et Causa Subdural Hematoma di IGD RS Panti Waluya Sawahan. Magister thesis, Universitas Brawijaya.

Abstract

Penurunan kesadaran dan kejang merupakan komplikasi prosedur kraniotomi yang paling sering ditemukan. Kondisi penurunan kesadaran disebabkan penekanan mansefalon sehingga terjadi gangguan autoregulasi yang menyebabkan peningkatan asam laktat dan hipoperfusi jaringan sehingga terjadi peningkatan kadar CO2 dan hipoksia sedangkan kejang disebabkan peningkatan TIK mengakibatkan herniasi otak kemudian terjadi gangguan SSP mengakibatkan gangguan koordinasi gerak sehingga kehilangan volunter otot. Desain penelitian ini menggunakan metode studi kasus (case study) berupa analisis asuhan keperawatan gawat darurat pada klien post kraniotomi et causa subdural hematoma dengan kondisi kejang dan penurunan kesadaran. Studi kasus ini dilakukan selama satu hari perawatan dengan menggunakan pendekatan analisis deskriptif yang terfokus pada asuhan keperawatan gawat darurat mulai dari pengkajian, diagnosa, intervensi, implementasi, dan evaluasi. Hasil penelitian ditemukan adanya penurunan kesadaran delirium, GCS 223, kejang, nyeri kepala, pusing, mual muntah, batuk, gurgling. Masalah keperawatan yang diprioritaskan yaitu bersihan jalan napas tidak efektif, resiko ketidakseimbangan elektrolit, resiko perfusi serebral tidak efektif, resiko aspirasi, dan resiko cedera. Intervensi yang diberikan sesuai diagnosa yaitu manajemen jalan napas, manajemen elektrolit, manajemen peningkatan tekanan intrakranial, pencegahan aspirasi, manajemen kesehatan lingkungan. Inovasi intervensi yang diberikan yaitu pemberian HOB 30o dan oksigenasi 3 lpm. Hasil evaluasi ditemukan peningkatan kesadaran menjadi somnolen, peningkatan CGS 344, tidak kejang berulang, tidak ada penumpukan sekret dan sputum dijalan napas, tidak tampak mual dan muntah, diaforesis tampak berkurang, MAP membaik.

English Abstract

Loss of consciousness and seizures are the most common complications of craniotomy procedures. The condition of decreased consciousness is caused by suppression of the mancephalic so that there is an autoregulation disorder that causes an increase in lactic acid and tissue hypoperfusion, resulting in an increase in CO2 levels and hypoxia. While seizures caused by an increase in ICP result in brain herniation, then CNS disorders occur resulting in impaired coordination of movement resulting in muscle voluntary loss. The design of this study used a case study method in the form of an analysis of emergency nursing care for post craniotomy et causa subdural hematoma clients with loss of consciousness and seizures. This case study was carried out for one day of treatment using a descriptive analytical approach that focused on emergency nursing care starting from assessment, diagnosis, intervention, implementation, and evaluation. The results of the study found decreased awareness of delirium, GCS 223, seizures, headaches, dizziness, nausea and vomiting, coughing, and gurgling. Priority nursing problems include ineffective airway clearance, risk of electrolyte imbalance, risk of ineffective cerebral perfusion, risk of aspiration, and risk of injury. Airway management, electrolyte management, management of increased intracranial pressure, aspiration prevention and management of health enviromental are all interventions based on the diagnosis. The intervention innovation provided was giving HOB 30o and oxygenation at 3 lpm. The results of the evaluation found an increase in consciousness to somnolence, an increase in CGS 344, no recurrent seizures, no accumulation of secretions and sputum in the airway, no nausea and vomiting, decreased diaphoresis, and improved MAP.

Item Type:	Thesis (Magister)
Identification Number:	042216
Uncontrolled Keywords:	Subdural hematoma, Post Kraniotomi, Penurunan Kedasadaran, Kejang-Subdural Hematoma, Post Craniotomy, Loss of Consciousness, Seizure
Divisions:	Fakultas Ilmu Kesehatan > Profesi Keperawatan
Depositing User:	soegeng sugeng
Date Deposited:	17 Jan 2024 04:06
Last Modified:	17 Jan 2024 08:20
URI:	http://repository.ub.ac.id/id/eprint/211360

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