Bismillah Lp Dhf

8/12/2019 Bismillah Lp Dhf

1/13

LAPORAN PENDAHULUAN

DEPARTEMEN: PEDIATRIK

DENGUE HEMORRAGHE FEVER

Disusun oleh:

NUNING KHUROTUL AFIDA

PSIK REGULER-2010

100!0201111011

PROGRAM STUDI ILMU KEPERAWATAN

FAKULTAS KEDOKTERAN

UNIVERSITAS BRAWIJAYA

MALANG 2014


2/13

DENGUE HEMORRHAGE FEVER

(DHF)

I" PENGERTIAN

1" De#$# %e&'$&$h Den(ue )DHF* $'$l$h su$+u ,en$.i+ $n(

'ise/$/.$n oleh i&us )arbovirus* $n( #$su. .e'$l$# +u/uh #el$lui

(i(i+$n n$#u.Aides aegypti. )Su&i$'i : !*

2" De#$# %e&'$&$h Den(ue )DHF* $'$l$h ,en$.i+ 'e#$# $.u+ $n(

'ise/$/.$n oleh e#,$+ se&o+,e i&us 'en(ue '$n 'i+$n'$i 'en($n

e#,$+ (e$l$ .linis u+$#$ $i+u 'en($n 'e#$# +in((i #$ni3es+$si

,e&'$&$h$n he,$+o#e($li '$n +$n'$ - +$n'$ .e($($l$n si&.ul$si s$#,$i

+i#/uln$ &en$+$n )sin'&o# &en$$+$n 'en(ue* se/$($i $.i/$+ '$&i

.e/o4o&$n ,l$s#$ $n( '$,$+ #ene/$/.$n .e#$+i$n" )Soe(i$n+o

Soe(en( : 5*

6" DHF $'$l$h su$+u ,en$.i+ in3e.si $n( 'ise/$/.$n i&us 'en(ue

'en($n 4i&i - 4i&i 'e#$# '$n #$ni3es+$si ,e&'$&$h$n" )DEPKES RI :

112*

II" ETILOGID%D 7 DHF 'ise/$/.$n oleh i&us 'en(ue '$n 'i+ul$&.$n oleh n$#u.

$i'es 'i In'onesi$ 'i.en$l 'u$ enis n$#u. $i'es $i+u :

1" Aides aegypti

P$lin( se&in( 'i+e#u.$n

N$#u. $n( hi'u, 'i '$e&$h +&o,is +e&u+$#$ hi'u, '$n

/e&.e#/$n( /i$. 'i '$l$# &u#$h $i+u 'i +e#,$+ ,en$#,un($n $i&

e&nih $+$u +e#,$+ ,en$#,un($n $i& 'i se.i+$& &u#$h"


3/13

N$#u. ini +$#,$. /e&lu&i. /e&/in+i. - /in+i. ,u+ih"

%i$s$n$ #en((i(i+ ,$'$ si$n( h$&i +e&u+$#$ ,$'$ ,$(i '$n so&e

h$&i"

8$&$. +e&/$n( 100 #e+e&"

2"Aedes Albopictus

Te#,$+ '$n h$/i+$+n$ 'i +e#,$+ $i& e&nih" %i$s$n$ 'ise.i+$&

&u#$h $+$u ,ohon - ,ohon 'i#$n$ +e&+$#,un( $i& hu$n $n(

/e&sih $i+u ,ohon ,is$n( ,$n'$n .$len( /e.$s 'll"

9en((i(i+ ,$'$ $.+u si$n( h$&i"

8$&$. +e&/$n( 0 #e+e&"

)R$#,en($n : 16;*

III" 9ANIFESTASI KLINIK

9enu&u+


4/13

>" DERA8AT %ERATNBA D%D

1" De&$$+ I : De#$# #en'$'$. 2 - ! h$&i 'ise&+$i (e$l$ .h$s '$n

s$+u-s$+un$ #$ni3es+$si ,e&'$&$h$n i$l$h ui +ou&niCue+

,osi+i3"

2" De&$$+ II : De&$$+ I 'ise&+$i 'en($n ,e&'$&$h$n s,on+$n 'i.uli+ $+$u

,e&'$&$h$n l$in"

6" De&$$+ III : De&$$+ II 'i+$#/$h .e($($l$n si&.ul$si &in($n $n(

'i+$n'$i 'en($n n$'i 4e,$+ '$n le#$h +e.$n$n n$'i

#enu&un ) ? 20 ##H(* $+$u hi,o+ensi )sis+oli. ? 0

##H(* $n( 'ise&+$i 'en($n .uli+ $n( 'in(in le#/$/

'$n ,en'e&i+$ (elis$h"

5" De&$$+ I> : De&$$+ III 'en($n sho4. /e&$+ 'en($n n$'i $n( +i'$.

+e&$/$ '$n +e.$n$n '$&$h $n( +i'$. +e&$+u& '$,$+

'ise&+$i 'en($n ,enu&un$n .es$'$&$n si$nosis '$n

$si'osis"

N% : - De&$$+ I '$n II 'ise/u+ DHF $+$u D%D +$n,$ &en$+$n

$+$u sho4."

- De&$$+ III '$n I> 'ise/u+ DHF $+$u D%D 'en($n

&en$+$n $+$u Den(ue Sho4. Sn'&o#"

UJI TOURNIQUET/RUMPEL LEEDE TEST POSITIF

Den($n #e#,e&+$h$n.$n #$nse+ +ensi#e+e& ,$'$ +e.$n$n $n+$&$ sis+ole '$n

'i$s+ole sel$#$ #eni+ .e#u'i$n 'ilih$+ $,$.$h $'$ +i#/ul ,e+e.ie $+$u

+i'$. 'i '$e&$h ole& len($n /$$h"

KRITERIA :) * %il$ u#l$h ,e+e.ie @ 20

) * %il$ u#l$h ,e+e.ie 10 - 20

) - * %il$ u#l$h ,e+e.ie 10

)R$#,en($n: 16 - 150*


5/13

>I" PATHOFISIOLOGI

) Soe(i$n+o Soe(en( : 2002 *


6/13

>II" PENATALAKSANAAN

1. Pen(en$l$n 'ini D%D /e&$+

G$#/$&$n .linis ,en+in( $n( #en$n'$.$n .e#un(.in$n $.$n

+e&$'in$ &en$+$n ) h$&i .e 6 - ! * $i+u :

$" Pe&u/$h$n senso&i. '$n ne&i ,e&u+

/" Pe&'$&$h$n n$+$ sel$in ,e&'$&$h$n .uli+

4" Te&'$,$+n$ e3usi ,leu&$ $+$u $si+es

'" Penin((i$n he#$+o.&i+ 20 $+$u le/ih

e" T&o#/osi+ .u&$n( '$&i 0"000 7 #i.&oli+e&

3" Hi,on$+&e#i$ 'en($n n$+&iu# u&in .u&$n( '$&i 10 ##ol7li+e&

(" EKG $/no$l

h" Hi,o+ensi

2. Pe#$n+$u$n .e+$+ ,$sien $n( s$.i+ /e&$+

P$&$#e+e& un+u. ,e#$n+$u$n .e+$+ DHF :

P$&$#e+e& Klinis P$&$#e+e& L$/o&$+o&iu#

Di$+esis ,e&'$&$h$n F% H+ P%F

Ge$l$ ,e+unu. so. & u&e$ ele.+&oli+ se&u#

T$n'$ $.u#ul$si 4$i&$n 'i&u$( .e-6 K$'$& N$ u&in

Os#ol$li+$s u&in '$n ,l$s#$

T$n'$ so. Al/u#in se&u#

u&$h u&in R

%e&$+ /$'$n h$&i$n EKG

Te.$n$n en$ sen+&$l G$s '$&$h '$n l$.+$+ '$&$h PT PTT

Fi/&ino(en se&u# FDP

KETERANGAN :

& J .&e$+inin

FDP J P&o'u. 'e(&$'$si 3i/&in

H+ J he#$+o.&i+

P%F J 3il# '$&$h +e,i

PT J $.+u ,&o+&o#/in PTT J $.+u +&o#/o,l$s+in ,$&si$l

3. 9e#,e&+$h$n.$nMilieu Interieur

$" 9e#/e&i.$n +e&$,i 4$i&$n in+&$en$


7/13

i" De.s+&ose '$l$# 05 N$l ) 50 #l7K( %% '$l$# 1 = 2

$# 'i+u&un.$n s$#,$i 10 #l7K( %%7$# * ,e&i.s$ H+ '$n

nil$i &es,on +e&h$'$, +e&$,i"

ii" Pl$s#$ 1 - 20 #l7K( %% ,$'$ &en$+$n /e&$+ $n( +i'$.

&es,onsi3 +e&h$'$, De.s+&ose 7 N$l"

iii" T&$ns3usi '$&$h"

/" 9e#/e&i.$n +in'$.$n su,o&+i3 $n( /e$n3$$+ se,e&+i ,e#/e&i$n

o.si(en #enu&un.$n suhu +u/uh 'en($n .o#,&es $+$u

,$&$se+$#ol"

4" Tin'$.$n $n( +i'$. /e&(un$ se,e&+i :

i" Pe#/e&i$n .o&+i.os+e&oi' he,$&in $so.ons+&i.+o& ,e&i3e&

'$n $n+i/io+i.$ +i'$. /e$n3$$+ '$l$# ,en$n($n$n D%D"

ii" 8$n($n #e#/e&i.$n 'iu&e+i. ,$'$ 3$se &en$+$n $+$u so.

.$&en$ '$,$+ #e#,e&/u&u. .e$'$$n hi,oole#i$"

) S$s+&o$s#o&o Su'i('o" 16 : 6!! = 6! 60 *

>III" PENGO%ATAN ATAU PENATALAKSANAAN TERAPEUTIK

1. Pe#/e&i$n 4$i&$n $n( 4u.u,

$i&$n 'i/e&i.$n un+u. #en(u&$n(i &$s$ h$us '$n 'ehi'&$si $.i/$+ '$&i

'e#$# +in((i $no&ei$ '$n #un+$h" Pen'e&i+$ ,e&lu 'i/e&i #inu#

se/$n$. #un(.in ) 1 = 2 li+e& '$l$# 25 $# *" P$'$ /e/e&$,$ ,en'e&i+$

'$,$+ 'i/e&i o&$li+"

2. Antipiretik

Se,e&+i (olon($n acetaminofen ) ,$&$4e+$#ol * $n($n /e&i.$n

(olon($n salisilat .$&en$ '$,$+ #ene/$/.$n /e&+$#/$hn$,e&'$&$h$n"

3. Surface cooling

4. Antikonvulsan

N% : %il$ ,en'e&i+$ .e$n( '$,$+ 'i/e&i.$n:

- Diaepam ! "alium #

- $enobarbital ! %uminal #

) R$#,en($n : 152 *


8/13

I" PENEGAHAN DHF

Un+u. #e#u+us.$n &$n+$i ,e#u+$&$n ,e#/e&$n+$s$n e.+o& 'i$n(($,

4$&$ $n( ,$lin( #e#$'$i s$$+ ini" See!"#$%& 'e!" *+e,&-"*

#e,..* $%"+ %&*," *#"!&* &* ,e!" #e$e,& 3e$,*+

$%"+ !&& $%"+ e5&&6 >e.+o& 'en(ue .hususn$ Aides

aegyptise/en$&n$ #u'$h 'i/e&$n+$s .$&en$ s$&$n( - s$&$n(n$ +e&/$+$s 'i

+e#,$+ $n( /e&isi $i& /e&sih '$n $&$. +e&/$n(n$ #$.si#u# 100 #e+e&"

Te+$,i .$&en$ e.+o& +e&se/$& lu$s un+u. .e/e&h$sil$n ,e#/e&$n+$s$n

'i,e&lu.$n total coverage) #eli,u+i selu&uh il$$h * $($& n$#u. +i'$.

'$,$+ /e&.e#/$n( /i$. l$(i"

A& 2 7&& 'e#e&$,&&$ e+,.

1" 9en((un$.$n inse.+isi'$

B$n( l$Mi# 'i,$.$i '$l$# ,&o(&$# ,e#/e&$n+$s$n 'e#$# /e&'$&$h

'en(ue :

$" 9$l$+hion un+u. #e#/unuh n$#u. 'e$s$ ) adultisida*

$&$ ,en((un$$n #$l$+hion i$l$h 'en($n ,en($s$,$n ) t&ermal

fogging * $+$u ,en($/u+$n ) cold fogging *" Un+u. ,e#$.$i$n

&u#$h +$n(($ '$,$+ 'i(un$.$n /e&/$($i enis inse.+isi'$ $n(

'ise#,&o+.$n 'i '$l$# .$#$& 7 &u$n($n #is$ln$ (olon($n

o&($no3os3$+ .$&/$#$+ $+$u ,&e+hoi'"

/" 'emep&os ! abate #un+u. #e#/unuh en+i. ) l$&$si'$ *"

$&$ ,en((un$$n +e#e,hos ! Abate # i$l$h 'en($n #en$/u&.$n

,$si& Abate ! sand granules #.e '$l$# s$&$n( - s$&$n( n$#u.

$e'es $i+u /e$n$ +e#,$+ ,en$#,un($n $i& /e&sih" Dosis $n('i(un$.$n i$l$h 1 ,,# $+$u 1 (&$# A/$+e SG 1 ,e& 10 li+e& $i&"

2" T$n,$ Ise.+isi'$

$&$n$ $'$l$h :

- 9en(u&$s /$. #$n'i +e#,$$n '$n +e#,$+ ,en$#,un($n $i&

#ini#$l 1 se#in((u ) ,e&.e#/$n($n +elu& .e n$#u. l$#$n$ !

- 10 h$&i *


9/13


10/13

2" Di$(nos$ Ke,e&$$+$n : Ke.u&$n($n olu#e 4$i&$n /e&hu/un($n

'en($n ,enin(.$+$n ,ee$/ili+$s

.$,ile& ,e&'$&$h$n #un+$h '$n 'e#$#"

Tuu$n : Se+el$h 'il$.u.$n +in'$.$n .e,e&$$+$n sel$#$ 625

$# .e/u+uh$n 4$i&$n .lien +e&,enuhi 'en($n /$i."

K&i+e&i$ H$sil : An$. #enunu..$n +$n'$ - +$n'$ +e&,enuhin$

.e/u+uh$n 4$i&$n si$nosis )-* .lien +$#,$. le/ih

+en$n( TT> no$l )n$'i:0-1107#eni+ TD:

110-1207!0-0 ##H( RR: 20-607#eni+ suhu:

6;-6!0*

INTER>ENSI :

$" O/se&$si TT> ,$lin( se'i.i+ se+i$, 5 $#"

/" 9oni+o& +$n'$ - +$n'$ #enin(.$+n$ .e.u&$n($n 4$i&$n : +u&(o&

+i'$. el$s+is u/un - u/un 4e.un( ,&o'u.si u&in #enu&un"

4" O/se&$si 4$+$+ in+$.e '$n ou+,u+"

'" %e&i.$n hi'&$si $n( $'e.u$+ sesu$i 'en($n .e/u+uh$n +u/uh"

e" 9oni+o& nil$i l$/o&$+o&iu# : ele.+&oli+ '$&$h /e&$+ enis u&in

se&u# $l/u#in"

3" Pe&+$h$n.$n in+$.e '$n ou+,u+ $n( $'e.u$+"

(" 9oni+o& '$n 4$+$+ /e&$+ /$'$n"

h" 9oni+o& ,e#/e&i$n 4$i&$n in+&$en$ se+i$, $#"

i" Ku&$n(i .ehil$n($n 4$i&$n $n( +i'$. +e&lih$+ ) Insensi/el


11/13

INTER>ENSI :

$" O/se&$si TT> ) .u$li+$s '$n 3&e.uensi 'enu+ n$'i +e.$n$n

'$&$h capillary refill*"

/" O/se&$si si&.ul$si ,$'$ e.s+&e#i+$s ) suhu .ele#/$,$n '$n

$&n$ *"

4" L$.u.$n ,enil$i$n .e#un(.in$n +e&$'in$ .e#$+i$n $&in($n

,$'$ e.s+&e#i+$s se,e&+i 'in(in ne&i ,e#/en(.$.$n .$.i"

5" Di$(nos$ Ke,e&$$+$n : Ke+i'$.sei#/$n($n nu+&isi: .u&$n( '$&i

.e/u+uh$n +u/uh /e&hu/un($n 'en($n

#u$l #un+$h +i'$. n$3su #$.$n"


$# .e/u+uh$n nu+&isi $'e.u$+

K&i+e&i$ H$sil : An$. #enunu..$n +$n'$ - +$n'$ .e/u+uh$n nu+&isi

$n( $'e.u$+ %%I

INTER>ENSI :

$" Iin.$n $n$. un+u. #$.$n - #$.$n$n $n( '$,$+ 'i+ole&$nsi

$n$. &en4$n$.$n un+u. #e#,e&/$i.i .u$li+$s ,$'$ s$$+ sele&$

#$.$n $n$. #enin(.$+"

/" %e&i.$n #$.$n$n $n( 'ise&+$i 'en($n su,le#en nu+&isi un+u.

#enin(.$+.$n .u$li+$s in+$.e nu+&isi"

4" Anu&.$n .e,$'$ o&$n(+u$ un+u. #e#/e&i.$n #$.$n$n 'en($n

+e.ni. ,o&si .e4il +$,i se&in("

'" Ti#/$n( /e&$+ /$'$n se+i$, h$&i ,$'$ $.+u $n( s$#$ '$n

'en($n s.$l$ $n( s$#$"e" Pe&+$h$n.$n .e/e&sih$n #ulu+ ,$sien"

3" 8el$s.$n ,en+in(n$ in+$.e nu+&isi $n( $'e.u$+ un+u.

,ene#/uh$n ,en$.i+"

" Di$(nos$ Ke,e&$$+$n : Pe&u/$h$n ,&oses .elu$&($ /e&hu/un($n

'en($n .on'isi $n$."


12/13


$# .elu$&($ '$,$+ #el$.u.$n .o,in( $'$,+i3

K&i+e&i$ H$sil : Kelu$&($ #enunu..$n .o,in( $n( $'$,+i3

#$n$e#en $.+u '$n ,e#/i$$$n ,e&$$+$n 'en($n /$i."

INTER>ENSI :

$" K$i ,e&$s$$n '$n ,e&se,si o&$n(+u$ $+$u $n((o+$ .elu$&($

+e&h$'$, si+u$si $n( ,enuh s+e&s"

/" Iin.$n o&$n(+u$ '$n .elu$&($ un+u. #e#/e&i.$n &es,on se4$&$

,$n$n( le/$& '$n i'en+i3i.$si 3$.+o& $n( ,$lin(

#en4e#$s.$n .elu$&($"

4" I'en+i3i.$si .o,in( $n( /i$s$ 'i(un$.$n '$n se/e&$,$ /es$&

.e/e&h$sil$nn$ '$l$# #en($+$si .e$'$$n

'" T$n$.$n ,$'$ .elu$&($ $,$ $n( '$,$+ 'il$.u.$n un+u.

#e#/u$+ $n$. 7 .elu$&($ #en$'i le/ih /$i. 7 '$n i.$

#e#un(.in.$n #e#/e&i.$n $,$ $n( 'i#in+$ oleh .elu$&($"

e" 9e#enuhi .e/u+uh$n '$s$& $n$. i.$ $n$. s$n($+ +e&($n+un(

'$l$# #el$.u.$n $.+ii+$s seh$&i - h$&i iin.$n h$l ini +i'$.

+e&$'i '$l$# $.+u $n( +i'$. +e&l$lu l$#$" Ke#u'i$n

/e&+$h$, #enin(.$+.$n .e#$n'i&i$n $n$."

" PERENANAAN PE9ULANGAN

$" %e&i.$n in3o$si +en+$n( .e/u+uh$n #el$.u.$n $.+ii+$s sesu$i

'en($n +in(.$+ ,e&.e#/$n($n '$n 3isi. $n$."

/" 8el$s.$n +e&$,i $n( 'i/e&i.$n : 'osis $.+u ,e#/e&i$n o/$+ se&+$

e3e. s$#,in( o/$+"4" 9enel$s.$n (e$l$ - (e$l$ .e.$#/uh$n ,en$.i+ '$n h$l $n(

h$&us 'il$.u.$n un+u. #en($+$si (e$l$"

'" Te.$n$n un+u. #el$.u.$n .on+&ol sesu$i $.+u $n( 'i+en+u.$n"

) Su&i$'i : = ;2 *


13/13

Documents

Bismillah Lp Dhf