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7/23/2019 Tutorial Terapi Cairan.docx
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Terapi Cairan Perioperatif Pada
Pasien SC G2P1A0 Hamil AtermDengan Riwayat SC Dengan
Hipokalemia
Kiki atma !i"aya #20100$101%1&
'(r)aiti Andiyani #20100$101*+&
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,dentitas
• 'ama - 'y.
• /sia - $ ta(n
•
Alamat - Pak(nen3 4K• 5RS- 067017201+
• Tgl 8p - 067017201+
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AnamnesisPasien peremp(an $ ta(n G2P1A0 keamilan $% mingg(
datang ke poli (nt(k kontrol r(tin keamilan. Pasien memp(nyairiwayat SC 9 ta(n yang lal(. Pasien s(da merasakan keneng7
keneng. Kel(ar airan dari "alan lair #7&3 gerak "anin #:&3 p(sing #7&3
m(al #7&3 m(nta#7&. Pasien mengatakan )adannya sering terasa
kak(.
• RPD- riwayat SC #:& 9 ta(n yang lal(3 riwayat HT #7&3 D5 #7&3 alergidan asma #7&
• RPK- riwayat HT #7&3 D5 #7&3 alergi dan asma #7&
• Riwayat 8)stetri - G2P1A03 anak pertama SC 9 ta(n yang
lal(#dengan P;<&3 ))-2*00 gr
• Riwayat Haid - terat(r3 menare (sia 1$ ta(n3 sikl(s 2% ari3 lama
aid =+ ari
• Riwayat A'C - R(tin di dokter
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Pemeriksaan isik K/- )aik3 ompos mentis
>ital sign - TD 1$0?100 mmHg. ' %% kpm3 R 1% kpm3 S
$+39 C3 << + kg3 T<- 1 m
Kepala dan leer- CA #7?7&3 S, #7?7&3 m(kosa m(l(t )asa3
lnn tidak tera)a3 mallampati 1
Toraks-
Par(- inspeksi simetris kanan kiri3 palpasi ketinggalan
gerak #7?7&3 perk(si sonor #:?:&3 a(sk(ltasi @esik(ler #:?:&
ant(ng- it(s ordis tak tampak3 S17S2 reg(ler
A)domen- inspeksi mem)(nit3 mem)("(r3 striaegra@idar(m #7&3 a(sk(ltasi )ising (s(s #:& normal3 palpasi
epar lien tidak tera)a3 nyeri tekan #7&3 perk(si pekak
)erali #7&
;kstremitas- akral angat3 CRT B2 detik3 edema #7&
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Cont....Stat(s 8)stetri
Tera)a "anin t(nggal3 meman"ang3 Pres)o3 P(ka3 T/ 2+ m3 H,S #:&
"arang3 selap(t ket()an (t(3 D #:& lendir dara #7&
Pemeriksaan Pen(n"ang
• Pemeriksaan Dara
o
Hemoglo)in- 11.9 #12719&o e(kosit- 10.+ #6710r)&
o Hematokrit- $ #$+72&
o Trom)osit- 2$ #10760&
o PPT- 123+ #1271%&
o APTT 2932 #20760&
o H)sag- #7&
o ;lektrolit - kali(m 23 #$373$&
Protein /rine :
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aporan AnestesiDiagnosa pra)eda - G2A1P0 amil aterm dengan P;R dan
Hipokalemia dengan riwayat SC ai P;<Diagnosa pasa)eda - G2A1P0 amil aterm dengan P;R dan
Hipokalemia dengan riwayat SC ai P;<
Diagnosa anestesi - ASA ,, proSC
enis tindakan operasi -SC
enis anestesi - Spinal Anestesi• Premedikasi - 7
• Sedasi - 7
• ,nd(ksi - <(pi@aain Spinal 20 mg
• 8)at78)atan - Analgetik - Ketorola $0mg
Antiemetik - 8ndansetron 6mg
• Terapi airan preoperatif -loading R $0 tpm
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Jam Tekanan darah
(mmHg)
15.10 160?%0
15.15 120/73
15.20 11*?92
15.25 121?9
1. Induksi (bupivacaine 20 mg)
2. Ondansetron 4 mg
3. Ketorolac 30 mg
Tekanan darah dan nadi selama operasi:
8ksitosin :5etergin
S(da terpasang ,@D R $0 tpm
Infus RL di gani dengan !a"#$
%g &
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Jam Tekanan darah
(mmHg)
15.30 100?+0
15.35 *?2
15.40 100?+0
15.45 10?+1
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Jam Tekanan darah
(mmHg)
15.50 10?+0
15.55 100?+0
16.00 111?*
16.05 100?++
16.10 11$?+0
16.15 111?+
16.20 10*?+*
8perasi selesai
Perkiraan perdaraan d(rante operasi se)anyak = 600
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PEMBAHASA
N
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