of 10

LP GGK

Published on July 2016 | Categories: Types, Brochures | Downloads: 30 | Comments: 0
148 views

qwertu

Comments

Content


LAPORAN PENDAHULUAN
ASUHAN KEPERAWATAN PADA KLIEN
GAGAL GINJAL KRONIK
Disusun Oleh:
Sri Mulyani
04/1822671/EIK/0439
PROGRAM STUDI ILMU KEPERAWATAN
FAKULTAS KEDOKTERAN UGM
YOGYAKARTA
2006
GAGAL GINJAL KRONIK
A P!n"!r#ian
Gagal ginjal kronik eru!akan gangguan "ungsi ginjal #ang
!rogresi" $an irre%ersi&le' #ang en#e&a&kan kea!uan (u&uh gagal
un(uk e!er(ahankan e(a&olise $an kesei&angan )airan au!un
elek(roli(' sehingga (i&ul gejala ureia *re(ensi urea $an sa!ah ni(rogen
lain $ala $arah+,
$ E#i%l%"i&'!ny!(a(
Gagal ginjal kronik (erja$i se(elah &er&agai a)a !en#aki( #ang
erusak ne"ron ginjal, -e&agian &esar eru!akan !en#aki( !arenki
ginjal $i"us $an &ila(eral,
1, In"eksi : !ielone"ri(is kronik
2, .en#aki( !era$angan : gloerulone"ri(is
3, .en#aki( %askuler hi!er(ensi" : ne"rosklerosis &enigna
ne"rosklerosis aligna
s(enosis ar(eri renalis
4, Gangguan jaringan !en#a&ung : -/E
.oli ar(eri(is no$osa
-klerosis sis(eik !rogresi"
0, Gangguan )ongeni(al $an here$i(er: .en#aki( ginjal !olikis(ik
1si$osis (u&uler ginjal
6, .en#aki( e(a&oli) : D2' Gou(' 3i!er!ara(iroi$ise'
1iloi$osis
7, 4e"ro!a(i o&s(ruk(i" : !en#alahgunaan analge(ik
ne"ro!a(i (i&ale
8, 4e"ro!a(i o&s(ruk(i" : Sal K!)i* (a"ian a#a+,
Kalkuli' neo!lasa' "i&rosis'
ne(ro!eri(oneal
Sal K!)i* (a"ian (a-a*,
3i!er(ro"i !ros(a(e' s(rik(ur ure(ra'
anoali )ongeni(al !a$a leher
kan$ung keih $an ure(ra
. Pa#%/i+i%l%"i
.erjalanan uu GGK elalui 3 s(a$iu:
1 S#a0iu) I : .enurunan )a$angan ginjal
5Krea(inin seru $an ka$ar 674 noral
51si!(oa(ik
58es &e&an kerja !a$a ginjal: !eeka(an keih' (es G9:
2 S#a0iu) II : Insu"isiensi ginjal
5Ka$ar 674 eningka( *(ergan(ung !a$a ka$ar !ro(ein $ala $ie(+
5Ka$ar krea(inin seru eningka(
54ok(uria $an !oliuri *karena kegagalan !eeka(an+
1$a 3 $eraja( insu"isiensi ginjal:
a, :ingan
40; 5 80; "ungsi ginjal $ala kea$aan noral
&, -e$ang
10; 5 40; "ungsi ginjal noral
), Kon$isi &era(
2; 5 20; "ungsi ginjal noral
3 S#a0iu) III, gagal ginjal s(a$iu akhir a(au ureia
5ka$ar ureu $an krea(inin sanga( eningka(
5ginjal su$ah (i$ak $a!a( enjaga hoeos(asis )airan $an elek(roli(
5air keih/urin isooso(is $engan !lasa' $engan 6< 1'010
Pa#%/i+i%l%"i u)u) GGK
3i!o(esis 6ri)ker *hi!o(esis ne"ron #ang u(uh+
=6ila ne"ron (erserang !en#aki( aka seluruh uni(n#a akan han)ur'
naun sisa ne"ron #ang asih u(uh (e(a! &ekerja noral>
<ulah ne"ron (urun se)ara !rogresi"
?
Ginjal elakukan a$a!(asi *ko!ensasi+
5sisa ne"ron engalai hi!er(ro!i
5!eningka(an ke)e!a(an "il(rasi' &e&an solu(e $an rea&sor&si
(u&ulus $ala (ia! ne"ron' eski!un G9: un(uk seluruh assa ne"ron
enurun $i &[email protected] noral
?
Kehilangan )airan $an elek(roli( $!( $i!er(ahankan
?
<k 70; assa ne"ron han)ur
Ke)e!a(an "il(rasi $an &e&a& solu(e &agi (ia! ne"ron eningka(
?
Kesei&angan gloerulus $an (u&ulus (i$ak $a!a( $i!er(ahankan
?
9leksi&ili(as !roses ekskresi A kon%ersi solu(e Aair ?
-e$iki( !eru&ahan !a$a $ii( engaki&a(kan kesei&angan (erganggu
?
3ilangn#a kea!uan eeka(kan/engen)erkan keih
6< 1'010 a(au 2'80 Osl *B konsen(rasi !lasa+
?
!oliuri' nok(uria
ne"ron (i$ak $a!a( lagi engko!ensasi $gn (e!a(
(erha$a! kele&ihan $an kekurangan 4a a(au air
8oksik 7reik
Gagal ginjal (aha! akhir
?
?G9:
Krea(inin C .ro$, 2e(, .ro(, 8er(i&un C !hos!ha(e seru
Dala $arah ? kalsiu seru
-ekresi !ara(horon

8u&uh ($k &eres!on $gn 4

Kalsiu $i (ulang ?
2e(,ak(i" %i(
D?
.eru&,!a (ulang/os(eo$is(ro"i ginjal

D Tan0a 0an G!1ala
1, Kelainan 3eo!oesis' $iani"es(asikan $engan aneia
a, :e(ensi (oksik ureia D heolisis sel eri(rosi(' ulserasi ukosa
sal,)erna' gangguan !e&ekuan' asa hi$u! eri(rosi( een$ek'
&iliru&uin seru eningka(/noral' uji )o&Es nega(i%e $an julah
re(ikulosi( noral,
&, De"isiensi horone eri(ro!oe(in
Ginjal su&er E-9 *Eri(ro!oe(i) -(iula(ing 9a)(or+ D $e", 3
eri(ro!oe(in DDe!resi susu (ulang D susu (ulang (i$ak
a!u &ereaksi (erha$a! !roses heolisis/!er$arahan D aneia
norokro norosi(er,
2, Kelainan -aluran )erna
a, 2ual' un(ah' hi)(h)u!
$iko!ensasi oleh "lora noral usus D aonia *433+ D
iri(asi/rangsang ukosa la&ung $an usus
&, -(oa(i(is ureia
2ukosa kering' lesi ulserasi luas' karena sekresi )airan sali%a
&an#ak engan$ung urea $an kurang enjaga ke&ersihan ulu(,
), .ankrea(i(is
6erhu&ungan $engan gangguan ekskresi enFi a#lase
3, Kelainan a(a
4, Kelainan kuli(
a, Ga(al
8eru(aa !a$a klien $gn $ialisis ru(in karena:
5(oksik ureia #ang kurang (er$ialisis
5!eningka(an ka$ar kaliu !hos!hor
5alergi &ahan5&ahan $ala !roses 3D
&, Kering &ersisik
Karena ureu eningka( eni&ulkan !eni&unan kris(al urea $i
&[email protected] kuli(
),Kuli( u$ah ear
0, 4euro!sikia(ri
6, Kelainan sela!u( serosa
7, 4eurologi D kejang o(o(
8, Kar$ioegali
E P!)!ri2+aan P!nun1an"
1,/a&ora(oriu
a, .eeriksaan !enurunan "ungsi ginjal
5ureu krea(inin
5asa ura( seru
&, I$en(i"ikasi e(iologi gagal ginjal
5analisis urin ru(in
5ikro&iologi urin
5kiia $arah
5elek(roli(
5iuno$iagnosis
), I$en(i"ikasi !erjalanan !en#aki(
5!rogresi"i(as !enurunan "ungsi ginjal
ureu krea(inin' klearens krea(inin (es(
GG8 B *140 H uur + I 66 *kg+
72 I krea(inin seru
@ani(a B 0'80
!ria B 0'80 I GG8
5heo!oesis : 3&' (ro&osi(' "i&rinogen' "a)(or !e&ekuan
5elek(roli(
5en$okrin : .83 $an 83'84
5!eeriksaan lain: in"ark iokar$
2, Diagnos(ik
a, E(iologi GGK $an (erinal
59o(o !olos a&$oen
57-G
54e"ro(ogra
5.ielogra"i re(rogra$e
5.ielogra"i an(egra$e
5i)(ua(ing G#s(o 7rogra!h# *2G7+
&, Diagnosis !e&uruk "ungsi ginjal
5re(ogra
57-G
F Mana"!)!n #!ra'i
GGK
8era!i konser%a(i"
.en#aki( ginjal (erinal

Dialisis 3D $i :-' :uah' G1.D
8rans!lan(asi ginjal
P!na#ala2+anaan 2%n+!r3a#i/
.enga(uran $ie( !ro(ein' kaliu' na(riu' )airan
T!ra'i +i)'#%)a#i2
-u!leen alkali' (rans"use' o&a(5o&a( lo)alAsis(eik' an(i hi!er(ensi
T!ra'i '!n""an#i
3D' G1.D' (rans!lan(asi
F K%)'li2a+i
53i!er(ensi
5hi!erkaleia
5aneia
5asi$osis e(a&oli)
5os(eo$is(ro!i ginjal
5se!sis
5neuro!a(i !eri"er
5hi!erureia
G Kla+i/i2a+i GGK a#au .KD 4.r%ni5 Ki0n!y Di+!a+!6 ,
S#a"! G(ran 2!ru+a2an "in1al GFR 4)l&)in&789: )
2
6
1 4oral a(au ele%a(e$ G9: J 90
2 2il$ $e)rease in G9: 60589
3 2o$era(e $e)rease in G9: 30509
4 -e%ere $e)rease in G9: 10529
0 :eKuires $ial#sis L 10
H Dia"n%+a 2!'!ra-a#an yan" +!rin" )un5ul
1, In(oleransi ak(i%i(as &,$ kele(ihan/keleahan' aneia' re(ensi !ro$uk
sa!ah $an !rose$ur $ial#sis.
2, Kele&ihan %olue )airan
3, Ke(i$aksei&angan nu(risi kurang $ari ke&u(uhan (u&uh &,$ in(ake
akanan #ang ina$ekua( *ual' un(ah' anoreksia $ll+,
4, .ola na"as (i$ak e"ek(i" &,$ e$ea !aru' asi$osis e(a&oli)'
!neuoni(is' !erikar$i(is,
0, Kurang !enge(ahuan (en(ang !en#aki( $an )ara [email protected](an &,$
kurangn#a in"orasi keseha(an,
6, .K -e!sis
7, Gangguan !er(ukaran gas
8, .enurunan )ar$ia) ou(!u( &,$ !eru&ahan !reloa$' a"(erloa$ $an se!sis
9, :esiko (erha$a! $isuse s#n$ro
DAFTAR PUSTAKA
6runner A -u$$ar(h' 2002' Buku Ajar Keperawatan Medikal Bedah' e$isi 8
%olue 2' EGG' <akar(a
6ongar$' 9re$eri)' -, -ue' $arr#l, M' 1994' Current Critical, Care Diagnosis and
Treatment, "irs( E$i(ion' .araoun( .u&lishing 6ussiness an$
Grou!' /os 1ngeles
2)Gloske#' 1996' Nursing Interventions Classiication !NIC"' 2os&#' 7-1
:al!h A :osen&erg' 2003' Nursing Diagnoses# Deinition $ Classiication %&&'(
%&&)' .hila$el!hia 7-1
.ri)e' -#l%ia 1 an$ Nillson' /orraine 2' 1996' *atoisiologi# Konsep Klinis
*roses(*roses pen+akit, E$isi e!a(' EGG' <akar(a
@@@, 7s, Else%ierheal(h,)o' 2004' 4ursing Diagnosis: or guide to *alnning
care' "i"(h E$i(ion


Sponsor Documents


Recommended

No recommend documents

Or use your account on DocShare.tips

Hide

Forgot your password?

Or register your new account on DocShare.tips

Hide

Lost your password? Please enter your email address. You will receive a link to create a new password.

Back to log-in

Close