tag:blogger.com,1999:blog-50432015685244149642024-03-12T19:57:10.068-07:00TENTANG JANTUNGINI TENTANG : ACS, UAP, NSTEMI, STEMI, CAD, MCI, ANGINA PECTORIS, CHF, ADHF, AHF, DCM, CARDIOMEGALI, LOW EF, MR, TR, PJB, TOF, TGA, PDA, VSD, ASD, PERICARDITIS, ANEURISMA AORTA, DISEKSI AORTA, PENYAKIT JANTUNG REMATIK, ASKEP JANTUNG Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.comBlogger91125tag:blogger.com,1999:blog-5043201568524414964.post-78205556075719449932016-06-10T18:47:00.001-07:002016-06-10T18:47:29.053-07:00Perawatan pasien Serangan jantung dirumah<div dir="ltr" style="text-align: left;" trbidi="on">
Ada beberapa hal yang harus diketahui oleh pasien dan keluarga tentang perawatan pasien serangan jantung atau bahasa medisnya acut coronary syndromes (ACS) di rumah. <br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhnqmKJnftiXL1oAklGjjciGxjuMYYwmD3VoNkcA-zaIL5s4Mp4OmioPgfWH4tVOvbhGSMAK4LEaBxad4gphPy5qj76ZJoFE0UFSqmAk7ojdNdESzkd_Uu5LCdIpMX3_RJFHuL2_7qS52Xt/s1600/serangan+jantung.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="159" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhnqmKJnftiXL1oAklGjjciGxjuMYYwmD3VoNkcA-zaIL5s4Mp4OmioPgfWH4tVOvbhGSMAK4LEaBxad4gphPy5qj76ZJoFE0UFSqmAk7ojdNdESzkd_Uu5LCdIpMX3_RJFHuL2_7qS52Xt/s320/serangan+jantung.jpg" width="320" /></a></div>
<br />
Beberapa hal dibawah ini bisa menjadi catatan anda jika anda, saudara, keluarga, atau teman anda pernah terkena serangan jantung atau ACS.<br />
Silahkan disimak :<br />
<br />
1. AKTIFITAS <br />
* aktifitas harian ringan bisa dilakukan segera setelah pulang perawatan<br />
* latihan rehabilitasi untuk optimalisasi aktifitas bisa dilakukan 1-2 minggu setelah PCI (Pemasangan cincin / ring di pembuluh darah jantung) dan setelah CABG (operasi By Pass) untuk mengurangi iskemik<br />
* Aktifitas seksual biasanya bisa dilakukan setelah 1-2 minggu untuk pasien resiko rendah setelah PCI dan 4 minggu untuk setelah CABG<br />
* bisa kembali menyetir mobil setelah 1minggu, tetapi jika bisa membuat stress sebaiknya dihindari<br />
* setelah pulang rawat diperbolehkan untuk bekerja<br />
* perjalanan udara sebaiknya setelah 2 minggu setelah pulang rawat, dianjurkan dengan pendamping dan bawalah Obat Nitrat untuk di bawah lidah jika diperlukan diperjalanan<br />
<br />
2. Faktor resiko serangan jantung > Merokok<br />
dari beberapa penelitian menunjukkan merokok meningkatkan resiko serangan jantung dan DM ( Diabetes Militus ) (ada peringatan dibungkus nya kan? :-) ) jadi berhentilah merokok, jika susah silahkan menghubungi klinik berhenti merokok (sudah ada dibeberapa rumah sakit ) , hindari lingkungan perokok dan terkena asap rokok juga ya...<br />
> Kontrol Tekanan Darah<br />
Target kita <130 atau="" dan="" darah="" dengan="" diit="" dm="" gangguan="" ginjal="" hipertensi="" jangan="" juga="" lupa="" makan="" minum="" mmhg="" nbsp="" nya="" obat="" p="" pada="" pasien="" sesuai="" tingginya..="" ya..="">> atur lemak (kolesterol )<br />
Atur pola hidup sehat, diit kurangi asupan lemak <7 badan="" berat="" berolahraga="" dan="" ideal="" jaga="" kolesterol="" mg="" nbsp="" p="" sehari="" teratur="">Dan jangan lupa minum obat kolesterolnya ya..<br />
> DM (Diabetes Militus)<br />
Minum atau suntik dengan teratur obat DM sesuai dosis yang diberikan dokter anda dan ubah pola hidup sehat, target gula darah puasa <6 110mg="" atau="" dl="" hba1c="" mendekati="" mmol="" nbsp="" normal="" p="">> Atur Berat Badan<br />
Obesitas meningkatkan resiko terkena serangan jantung lho.... jadi olah raga dan diit yang benar ya agar mendapat BMI ideal<br />
Hitung BMI ( Body Mass Index ) rumus = Berat Badan (Kg)/ (tinggi badan*tinggi badan (M) target untuk orang asia dewasa 18,5 - 22,9 kg/m2<br />
> Berolah Raga<br />
Berolahraga 30-60mnt / hari dan setidaknya 5 hari dalam seminggu<br />
Ikuti program rehabilitasi jantung sehat ya.. ( ada di Rumah sakit )<br />
> Modifikasi diit<br />
Diit rendah lemak jenuh, rendah garam, tinggi lemak tak jenuh, tinggi buah dan sayuran ya..<br />
Berhenti mengkonsumsi alkohol<br />
Jika perlu konsultasi ke ahli gizi.<br />
<br />
3. Jangan lupa untuk kontrol secara teratur ke dokter anda, biasanya awal setelah pulang rawat akan kontrol rutin tiap bulan, setelah 1th menjadi tiap 3bln, dan tiap 6bln sesuai kondisi pasien.<br />
<br />
4. Minum obat secara teratur sesuai dengan yang diresepkan dokter anda jangan berhenti minum obat tanpa petunjuk dokter anda (kebanyakan pasien dengan serangan jantung mengkonsumsi obat seumur hidup).<br />
<br />
Semoga Bermanfaat<br />
<br />
<br />
<br />
<br />
<br />
</6></7></130><br />
<div>
<br /></div>
</div>
Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-85876083309516319522016-06-10T17:06:00.001-07:002016-06-10T18:48:14.517-07:00PERAWATAN PASIEN GAGAL JANTUNG DI RUMAH<div dir="ltr" style="text-align: left;" trbidi="on">
Perawatan Pasien Gagal Jantung di Rumah<br />
<br />
Masih banyaknya pasien dengan diagnosa Gagal Jantung yang sering keluar masuk dalam perawatan di rumah sakit, beberapa hal dibawah ini dapat membuat teman, saudara, orang tua anda yang menderita gagal jantung bisa hidup lebih optimal dan produktif<br />
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<br />
Hal – hal penting yang harus diketahui pasien dan keluarga saat perawatan pasien gagal jantung di rumah adalah mengubah kebiasaan untuk meningkatkan kesehatan:<br />
1. Pahami nama obat yang diminum, dosis dan efek sampingnya dan minumlah dengan teratur, hindari NSAID untuk menekan batuk, karena NSAID bisa menyebabkan retensi Na, peripheral vasokontriksi, dan menurunkan efisiensi serta meningkatkan toxicity dari ACE inhibitor dan diuretic<br />
<br />
2. untuk merubah gaya hidup, sikap yang acuh bisa memperburuk kondisi gagal jantung<br />
<br />
3. Ikuti konseling gagal jantung / klinik gagal jantung untuk mendiskusikan masalah yang timbul karena gagal jantung dan solusinya dengan psikolog<br />
<br />
4. Berobat / control dengan teratur sesuai dengan petunjuk dokter anda<br />
<br />
5. Makan makanan yang sehat dan seimbang dan diit rendah/tanpa garam<br />
garam bersifat menarik air kedalam tubuh sehingga dapat memperberat kerja jantung dan pernapasan,<br />
diit rendah garam memungkinkan pemakaian dosis diuretic paling kecil<br />
Bila membeli makanan, baca labelnya dan lihat kandungan garamnya hindari makanan kemasan, cepat saji, dan direstoran karena biasanya mengandung sodium, diit garam di perketat < 1,5g/hari (< 1sendok teh dari daram meja/hari)<br />
Jauhkan garam dari dapur dan meja makan ganti dengan perasa herbal/ alami<br />
<br />
6. Makan makanan yang masih segar (sayur, buah, ikan, daging)<br />
<br />
7. Jika perlu konsultasikan dengan ahli gizi anda<br />
<br />
8. Coba untuk baraktifitas secara bertahap, dan berolahraga<br />
Berolahraga ringan dengan teratur akan melatih dan memperkuat pompa jantung, mengurangi berat badan, memperlancar peredaran darah, menurunkan kadar kolesterol dan mengurangi stress.<br />
Diskusikan aktifitas seksual pasien dengan pasangan (dianjurkan untuk mengikuti konseling), anjurkan (jka perlu)minum nitrat sublingual sebelum melakukan hubungan seks, ikuti rehabilitasi medis di rumah sakit<br />
<br />
9. Stop merokok, dan berdekatan dengan orang yang sedang merokok, stop kebiasaan minum minuman beralkohol<br />
<br />
10. Timbang berat badan setiap hari dengan alat timbangan yang sama, waspadai jika ada kenaikan berat badan 2kg/3hari (dosis diuretic mungkin perlu ditingkatkan), segera pergi kedokter untuk pengobatan<br />
<br />
11. Batasi masukan cairan 1,5 – 2 liter/hari<br />
Jika pasien mengalami kegemukan kurangi berat badan (target BMI untuk asia dewasa : 18,5 – 22,9 Kg/m2), maximum berat badan adalah 5% target BMI<br />
<br />
12. Perhatikan produksi air seni (BAK) dalam sehari (normal 0,5cc/kgBB/jam), jika kurang hubungi dokter<br />
<br />
13. Konsultasikan dengan dokter sebelum melakukan Perjalanan melalui udara yang lama, perhatikan tanda – tanda : dehidrasi, oedema tungkai bawah, deep venous thrombosis (DVT)<br />
<br />
14. Jika ada keluhan sakit baik yang berhubungan dengan sesak nafas ataupun yang lain usahakan untuk relaks, beristirahatlah jika dengan istirahat tidak berkurang segera ke dokter untuk pengobatan. Jangan minum obat sembarangan karena beberapa obat dapat bereaksi dengan obat gagal jantung<br />
<br />
15. Pahami dan perbanyak informasi tentang gagal jantung melalui membaca buku tentang gagal jantung, mengikuti grup / club gagal jantung yang ada disekitar anda ataupun di internet .<br />
<br />
16. Banyak pasien gagal jantung mengalami kekurangan gizi biasanya tersamar karena oedema, makan sedikit tapi sering perlu pada pasien yang mual, sesak atau lemah<br />
<br />
17. untuk Imunisasi pneumococcal dan influenza<br />
<br />
18. Diskusikan dan rencanakan kehamilan dan kontrasepsi dengan dokter, kehamilan meningkatkan volume darah, cardiac output, dan cairan intra selular, beberapa obat gagal jantung tidak diperbolehkan untuk ibu hamil<br />
<br />
Semoga bermanfaat..</div>
Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-7051564965217955262012-12-04T04:04:00.002-08:002012-12-04T04:04:29.738-08:00ALAT PACU JANTUNG PERMANEN / PERMANENT PACE MAKER / PPM<br />
<div class="MsoNormal">
<b>ALAT PACU JANTUNG
PERMANEN / PERMANENT PACE MAKER / PPM<o:p></o:p></b></div>
<div class="MsoNormal">
<b><br /></b></div>
<div class="MsoNormal">
<b><i>Apakah alat pacu jantung / Pacemaker?</i></b></div>
<div class="MsoNormal">
<b><i><br /></i></b></div>
<div class="MsoNormal">
Dokter Anda telah merekomendasikan alat pacu jantung karena
ada tanda-tanda bahwa jantung Anda tidak
berdetak semestinya atau ada masalah dengan sinyal listrik alami jantung anda yang
mempengaruhi kerja jantung Anda. Sebuah alat pacu jantung permanen terdiri dari
generator dan lead yang biasanya ditanamkan ke dada bagian atas melalui sayatan
kecil. Generator adalah alat logam khusus yang mengandung sumber daya dan timer
yang mengatur seberapa sering alat pacu jantung mengirimkan sinyal listrik.
Kehidupan generator biasanya 7 sampai 10 tahun. lead memungkinkan alat pacu
jantung untuk memantau irama jantung Anda dan mengirimkan sinyal-sinyal listrik
untuk membuat jantung berdenyut saat diperlukan.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><i>Diagnosa</i></b></div>
<div class="MsoNormal">
<b><i><br /></i></b></div>
<div class="MsoNormal">
Sinyal listrik normal dimulai di bagian atas jantung di
daerah yang disebut sinus (SA) node terletak di atrium kanan. Sinyal kemudian
berjalan melalui AV node ke ruang bawah jantung. Sebagai sinyal mencapai dasar
jantung, sehingga memungkinkan jantung berkontraksi. Detak jantung normal
adalah 60 sampai 100 denyut per menit saat istirahat dan bervariasi dengan
aktivitas.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><i>Beberapa masalah yang mungkin memerlukan penggunaan pacu
jantung :</i></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
• Kegagalan SA node untuk mengirimkan sinyal-sinyal listrik
yang memadai mengakibatkan denyut jantung yang lambat.</div>
<div class="MsoNormal">
• adanya blok pada / di bawah AV yang mencegah hantaran
listrik jantung mencapai ruang bawah jantung.</div>
<div class="MsoNormal">
• irama jantung abnormal yang tidak dipengaruhi oleh obat.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><i>Posisi pemasangan alat Pacu jantung Tetap / permanent pace
maker (PPM)</i></b></div>
<div class="MsoNormal">
<b><i><br /></i></b></div>
<div class="MsoNormal">
Alat pacu jantung biasanya ditanamkan di dada bagian atas
dan lead yang berulir akan ditempatkan melalui pembuluh darah ke jantung.
Generator akan dihubungkan dengan lead dan ditempatkan di bawah kulit Anda.
Sadapan harus menyentuh jantung sehingga sinyal listrik dapat mengalir
bolak-balik antara jantun dan generator. Dalam beberapa kasus, Anda mungkin
memerlukan alat pacu jantung sementara. Sebuah alat pacu jantung sementara
ditempatkan di luar tubuh dan akan dilepas setelah alat pacu jantung permanen
ditanam (dipasang).</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><i>Persiapan Sebelum Pemasangan Pacemaker</i></b></div>
<div class="MsoNormal">
<b><i><br /></i></b></div>
<div class="MsoNormal">
Sebelum pemasangan pacu jantung, dokter jantung anda akan
berdiskusi tentang manfaat dari pacu jantung, dan proses pemasangan, banyaklah
bertanya dan ungkapkan ketakutan anda untuk mendapatkan jawaban dari dokter.</div>
<div class="MsoNormal">
Akan ada beberapa pemeriksaan : cek laboratorium, perekaman
EKG, foto rontgent, jika anda hamil informasikan</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><i>Harap perhatikan hal berikut sebelum tindakan pemasangan pacu
jantung:</i></b></div>
<div class="MsoNormal">
<b><i><br /></i></b></div>
<div class="MsoNormal">
</div>
<ul>
<li>Pastikan anda telah mengisi surat ijin tindakan dan surat
persetujuan biaya tindakan dari asuransi anda.</li>
<li> konsultasikan dengan dokter jantung anda Jika Anda
penderita diabetes atau minum obat pengencer darah untuk kemungkinan persiapan
khusus,</li>
<li>Informasikan alergi yang anda miliki terhadap (iodion,
latex, plaster, obat, minuman, makanan, dll)</li>
<li>Bawalah daftar semua obat yang biasa anda minum. minumlah
obat sesuai dengan perintah dokter, beberapa obat mungkin akan dihentikan
sebelum tindakan.</li>
<li>Biasanya, anda akan dipuasakan 6 – 8 jam sebelum tindakan,
diperbolehkan minum obat rutin dan air putih. </li>
<li>Anda akan diberi sebuah gaun rumah sakit untuk dipakai. </li>
<li>Ruangan tindakan dingin, sehingga mungkin anda perlu memakai kaus kaki. </li>
<li>Anda
akan dapat memakai kacamata dan alat bantu dengar. </li>
<li>Silakan tinggalkan perhiasan
Anda di rumah. </li>
<li>Anda akan diminta untuk melepas gigi palsu Anda. </li>
<li>Sebuah jalur Infus akan dipasang. </li>
<li>Selama prosedur, keluarga Anda dapat menunggu di ruang tunggu di
Layanan Kardiologi. Mereka akan diberitahu ketika prosedur Anda selesai dan
akan diizinkan untuk melihat Anda ketika Anda berada di daerah pemulihan.</li>
</ul>
<div class="MsoNormal">
<b>SAAT PEMASANGAN PACU JANTUNG (PACE MAKER)</b></div>
<div class="MsoNormal">
<b><br /></b></div>
<div class="MsoNormal">
Anda akan dibawa ke Lab Kateterisasi Jantung (Cath Lab) dan
pindah ke meja x-ray.</div>
<div class="MsoNormal">
Diatas meja tindakan akan ada layar televisi yang besar. </div>
<div class="MsoNormal">
Tim
bedah terdiri dari dokter jantung, perawat dan teknisi.</div>
<div class="MsoNormal">
Mereka akan mengenakan
masker, gaun dan sarung tangan. Setelah diposisikan di atas meja x-ray, Anda
akan terhubung ke berbagai monitor dan ditutupi dengan kain steril.</div>
<div class="MsoNormal">
• Anda mungkin akan diberi obat melalui Infus sebelum
prosedur untuk membantu Anda bersantai. Obat ini dapat membuat Anda mengantuk.</div>
<div class="MsoNormal">
• Daerah penyisipan pada dada bagian atas akan dicukur dan dibersihkan
untuk mencegah infeksi.</div>
<div class="MsoNormal">
• Anestesi lokal akan diberikan untuk menghilangkan nyeri
pada area penyisipan.</div>
<div class="MsoNormal">
• dokter jantung akan membuat sayatan kecil sekitar 1-3 inci
untuk penyisipan alat pacu jantung.</div>
<div class="MsoNormal">
• Sadapan akan berulir melalui pembuluh darah ke jantung dan
terhubung ke generator.</div>
<div class="MsoNormal">
• Generator akan diposisikan tepat di bawah kulit.</div>
<div class="MsoNormal">
• dokter jantung akan menguji dan memprogram alat pacu
jantung sesuai dengan kebutuhan anda.</div>
<div class="MsoNormal">
• sayatan kemudian akan ditutup dengan jahitan dan dapat
ditutupi dengan steri-strip.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><i>Setelah Pemasangan Pacemaker (pacu jantung)</i></b></div>
<div class="MsoNormal">
<b><i><br /></i></b></div>
<div class="MsoNormal">
</div>
<ul>
<li>Prosedur akan memakan waktu 1-2 jam. </li>
<li>dokter jantung anda akan menjelaskan hasil pemasanga pacu
jantung setelah selesai tindakan. </li>
<li>Setelah selesai prosedur mungkin Anda akan dirawat diruang
CVCU (ruang ICU jantung), keluarga Anda dapat mengunjungi saat jam kunjung.</li>
<li> irama jantung Anda akan dipantau terus menerus. </li>
<li>Mintalah perawat untuk obat sakit bila diperlukan dan melaporkan
jika tidak ada perubahan</li>
<li> Sangat penting bagi Anda membatasi gerakan lengan Anda di
sisi dimana alat pacu jantung ditanamkan selama 24 jam pertama. </li>
<li>Malam pertama, jangan
berbaring di sisi alat pacu jantung dipasang. </li>
<li>Sebelum pulang, dokter ahli jantung Anda dapat
menyesuaikan atau mengubah program alat pacu jantung Anda sesuai dengan
kebutuhan Anda. </li>
<li>Salinan dari program alat pacu jantung Anda akan diberikan
kepada Anda untuk dibawa setiap saat.</li>
<li>Hubungi dokter ahli jantung anda jika ada pertanyaan atau
masalah Setelah Anda tiba di rumah, .</li>
</ul>
<br />
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><i>Pulang ke rumah setelah pemasangan Pacemaker </i></b></div>
<div class="MsoNormal">
<b><i><br /></i></b></div>
<div class="MsoNormal">
Lihatlah sayatan Anda sebelum Anda meninggalkan rumah sakit.
Periksa setiap hari di rumah untuk memantau setiap perubahan.</div>
<div class="MsoNormal">
Hubungi dokter ahli jantung Anda jika:</div>
<div class="MsoNormal">
• luka basah</div>
<div class="MsoNormal">
• kemerahan</div>
<div class="MsoNormal">
• pembengkakan</div>
<div class="MsoNormal">
• teraba hangat pada area luka</div>
<div class="MsoNormal">
• lemah</div>
<div class="MsoNormal">
• Demam lebih dari 38⁰C</div>
<div class="MsoNormal">
Jangan memakai pakaian ketat, membatasi gerak, menekanan
luka sayatan atau alat pacu jantung. Termasuk bra pada perempuan.</div>
<div class="MsoNormal">
Tunggu 7 sampai 10 hari sebelum luka sayatan Anda sembuh.
Sementara itu jangan basahi luka sayatan saat mandi.</div>
<div class="MsoNormal">
Jika sayatan luka mulai mengering dan tampak penyembuhan ,
Anda dapat menggunakan lotion sekitar area sayatan untuk meringankan kekeringan
dan gatal.</div>
<div class="MsoNormal">
Plester penutup luka akan dibuka, bisa juga terbuka sendiri,
saat control ke poliklinik bekas plester dan luka akan dibersihkan.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><i>Follow-Up Perawatan saatnya kontrol ke poliklinik</i></b></div>
<div class="MsoNormal">
<b><i><br /></i></b></div>
<div class="MsoNormal">
Kontrol ke poliklinik kardiolog Anda 1 sampai 2 minggu setelah alat
pacu jantung dipasang. </div>
<div class="MsoNormal">
Selama pemeriksaan rutin, Anda akan terhubung ke monitor
jantung dan programmer alat pacu jantung. Perubahan dalam program pacu jantung
mungkin diperlukan sesuai kondii anda. </div>
<div class="MsoNormal">
Bawalah selalu kartu pacu jantung anda
setiap kontrol ke poliklinik dan kemana saja anda pergi</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><i>Pedoman Kegiatan di rumah setelah pemasangan pacu jantung menetap (PPM)</i></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
</div>
<ul>
<li>Anda harus membatasi penggunaan lengan dan bahu pada
lengan yang terpasang pacu jantung hingga 1 sampai 3 bulan pertama. Anda tidak
boleh melakukan pekerjaan mendorong, menarik, beban berat atau mengangkat
lengan Anda di atas bahu Anda sampai diperintahkan oleh kardiolog Anda.</li>
<li> Jangan mengemudi sampai disarankan oleh dokter ahli
jantung Anda. Ini biasanya 1 sampai 4 minggu.</li>
<li> Anda dapat melakukan pekerjaan rumah tangga ringan seperti
mencuci piring dan memasak. Hindari mesin penyedot debu, mengangkat laundry, membersihkan
barang – barang yang berada diatas, dan meraih barang yang jauh.</li>
<li> Tanyakan kepada dokter ahli jantung Anda sebelum melakukan kegiatan
olahraga seperti golf, bowling, berburu, memancing atau olahraga berat lainnya.</li>
</ul>
<br />
<div class="MsoNormal">
<b><i>Yang harus diwaspadai setelah pemasangan pacu jantung menetap / </i></b><b><i>PPM (pemanent pace maker)</i></b></div>
<div class="MsoNormal">
<b><i> </i></b></div>
<div class="MsoNormal">
</div>
<ul>
<li>Hindari berada di dekat daerah dengan tegangan tinggi,
medan gaya magnet, atau radiasi karena dapat menyebabkan kerusakan alat pacu
jantung. Daerah yang ada kabel tegangan tinggi, pembangkit listrik, magnet
industri besar dan mesin las/ bubut. </li>
<li>Gejala kerusakan alat pacu jantung adalah
pusing, ringan atau perubahan irama jantung. Jika gejala-gejala muncul,
menjauhlah 10 meter dan periksa denyut
nadi Anda.</li>
<li> Alat pacu jantung terbaru tidak terpengaruh oleh oven
microwave. Karena telah memiliki mekanisme keamanan dari gangguan listrik.</li>
<li> Ketika Anda pergi ke bandara,bawalah selalu kartu alat
pacu jantung Anda. Karena alat pacu jantung mengandung logam, mungkin memicu
detektor logam bandara. Jelaskan kepada petugas bandara bahwa Anda memakai alat
pacu jantung sehingga pengaturan khusus dapat dibuat untuk pemeriksaan keamanan.
Detektor logam tidak akan membahayakan alat pacu jantung.</li>
<li> Jangan melakukan tes MRI (Magnetic Resonance Imaging)
karena dapat merusak alat pacu jantung Anda.</li>
</ul>
<br />
<div class="MsoNormal">
<b><i>Hubungi dokter ahli jantung Anda jika Anda mersakan :</i></b></div>
<div class="MsoNormal">
</div>
<ul>
<li> sakit parah pada area pemasangan alat pacu jantung</li>
<li> sering cegukan</li>
<li> otot perut Anda berkedut</li>
<li> sesak napas</li>
<li> pusing, kepala ringan atau pingsan</li>
<li> tanda-tanda infeksi: luka yang bernanah, kemerahan, bengkak,terasa hangat pada luka, demam yang tidak biasa, kelemahan</li>
</ul>
<br />
<div class="MsoNormal">
<b>dirumah kecilku yang nyaman di cinangka depok, tertanggal <i>03 desember 2012</i></b></div>
<div class="MsoNormal">
<b>semoga bermanfaat, jika ada ketidak pahaman dengan artikel ini harap menghubungi ahlinya ya....</b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-35149873278044950422012-05-15T23:09:00.002-07:002012-05-15T23:09:44.263-07:00MEMBERI MAKAN MELALUI SELANG NGT<div dir="ltr" style="text-align: left;" trbidi="on">
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<div align="center" class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; mso-line-height-alt: 11.5pt; text-align: center;">
<b><span style="color: #333333; font-size: 12.0pt; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;"><br /></span></b><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<b><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">A.</span></b><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><b><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">DEFINISI</span></b><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Memberi makan pada klien sesuai diit melalui selang NGT</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<b><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">B.</span></b><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><b><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">TUJUAN</span></b><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span lang="FI" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: FI; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">1.</span><span lang="FI" style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-ansi-language: FI; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span lang="FI" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: FI; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Untuk memperbaiki atau mempertahankan status
nutrisi klien</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">2.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Untuk memberikan obat</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<b><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">C.</span></b><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><b><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">PRINSIP</span></b><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">1.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Makanan yang dapat diberikan adalah makanan cair, makanan yang
diblender halus, dan formula khusus makanan enteral</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span lang="SV" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">2.</span><span lang="SV" style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-ansi-language: SV; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Residu
lambung harus dicek sebelum memberikan makanan.</span><span lang="SV" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Residu > 50 cc, tunda pemberian sampai 1 jam. Jika
setelah 1 jam jumlah residu tetap, kolaborasi dengan dokter untuk program
selanjutnya.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span lang="SV" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">3.</span><span lang="SV" style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-ansi-language: SV; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span lang="SV" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Hindari mendorong makanan untuk mencegah
iritasi lambung. Kecepatan yang direkomendasikan adalah pemberian dengan
ketinggian sekitar 45 cm dari abdomen.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span lang="SV" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">4.</span><span lang="SV" style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-ansi-language: SV; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span lang="SV" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Perhatikan interaksi obat dengan makanan,
terutama dengan susu jika ada pemberian obat per oral.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<b><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">D.</span></b><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><b><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">PERSIAPAN</span></b><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">1.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Cairan makanan</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">2.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Syringe 20-50cc</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">3.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Gelas ukur 60 ml</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">4.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Pompa makanan (jika ada)</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">5.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Tissue</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">6.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Bengkok</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 28.35pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<b><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">E.</span></b><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><b><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">PROSEDUR</span></b><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">1.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Mengecek program terapy medik</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">2.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Menjelaskan tindakan yang akan dilakukan</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">3.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Mencuci tangan</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">4.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Menyiapkan alat disamping tempat tidur</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">5.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Mengkaji adanya alergi makanan, bising usus, masalah-masalah yang
berkaitan dengan pemberian makanan melalui NGT (muntah, diare, konstipasi,
distensi abdomen)</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">6.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Menyiapkan makanan dan obat (jika ada) yang akan diberikan. Sesuai
dengan terapi medik.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">7.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Menjaga privacy klien</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">8.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Membantu klien dalam posisi fowler di tempat tidur atau duduk di
kursi. Jika posisi duduk merupakan kontra indikasi bagi klien, posisi miring
kanan dengan kepala agak tinggi boleh dilakukan.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">9.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Mengecek penempatan/kepatenan NGT: menempatkan kateter tip dalam
keadaan tertutup pendorongnya di ujung selang NGT. Aspirasi isi lambung,
kemudian cek PH.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">10.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Mengkaji residu lambung .</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">11.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Memberikan makanan via NGT :</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.05pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">a.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Bolus/intermiten feeding</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 113.4pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">1)</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Klem selang dengan cara menekuk ujung selang dengan menggunakan
tangan yang tidak dominan, melepaskan kateter tip dari selang dengan
tangan non dominan, kemudian lepaskan pendorongnya dari kateter tip.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 113.4pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span lang="NO-BOK" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">2)</span><span lang="NO-BOK" style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Memasukkan
kembali suntikan tanpa pendorongnya di ujung selang. </span><span lang="NO-BOK" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Tangan yang tidak dominan tetap mengklem
selang. Meninggikan ujung selang sekitar 18 inchi atau 45 cm dari abdomen
klien.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 113.4pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span lang="NO-BOK" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">3)</span><span lang="NO-BOK" style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span lang="NO-BOK" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: NO-BOK; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Memasukkan makanan/formula ke dalam
suntikan sampai penuh, kemudian buka klem selang sehingga makanan masuk melalui
selang perlahan-lahan.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 113.4pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span lang="SV" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">4)</span><span lang="SV" style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-ansi-language: SV; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span lang="SV" style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-ansi-language: SV; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Mengisi kembali kateter tip ketika
makanan/formula dalam suntikan sebelumnya masih sedikit (jangan sampai kosong
benar)</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 85.05pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">b.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Contineus drip method</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 113.4pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">1)</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Menghubungkan selang dengan pengaturan kecepatan aliran, (seperti
selang infus) dengan botol makanan. Mengalirkan makanan/formula sampai ke ujung
selang atau keluar sedikit. Atur klem, gantung botol makanan/formula sekitar 12
inch atau 30 cm dari hidung.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 113.4pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">2)</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Menghubungkan selang dari botol dengan NGT, kemudian membuka klem
dan mengatur aliran.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">12.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Setelah makanan/formula habis, membilas dengan air putih 60 ml,
menyisakan air tetap berada di selang NGT. Melepaskan tip dari selang NGT, lalu
mengklem dan menutup selang NGT.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">13.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Membantu klien mengatur posisi yang nyaman sesuai keinginan klien,
setelah 30 menit pemberian makanan.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">14.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Merapikan dan membersihkan alat</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">15.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Mencuci tangan</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">16.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Mengevaluasi respon klien</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">17.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Merencanakan tindak lanjut</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 56.7pt; margin-right: 0in; margin-top: 0in; mso-line-height-alt: 11.5pt; text-align: justify; text-indent: -28.35pt;">
<span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">18.</span><span style="color: black; font-family: "Times New Roman","serif"; font-size: 7.0pt; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";"> </span><span style="color: black; font-family: "Palatino Linotype","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Melakukan dokumentasi tindakan dan hasil</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">Referensi :</span></b><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">Bobak, K.
Jensen, 2005, Perawatan Maternitas. Jakarta. EGC</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">Elly,
Nurrachmah, 2001, Nutrisi dalam keperawatan, CV Sagung Seto, Jakarta.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">Depkes RI.
2000. Keperawatan Dasar Ruangan Jakarta.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">Engenderhealt.
2000. Infection Prevention, New York.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 42.55pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -42.55pt;">
<span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">JHPIEGO, 2003.
Panduan Pengajaran Asuhan Kebidanan, Buku 5 Asuhan Bayi Baru Lahir Jakarta.
Pusdiknakes.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 42.55pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -42.55pt;">
<span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">JNPK_KR.2004.
Panduan Pencegahan Infeksi Untuk Fasilitas Pelayanan Kesehatan Dengan Sumber
Daya Terbatas. Jakarta : Yayasan Bina Pustaka Sarwono Prawiroharjo.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">Johnson, Ruth,
Taylor. 2005. Buku Ajar Praktek Kebidanan. Jakarta. EGC.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 42.55pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -42.55pt;">
<span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">Kozier,
Barbara, 2000, Fundamental of Nursing : Concepts, Prosess and Practice : Sixth
edition, Menlo Park, Calofornia.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 42.55pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -42.55pt;">
<span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">Potter, 2000,
Perry Guide to Basic Skill and Prosedur Dasar, Edisi III, Alih bahasa Ester
Monica, Penerbit buku kedokteran EGC.</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<span lang="IN" style="color: #333333; font-size: 12.0pt; mso-ansi-language: IN; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: "Times New Roman"; mso-hansi-font-family: Calibri;">Samba,
Suharyati, 2005. Buku Ajar Praktik Kebidanan. Jakarta. EG</span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal">
<br /></div>
<h3 style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 3.05pt;">
<span style="color: #555544; font-family: "Tahoma","sans-serif"; font-size: 9.5pt;"><br />
PROSEDUR TETAP KOMPETENSI ICU</span></h3>
<h1 style="mso-line-height-alt: 10.9pt; text-align: justify;">
<span class="apple-style-span"><span style="color: #555544; font-family: "Tahoma","sans-serif";">PROSEDUR TETAP : UJI AIR</span></span><span style="color: #555544; font-family: "Tahoma","sans-serif"; font-size: 24.0pt;"></span></h1>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 112.2pt; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -93.5pt;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">1.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Pengertian</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">:
Uji air adalah suatu test absorbsi terhadap gastrointestinal.</span></b></span><b><span style="color: #555544; font-family: "Times New Roman","serif"; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 112.2pt; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -93.5pt;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">2.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Tujuan</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">:
Untuk mengetahui fungsi absorbsi dan peristaltik usus.</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 112.2pt; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Indikasi :</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 1.85in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.35in;">
<span class="apple-style-span"><b><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;">1.</span></b></span><span class="apple-converted-space"><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;">Pada
penderita tertentu dengan penurunan kesadaran.</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 1.85in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.35in;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">2.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Pada
penderita setelah dipuasakan pada waktu tertentu.</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 1.85in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.35in;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">3.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Pada
penderita yang sesudah dilakukan tindakan operasi.</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 1.85in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.35in;">
<span class="apple-style-span"><b><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;">4.</span></b></span><span class="apple-converted-space"><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;">Pada
penderita yang terpasang ventilasi mekanik invasif.</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 112.2pt; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -93.5pt;">
<span class="apple-style-span"><b><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;">3.</span></b></span><span class="apple-converted-space"><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;">Kebijakan</span></b></span><span class="apple-converted-space"><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;">:
Memenuhi kebutuhan nutrisi, keseimbangan cairan dan elektrolit.</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 112.2pt; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -93.5pt;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">4.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Prosedur</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">:</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 1.85in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.35in;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">1.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Persiapan</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">:
NGT</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 3.0in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Spuit 50 cc</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 3.0in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Air putih (dextrose 5 %)</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 3.0in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Lap makan</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 1.85in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.35in;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">2.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Langkah
– langkah :</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 2.15in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.3in;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">1.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Cek
posisi NGT.</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 2.15in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.3in;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">2.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Aspirasikan
isi lambung.</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 2.15in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.3in;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">3.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Berikan
pada :</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 3.0in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Jam I, 30 ml air putih (dextrose 5 %)</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 3.0in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Jam II, 30 ml air putih (dextrose 5 %)</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 3.0in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Jam III, 30 ml air putih (dextrose 5 %)</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 3.0in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Jam IV, 30 ml air putih (dextrose 5 %)</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 2.15in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.3in;">
<span class="apple-style-span"><b><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;">4.</span></b></span><span class="apple-converted-space"><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;">Klem
NGT, tunggu 1 jam – aspirasi, bila :</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 2.15in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Jumlah residu > 60 ml, tunda enteral</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 2.15in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Jumlah residu <></span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 2.15in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span lang="SV" style="color: #555544; mso-ansi-language: SV; mso-font-kerning: 18.0pt;">Klem NGT, tunggu 1 jam –
aspirasi, bila :</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 2.15in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span lang="FI" style="color: #555544; mso-ansi-language: FI; mso-font-kerning: 18.0pt;">Cairan aspirasi > 50 ml, stop
enteral.</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 2.15in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify;">
<span class="apple-style-span"><b><span lang="FI" style="color: #555544; mso-ansi-language: FI; mso-font-kerning: 18.0pt;">Cairan aspirasi <></span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal" style="line-height: 14.5pt; margin-bottom: 12.0pt; margin-left: 2.15in; margin-right: 0in; margin-top: 3.05pt; mso-outline-level: 2; text-align: justify; text-indent: -.3in;">
<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">5.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Tingkatkan
enteral sesuai kebutuhan.</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
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<span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">5.</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">Unit
Terkait</span></b></span><span class="apple-converted-space"><span style="color: #555544; mso-font-kerning: 18.0pt;"> </span></span><span class="apple-style-span"><b><span style="color: #555544; mso-font-kerning: 18.0pt;">:
Instalasi Gizi</span></b></span><b><span style="color: #555544; mso-font-kerning: 18.0pt;"></span></b></div>
<div class="MsoNormal">
<br /></div>
</div>Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-82493688802846416272011-11-19T06:07:00.001-08:002011-11-19T07:09:03.198-08:00MANAGEMENT OF ANTIKOAGULANT THERAPY<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-size: 48pt;"><b><span class="Apple-style-span" style="font-family: 'Courier New', Courier, monospace;">MANAGEMENT OF ANTIKOAGULANT THERAPY</span></b></span><br />
<span style="font-family: Garamond;"><b><span class="Apple-style-span" style="font-size: x-small;"><br /></span></b></span><br />
<br />
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<span style="color: #ffcc00; font-family: Wingdings;">n</span><b><span style="font-family: Garamond;">Atherotrombosis</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">merupakan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">penyebab</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">kematian</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">terbesar</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">di</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dunia</span><span style="font-family: Garamond;">
</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Indonesia </span><span style="font-family: Garamond;">diketahui</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">bahwa</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">penyebab</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">kematian</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">serebrovaskuler</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">kardiovaskuler</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">adalah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sebesar</span><span style="font-family: Garamond;"> 20,5% </span><span style="font-family: Garamond;">dan</span><span style="font-family: Garamond;"> 70% </span><span style="font-family: Garamond;">diantaranya</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">disebabkan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">oleh</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">trombosis</span><span style="font-family: Garamond;"> (</span><span style="font-family: Garamond;">Depkes</span><span style="font-family: Garamond;"> (1997))</span></b></div>
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<b><span style="line-height: 12px;"><span style="font-family: Wingdings;">n</span></span><span style="font-family: Garamond; line-height: 12px;">Trombosis</span><span style="font-family: Garamond; line-height: 12px;"> </span><span style="font-family: Garamond; line-height: 12px;">adalah</span><span style="font-family: Garamond; line-height: 12px;"> </span><span style="font-family: Garamond; line-height: 12px;">pembentukan</span><span style="font-family: Garamond; line-height: 12px;"> </span><span style="font-family: Garamond; line-height: 12px;">bekuan</span><span style="font-family: Garamond; line-height: 12px;"> </span><span style="font-family: Garamond; line-height: 12px;">darah</span><span style="font-family: Garamond; line-height: 12px;"> (</span><span style="font-family: Garamond; line-height: 12px;">trombosis</span><span style="font-family: Garamond; line-height: 12px;">) </span><span style="font-family: Garamond; line-height: 12px;">dalam</span><span style="font-family: Garamond; line-height: 12px;"> </span><span style="font-family: Garamond; line-height: 12px;">sistem</span><span style="font-family: Garamond; line-height: 12px;"> </span><span style="font-family: Garamond; line-height: 12px;">kardiovaskuler</span><span style="font-family: Garamond; line-height: 12px;">,</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">bekuan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">darah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">terjadi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">di</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">arteri</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">koroner</span><span style="font-family: Garamond;"> </span><span style="font-family: Wingdings;">à</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">serangan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">jantung</span><span style="font-family: Garamond;"> </span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">bekuan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">darah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">terdapat</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">di</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">arteri</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">serebral</span><span style="font-family: Garamond;"> </span><span style="font-family: Wingdings;">à</span><span style="font-family: Garamond;"> stroke. </span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Antikoagulan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">mengurangi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">kecenderungan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">terbentuknya</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">bekuan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">darah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dengan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">cara</span><span style="font-family: Garamond;"> </span></b></div>
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<b><span style="font-family: Garamond;">mencegah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">aksi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dari</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">faktor</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pembekuan</span><span style="font-family: Garamond;">. </span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Antikoagulan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">seringkali</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">disebut</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sebagai</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pengencer</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">darah</span><span style="font-family: Garamond;">, </span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Efek</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dari</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">antikoagulan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">adalah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">perdarahan</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">maka</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">diperlukan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pemantauan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">ketat</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pada</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pasien</span><span style="font-family: Garamond;"> </span></b></div>
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<b><span style="font-family: Garamond;">yang </span><span style="font-family: Garamond;">mendapatkan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">terapi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">antikoagulan</span></b></div>
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<span class="Apple-style-span" style="font-family: Garamond; font-weight: bold; line-height: normal;"><span class="Apple-style-span" style="font-size: large;">Hemostatis</span></span></div>
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<span style="font-size: 28.0pt;"><span style="color: #ffcc00; font-family: Wingdings; font-size: 70%; mso-color-index: 10; mso-special-format: bullet;">n</span></span><span style="font-family: Garamond;">Penghentian</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">perdarahan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">setelah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pembuluh</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">darah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">mengalami</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">cidera</span><span style="font-family: Garamond;"> (trauma).</span></div>
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<span style="font-size: 28.0pt;"><span style="color: #ffcc00; font-family: Wingdings; font-size: 70%; mso-color-index: 10; mso-special-format: bullet;">n</span></span><span style="font-family: Garamond;">Hemostasis</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">terjadi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">melalui</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">beberapa</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">cara</span><span style="font-family: Garamond;">:</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">1. </span><span style="font-family: Garamond;">Spasme</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pembuluh</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">darah</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">2. </span><span style="font-family: Garamond;">Pembentukan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sumbat</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">trombosit</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">3. </span><span style="font-family: Garamond;">Pembentukan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">bekuan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">darah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sebagai</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">hasil</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dari</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pembekuan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">darah</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-size: 28.0pt;"><span style="color: #ffcc00; font-family: Wingdings; font-size: 70%; mso-color-index: 10; mso-special-format: bullet;">n</span></span><span style="font-family: Garamond;">Proses</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pembentukan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">darah</span><span style="font-family: Garamond;"> terjadi melalui tiga fase</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">1. Pembentukan protrombin </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">2. Perubahan protrombin menjadi trombin </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">3. Perubahan fibrinogen menjadi fibrin </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Garamond;"><br /></span></div>
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<span style="font-family: Garamond;"><br /></span></div>
</div>
<div class="separator" style="clear: both; text-align: center;">
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<span class="Apple-style-span" style="font-family: Garamond; font-weight: bold; line-height: normal;"><br /></span></div>
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<b><span style="font-family: Garamond;"><br /></span></b></div>
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<b><span style="font-family: Garamond;"><br /></span></b></div>
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<b><span style="font-family: Garamond;"><br /></span></b></div>
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<span style="font-family: Garamond; font-weight: bold;"><span class="Apple-style-span" style="font-size: large;">Antithrombotic Agents: Mechanism of Action</span></span></div>
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<span style="font-family: Calibri;">1.</span><span style="font-family: Garamond;">Anticoagulants:
prevent clot formation and extension</span></div>
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<span style="font-family: Calibri;">2.</span><span style="font-family: Garamond;">Antiplatelet</span><span style="font-family: Garamond;"> drugs: interfere with
platelet activity</span></div>
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<span style="font-family: Calibri;">3.</span><span style="font-family: Garamond;">Thrombolytic
agents: dissolve existing thrombin</span></div>
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<span class="Apple-style-span" style="font-family: Garamond; font-size: large; font-weight: bold;"><br /></span></div>
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<span class="Apple-style-span" style="font-family: Garamond; font-size: large; font-weight: bold;">Faktor pembekuan :</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">I. Fibrinogen</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">II. Protrombin</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">IIITromboplastin jaringan </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">IV. </span><span style="font-family: Garamond;">Kalsium</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">V. Labil </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">VI. Faktor stabil </span><span style="color: white; font-family: Garamond; font-size: 28pt;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">VIII. Faktor antihemofilik</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">IX. Faktor Chistmas</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">X. Faktor stuart power</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">XI. </span><span style="font-family: Garamond;">Plasmatromboplastin</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">XII. Faktor Hageman</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">XIII.Faktor stabilisasi fibrin</span><span style="font-family: Garamond;">
</span></div>
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<span class="Apple-style-span" style="font-family: Garamond;"><br /></span></div>
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<span class="Apple-style-span" style="font-family: Garamond;">ANTIKOAGULAN</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Obat yang digunakan untuk
mencegah pembentukan darah dengan jalan menghambat pembentukan atau menghambat
fungsi beberapa faktor pembentukan darah. </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Garamond;"><br /></span></div>
</div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Tujuan utama dari terapi
antiokoagulan :</span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Garamond; text-indent: -29px;">1. </span><span style="font-family: Garamond; text-indent: -29px;">Mencegah</span><span style="font-family: Garamond; text-indent: -29px;"> </span><span style="font-family: Garamond; text-indent: -29px;">penimbunan</span><span style="font-family: Garamond; text-indent: -29px;"> fibrin</span></div>
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<span style="font-family: Garamond; text-indent: -29px;">2. </span><span style="font-family: Garamond; text-indent: -29px;">Mencegah</span><span style="font-family: Garamond; text-indent: -29px;"> </span><span style="font-family: Garamond; text-indent: -29px;">perluasan</span><span style="font-family: Garamond; text-indent: -29px;"> </span><span style="font-family: Garamond; text-indent: -29px;">thrombos</span><span style="font-family: Garamond; text-indent: -29px;"> </span></div>
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<span style="font-family: Garamond; text-indent: -29px;">3. </span><span style="font-family: Garamond; text-indent: -29px;">Mencegah</span><span style="font-family: Garamond; text-indent: -29px;"> </span><span style="font-family: Garamond; text-indent: -29px;">komplikasi</span><span style="font-family: Garamond; text-indent: -29px;"> </span><span style="font-family: Garamond; text-indent: -29px;">tromboemboli</span></div>
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<span style="font-family: Garamond; text-indent: -29px;">OBAT - OBAT ANTI KOAGULAN</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Penghambat</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sintesa</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">faktor</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pembekuan</span><span style="font-family: Garamond;"> (</span><span style="font-family: Garamond;">warfarin</span><span style="font-family: Garamond;">)</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Antithrombotic Agents
(heparin)</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Fibrinolytic</span><span style="font-family: Garamond;"> Agent</span></div>
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<span class="Apple-style-span" style="font-size: x-small;"><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Antiplatelet</span><span style="font-family: Garamond;"> Agents</span><span style="color: white; font-family: Garamond;"> </span></span></div>
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<span class="Apple-style-span" style="font-size: x-small;"><span style="color: white; font-family: Garamond;"><br /></span></span></div>
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<span class="Apple-style-span" style="font-size: x-small;"><span style="color: white; font-family: Garamond;"><br /></span></span></div>
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<span class="Apple-style-span" style="font-size: large;"><span style="font-family: Garamond; font-weight: bold;">Warfarin</span><span style="font-family: Garamond; font-weight: bold;"> (</span><span style="font-family: Garamond; font-weight: bold;">Coumarin</span><span style="font-family: Garamond; font-weight: bold;">, Coumadin, </span><span style="font-family: Garamond; font-weight: bold;">Panwarfin</span><span style="font-family: Garamond;">)</span></span></div>
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<span class="Apple-style-span" style="font-size: large;"><span style="font-family: Garamond;"><br /></span></span></div>
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<span style="font-family: Garamond;"></span></div>
<div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Adalah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">antikoagulan</span><span style="font-family: Garamond;"> oral </span><span style="font-family: Garamond;">dan</span><span style="font-family: Garamond;"> paling </span><span style="font-family: Garamond;">sering</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">digunakan</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">dosis</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">tunggal</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">bekerja</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Garamond;">menghambat</span><span style="font-family: Garamond;">/</span><span style="font-family: Garamond;">mengganggu</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sintesa</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">faktor</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pembekuan</span><span style="font-family: Garamond;"> vitamin K dependent (</span><span style="font-family: Garamond;">faktor</span><span style="font-family: Garamond;"> II, </span></div>
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<span style="font-family: Garamond;">VII, IX, X). </span><span style="font-family: Garamond;">Mencegah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pembentukan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">bekuan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">perluasan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">tetapi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">tidak</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">melarutkan</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Garamond;">bekuan</span><span style="font-family: Garamond;">. </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Indikasi</span><span style="font-family: Garamond;"> : </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond; font-style: italic;">Acute myocardial
infarction</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">transmural</span><span style="font-family: Garamond;"> anterior and </span><span style="font-family: Garamond; font-style: italic;">large
inferior wall </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">Atrial</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">fibrilasi</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond; font-style: italic;">Deep Vein Thrombosis
Treatment and Prophylaxis </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond; font-style: italic;">Mechanical and prosthetic
heart valves </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond; font-style: italic;">Fulomnary</span><span style="font-family: Garamond; font-style: italic;">
embolism treatment and </span><span style="font-family: Garamond; font-style: italic;">propohylaxis</span><span style="font-family: Garamond; font-style: italic;"> </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond; font-style: italic;">Cardiornyopathies</span><span style="font-family: Garamond; font-style: italic;">
</span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond; font-style: italic;">Valvuler</span><span style="font-family: Garamond; font-style: italic;">
heart disease </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond; font-style: italic;">Acute </span><span style="font-family: Garamond; font-style: italic;">cardioembolic</span><span style="font-family: Garamond; font-style: italic;">
stroke in on hypertensive patients</span><span style="font-family: Garamond;"> </span></div>
</div>
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<span style="font-family: Garamond;"><br /></span></div>
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<span style="font-family: Garamond; font-weight: bold;">Kontraindikasi </span><span style="font-family: Garamond;">:</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Perdarahan aktif / cenderung perdarahan </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Ulkus peptikum aktif </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Aneurisma </span></div>
<div style="direction: ltr; line-height: 80%; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 4.8pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Perdarahan serebrovaskuler </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Varises esophagus </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Intoleransi warfarin atau alergi seperti rash akut, diare dan
mual </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Kehamilan</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">warfarin</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dapat</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">melewati</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">plasenta</span><span style="font-family: Garamond;"> yang </span><span style="font-family: Garamond;">menyebabkan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">teratogenicity</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Garamond;">dan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">perdarahan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">janin</span><span style="font-family: Garamond;">. </span></div>
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<span style="font-family: Garamond; font-weight: bold;">Efek</span><span style="font-family: Garamond; font-weight: bold;"> </span><span style="font-family: Garamond; font-weight: bold;">Samping</span><span style="font-family: Garamond; font-weight: bold;"> :</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Perdarahan</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Nekrosis</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">kulit</span><span style="font-family: Garamond;">. </span><span style="font-family: Garamond;">Jarang</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">terjadi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">tapi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">cukup</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">serius</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">terjadi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pada</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">hari</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">ke</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">tiga</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sampai</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Garamond;">hari</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">ke</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">delapan</span><span style="font-family: Garamond;">. </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Sindrom</span><span style="font-family: Garamond;"> purple toe, </span><span style="font-family: Garamond;">biasanya</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">terjadi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pada</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">tiga</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sampai</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sepuluh</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">minggu</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">setelah</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Garamond;">pemberian</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">terapi</span><span style="font-family: Garamond;">. </span><span style="font-family: Garamond;">Perlu</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dipertimbangkan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">penyebab</span><span style="font-family: Garamond;"> lain </span><span style="font-family: Garamond;">seperti</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">vaskulitis</span><span style="font-family: Garamond;">, AMI </span></div>
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<span style="font-family: Garamond;">dengan</span><span style="font-family: Garamond;"> emboli </span><span style="font-family: Garamond;">dan</span><span style="font-family: Garamond;"> diabetes mellitus. </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Alopesia</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">osteoporesis</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">gangguan</span><span style="font-family: Garamond;"> gastrointestinal </span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsPKjgAp_Fj8PjoI4sDlY2lr55x05Vfm7whHmCagumvNlaqyJbAermRYpOIPjIa8Aky5mW7Lkcemb_6zEYcs8VPHPVvJ6dyQzZAF5OfcCma-UET9tVojzLf1zzfiM4mzCq1Ie2LNru3M8p/s1600/New+Picture+%252847%2529.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span class="Apple-style-span" style="color: black;"><img border="0" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsPKjgAp_Fj8PjoI4sDlY2lr55x05Vfm7whHmCagumvNlaqyJbAermRYpOIPjIa8Aky5mW7Lkcemb_6zEYcs8VPHPVvJ6dyQzZAF5OfcCma-UET9tVojzLf1zzfiM4mzCq1Ie2LNru3M8p/s640/New+Picture+%252847%2529.png" width="640" /></span></a></div>
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<span class="Apple-style-span" style="font-size: large;"><span style="font-family: Garamond; font-weight: bold;">Protombin</span><span style="font-family: Garamond; font-weight: bold;"> Time (PT)/INR (International Normalized Ratio)</span></span></div>
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<span style="font-size: 24.0pt;"><span style="color: #ffcc00; font-family: Wingdings; font-size: 70%; mso-color-index: 10; mso-special-format: bullet;">n</span></span><span style="font-family: Garamond;">P</span><span style="font-family: Garamond;">T/INR adalah
pemeriksaan darah untuk memonitor terapi warfarin dan untuk menentukan dosis
warfarin yang tepat. </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Pertama kali minum warfarin pemeriksaan PT/INR dilakukan 2-3
x/minggu, dokter menentukan dosis warfarin yang tepat, selanjuntya cek PT/INR
1-2 x/minggu atau beberapa minggu. Jika nilai INR sudah sesuai dengan nilai
yang diharapkan tes dilakukan tiap 3-4 minggu sekali.</span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Konsensus</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">Amireican</span><span style="font-family: Garamond;"> College of Chest
Physician’s </span><span style="font-family: Garamond;">merekomendasikan</span><span style="font-family: Garamond;"> target INR 2,5 (Range
2,0-3.0) </span><span style="font-family: Garamond;">untuk</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sebagian</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">besar</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">kondisi</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">untuk</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">katup</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">mekanik</span><span style="font-family: Garamond;"> INR 3 (range 2.5-3.5). </span></div>
</div>
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<b><span style="font-family: Garamond;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></b></div>
<br />
<span class="Apple-style-span" style="font-size: large;"><span style="font-family: Garamond; font-weight: bold;">Heparin</span><span style="font-family: Garamond;"> (</span><span style="font-family: Garamond;">Unfractined</span><span style="font-family: Garamond;"> Heparin)</span></span><br />
<br />
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Mukopolisakarida</span><span style="font-family: Arial;"> yang </span><span style="font-family: Arial;">menghambat</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">bekuan</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">darah</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">dengan</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">mengubah</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">protrombin</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">menjadi</span><span style="font-family: Arial;"> </span></div>
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<span style="font-family: Arial;">trombin</span><span style="font-family: Arial;">, heparin </span><span style="font-family: Arial;">juga</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">menghambat</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">agregasi</span><span style="font-family: Arial;"> platelet </span><span style="font-family: Arial;">oleh</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">trombin</span><span style="font-family: Arial;">. </span><span style="font-family: Arial;">Kerja</span><span style="font-family: Arial;"> heparin </span><span style="font-family: Arial;">berlangsung</span><span style="font-family: Arial;"> </span></div>
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<span style="font-family: Arial;">kira-kira</span><span style="font-family: Arial;"> 1,5 </span><span style="font-family: Arial;">sampai</span><span style="font-family: Arial;"> 4 jam. Heparin yang </span><span style="font-family: Arial;">telah</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">disuntikkan</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">akan</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">dihancurkan</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">oleh</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">enzim</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">dalam</span><span style="font-family: Arial;"> </span></div>
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<span style="font-family: Arial;">darah</span><span style="font-family: Arial;"> yang </span><span style="font-family: Arial;">disebut</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">heparinase</span><span style="font-family: Arial;">. </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Arial;"><br /></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Indikasi : </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Pencegahan dan
pengobatan gangguan tromboemboli arteri dan vena </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Infark Miokard Akut
</span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Atrial fibrilasi
dengan emboli </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Coronary
angioplasty </span></div>
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<span style="font-family: Arial;"><br /></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Kontraindikasi : </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Perdarahan aktif
termasuk perdarahan intraserebral </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Hipersensitif
heparin atau produk daging babi </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Heparin Induced </span><span style="font-family: Arial;">Trombocitopenia</span><span style="font-family: Arial;"> (HIT) </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Gagal</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">ginjal</span><span style="font-family: Arial;"> </span></div>
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<span style="font-family: Arial;"><br /></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Efek</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">Samping</span><span style="font-family: Arial;"> : </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Perdarahan</span><span style="font-family: Arial;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Alergi</span><span style="font-family: Arial;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Heparin Induced </span><span style="font-family: Arial;">Trombocytopenia</span><span style="font-family: Arial;"> (HIT)</span></div>
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<span style="font-family: Arial;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></div>
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<span class="Apple-style-span" style="font-size: large;"><span style="font-family: Garamond; font-weight: bold;">Swicth</span><span style="font-family: Garamond; font-weight: bold;"> Heparin to </span><span style="font-family: Garamond; font-weight: bold;">warfarin</span></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Generally, </span><span style="font-family: Garamond;">warfarin</span><span style="font-family: Garamond;"> can be started on the same day as heparin.</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Heparin should overlap for at least 3 to 4
days or until the INR value is within the </span></div>
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<span style="font-family: Garamond;">therapeutic range for two consecutive
days before heparin is discontinued.</span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Garamond;"><br /></span></div>
</div>
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<span style="font-family: Garamond;"><span class="Apple-style-span" style="font-size: large;">Low-Molecular-Weight
Heparins (LMWH)</span></span></div>
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<span style="font-family: Garamond;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></div>
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<div style="direction: ltr; line-height: 80%; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 4.8pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">LMWH</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Deltaparin
(fragmin) </span><span style="font-family: Garamond;">
</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Encxaparin
(Lovenox) </span><span style="font-family: Garamond;">
</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Nadroparin
(Fraxiparin) </span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Indikasi :</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">
</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Pencegahan
tromboemboli </span><span style="font-family: Garamond;">
</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Pengobatan DVT </span><span style="font-family: Garamond;">
</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Angina tidak stabil
dengan non Q miocard infarction </span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Kontraindikasi</span><span style="font-family: Garamond;"> : </span><span style="font-family: Garamond;">
</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Perdarahan </span><span style="font-family: Garamond;">
</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Trombositopenia </span><span style="font-family: Garamond;">
</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Gagal ginjal </span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Efek Samping </span></b><b><span style="font-family: Garamond;">:</span><span style="font-family: Garamond;"> </span></b></div>
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<b style="text-indent: -29px;"><span style="font-family: Wingdings;"> n</span><span style="font-family: Garamond;">Perdarahan </span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Hematoma pada daerah suntika </span><span style="font-family: Garamond;">
</span></b></div>
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<b><span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Alergi </span><span style="font-family: Garamond;">
</span></b></div>
<div style="line-height: 80%;">
<b><span style="font-family: Garamond;"><br /></span></b></div>
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<b><span style="font-family: Garamond;">FIBRINOLITIK</span></b></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">ditujukan untuk melarutkan setiap thrombus yang telah
terbentuk di arteri koroner, </span></div>
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<span style="font-family: Garamond;">memperkecil penyumbatan dan juga luasnya infark
(Brunner & Suddarth, </span></div>
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<span style="font-family: Garamond;">2001). </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond; font-weight: bold;">Indikasi : </span><span style="font-family: Garamond; font-weight: bold;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Usia kurang dari 75
tahun </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Onset </span><u><span style="font-family: Garamond;"><</span></u><span style="font-family: Garamond;"> 12 jam sejak mulainya sakit dada khas infark </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Evaluasi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">segmen</span><span style="font-family: Garamond;"> ST > 0,1 mV </span><span style="font-family: Garamond;">pada</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dua</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">sandapan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">atau</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">lebih</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Bundle Branch Block
/ adanya LBB baru</span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Tidak ada
kontraindikasi </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond; font-weight: bold;">Kontraindikasi :</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Mutlak :Riwayat
stroke perdarahan, neoplasma intrakranial, perdarahan </span></div>
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<span style="font-family: Garamond;">internal aktif, diseksi
aorta. </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Relatif :Hipertensi
yang tidak terkontrol, sedang dalam terapi koagulan, </span></div>
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<span style="font-family: Garamond;">trauma baru dalam dua
minggu, perdarahan yang tidak terkontrol, perdarahan </span></div>
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<span style="font-family: Garamond;">interval tidak termasuk
menstruasi, riwayat pemberian atau alergi </span></div>
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<span style="font-family: Garamond;">streptokinase sebelumnya, kehamilan,
ulkus peptikum aktif. </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Efek</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">SamPing</span><span style="font-family: Garamond;"> :</span></div>
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<span style="font-family: Wingdings; text-indent: -29px;"> n</span><span style="font-family: Garamond; text-indent: -29px;">Perdarahan</span></div>
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<span style="font-family: Garamond;"></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Aritmia</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">jantung</span><span style="font-family: Garamond;"></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Hipotensi</span><span style="font-family: Garamond;"></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Alergi</span><span style="color: white; font-family: Garamond; font-size: 18pt;"></span></div>
<div>
<span style="font-family: Garamond;"><br /></span></div>
</div>
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<span style="font-family: Garamond;"><br /></span></div>
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<span style="font-family: Garamond; font-weight: bold; line-height: 14px;">Selektif</span><span style="font-family: Garamond; font-weight: bold; line-height: 14px;"> FibrIN :</span></div>
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<span style="font-family: Wingdings; line-height: 14px;">n</span><span style="font-family: Garamond; line-height: 14px;">Tissue - type </span><span style="font-family: Garamond; line-height: 14px;">Plasminogen</span><span style="font-family: Garamond; line-height: 14px;"> Activator (t-PA)</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Recombinan</span><span style="font-family: Garamond;"> Tissue </span><span style="font-family: Garamond;">Plasminogen</span><span style="font-family: Garamond;"> Activator (r-TPA)</span></div>
<div style="direction: ltr; line-height: 14px; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 6.72pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Recombinan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">Plasminogen</span><span style="font-family: Garamond;"> Activator (</span><span style="font-family: Garamond;">relaplase</span><span style="font-family: Garamond;">-r-PA)</span></div>
<div style="direction: ltr; line-height: 14px; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 6.72pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<span style="font-family: Garamond; font-weight: bold;">Non </span><span style="font-family: Garamond; font-weight: bold;">Selektif</span><span style="font-family: Garamond; font-weight: bold;"> Fibrin</span><span style="font-family: Garamond;"></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Streptokinase</span></div>
<div style="direction: ltr; line-height: 14px; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 6.72pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Urikinase</span><span style="font-family: Garamond;"></span></div>
<div style="direction: ltr; line-height: 80%; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 4.8pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<span style="font-family: Wingdings; line-height: 14px;">n</span><span style="font-family: Garamond; line-height: 14px;">Anisoglate</span><span style="font-family: Garamond; line-height: 14px;"> </span><span style="font-family: Garamond; line-height: 14px;">Plasminogen</span><span style="font-family: Garamond; line-height: 14px;"> Streptokinase </span><span style="font-family: Garamond; line-height: 14px;">Aktivator</span><span style="font-family: Garamond; line-height: 14px;"> Complex (ASPAC)</span></div>
<div style="direction: ltr; line-height: 80%; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 4.8pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<span style="font-family: Garamond; font-weight: bold;"><br /></span></div>
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<span style="font-family: Garamond; font-weight: bold;">r-</span><span style="font-family: Garamond; font-weight: bold;">TPA (recombinant Tissue </span><span style="font-family: Garamond; font-weight: bold;">Plasminogen</span><span style="font-family: Garamond; font-weight: bold;"> Activator)</span></div>
<div style="direction: ltr; line-height: 80%; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 3.84pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Sebaiknya diberikan sebelum 6 jam </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Berikan bolus 15 mg IV </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Lanjutkan 0,75 mg/kgBB (maksimal 50 mg) dalam drip selama 30
menit.</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Kemudian</span><span style="font-family: Garamond;"> 0,50 mg/</span><span style="font-family: Garamond;">kgBB</span><span style="font-family: Garamond;"> (</span><span style="font-family: Garamond;">maksimal</span><span style="font-family: Garamond;"> 35 mg) </span><span style="font-family: Garamond;">selama</span><span style="font-family: Garamond;"> 60 </span><span style="font-family: Garamond;">menit</span><span style="font-family: Garamond;">. </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Total </span><span style="font-family: Garamond;">dosi</span><span style="font-family: Garamond;">s</span><span style="font-family: Garamond;"> </span><u><span style="font-family: Garamond;"><</span></u><span style="font-family: Garamond;"> 100 mg</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Berikan</span><span style="font-family: Garamond;"> heparin IV 5000 </span><span style="font-family: Garamond;">ui</span><span style="font-family: Garamond;"> bolus </span><span style="font-family: Garamond;">pada</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">saat</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">bersamaan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dengan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pemberian</span><span style="font-family: Garamond;"> r-TPA </span></div>
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<span style="font-family: Garamond;">bolus, </span><span style="font-family: Garamond;">dilanjutkan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dengan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pemberian</span><span style="font-family: Garamond;"> heparin drip. 1000
unit/jam, </span><span style="font-family: Garamond;">kemudian</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dosis</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Garamond;">disesuaikan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dengan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">nilai</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">aPTT</span><span style="font-family: Garamond;">. </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Cek</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">aPTT</span><span style="font-family: Garamond;"> 4 jam </span><span style="font-family: Garamond;">setelah</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pemberian</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">heparian</span><span style="font-family: Garamond;"> (</span><span style="font-family: Garamond;">standar</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pelayanan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">medik</span><span style="font-family: Garamond;"> RSJHK </span></div>
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<span style="font-family: Garamond;">adalah</span><span style="font-family: Garamond;"> 12 jam). </span></div>
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<span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Garamond; font-weight: bold;">Streptokinase </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Sebelum</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pemberian</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">berikan</span><span style="font-family: Garamond;"> hydrocortisone 100 mg IV </span><span style="font-family: Garamond;">sebagai</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">profilaksis</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dari</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Garamond;">reaksi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">alergi</span><span style="font-family: Garamond;">. </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">1.500.000 </span><span style="font-family: Garamond;">untuk</span><span style="font-family: Garamond;">
streptokinase </span><span style="font-family: Garamond;">dalam</span><span style="font-family: Garamond;"> 100 ml Dextrose 5%, </span><span style="font-family: Garamond;">diberikan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">secara</span><span style="font-family: Garamond;"> IV 3 </span></div>
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<span style="font-family: Garamond;">ml </span><span style="font-family: Garamond;">dan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">observasi</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">selama</span><span style="font-family: Garamond;"> 10 </span><span style="font-family: Garamond;">menit</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">terhadap</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">tanda</span><span style="font-family: Garamond;"> anaphylaxis, </span><span style="font-family: Garamond;">bronchospasme</span><span style="font-family: Garamond;">, </span></div>
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<span style="font-family: Garamond;">urtikaria</span><span style="font-family: Garamond;">. </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Berikan</span><span style="font-family: Garamond;"> 97 ml </span><span style="font-family: Garamond;">selama</span><span style="font-family: Garamond;"> 60 </span><span style="font-family: Garamond;">menit</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Berikan heparin 12.500 unit, secara subcutan 4 jam
setelah pengobatan </span></div>
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<span style="font-family: Garamond;">trombolisis. </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Heparin drip 1000 ui/jam (standar pelayanan medik).</span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Garamond;"><br /></span></div>
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif;">ANTI PLATELET</span></div>
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<span style="font-family: Garamond; line-height: 14px;">Antiplatelet</span><span style="font-family: Garamond; line-height: 14px;"> Agents : </span><span style="font-family: Garamond; line-height: 14px;">Obat</span><span style="font-family: Garamond; line-height: 14px;"> yang </span><span style="font-family: Garamond; line-height: 14px;">menghambat</span><span style="font-family: Garamond; line-height: 14px;"> </span><span style="font-family: Garamond; line-height: 14px;">fungsi</span><span style="font-family: Garamond; line-height: 14px;"> platelet (</span><span style="font-family: Garamond; line-height: 14px;">sel</span><span style="font-family: Garamond; line-height: 14px;"> </span><span style="font-family: Garamond; line-height: 14px;">pembeku</span><span style="font-family: Garamond; line-height: 14px;"> </span><span style="font-family: Garamond; line-height: 14px;">darah</span><span style="font-family: Garamond; line-height: 14px;">)</span></div>
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<div style="direction: ltr; line-height: 14px; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 6.72pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Oral </span><span style="font-family: Garamond;">Antiplatelet</span><span style="font-family: Garamond;"></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Aspirin</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Clopidogrel</span><span style="font-family: Garamond;"> (</span><span style="font-family: Garamond;">Plavix</span><span style="font-family: Garamond;">)</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Ticlopidine</span><span style="font-family: Garamond;"> (</span><span style="font-family: Garamond;">Ticlid</span><span style="font-family: Garamond;">)</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Intravenous </span><span style="font-family: Garamond;">Antiplatelet</span><span style="font-family: Garamond;"></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Abciximab</span><span style="font-family: Garamond;"> (</span><span style="font-family: Garamond;">Reopro</span><span style="font-family: Garamond;">)</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Eptifibatide</span><span style="font-family: Garamond;"> (</span><span style="font-family: Garamond;">Integrilin</span><span style="font-family: Garamond;">)</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Tirofiban</span><span style="font-family: Garamond;"> (</span><span style="font-family: Garamond;">Agrastat</span><span style="font-family: Garamond;">)</span><span style="color: white; font-family: Garamond; font-size: 24pt;"> </span></div>
</div>
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<div style="direction: ltr; line-height: 14px; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 6.72pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<span class="Apple-style-span" style="font-family: Wingdings;"><br /></span></div>
</div>
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<span class="Apple-style-span" style="font-family: Garamond; font-size: large;">ASPIRIN</span></div>
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<span class="Apple-style-span" style="font-family: Garamond; font-size: large;"><br /></span></div>
<div style="direction: ltr; line-height: 80%; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 3.84pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<div style="direction: ltr; line-height: 80%; margin-bottom: 0pt; margin-left: 0.38in; margin-top: 4.8pt; text-indent: -0.38in; unicode-bidi: embed; vertical-align: baseline;">
<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">yang dapat menurunkan adhesi dan agresi platelet dengan cara </span></div>
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<span style="font-family: Arial;">menghambat enzim siklooksigenase sehingga terjadi hambatan </span></div>
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<span style="font-family: Arial;">pembentukan
tromboksan A2 dan protaksilin. Tromboksan A2</span></div>
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<span style="font-family: Arial;"> merupakan vasokontriktor yang
menginduksi pengeluaran granula-</span></div>
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<span style="font-family: Arial;">granula intraseluler sehingga terjadi agregasi
platelet. </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Indikasi obat antiplatelet : </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Infark miokar akut </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Pencegahan
trombosis setelah operasi bypass </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Mengurangi resiko
serangan ulang Transient Ischemic Attack </span></div>
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<span style="font-family: Arial;">(TIA) </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Pencegahan stroke
akibat atrial fibrilasi (Warfarin </span></div>
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<span style="font-family: Arial;">dikontraindikasikan) </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Kontraindikasi : </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Pasien dengan
gangguan lambung (tukak lambung) </span><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Gangguan</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">perdarahan</span><span style="font-family: Arial;">/</span><span style="font-family: Arial;">perdarahan</span><span style="font-family: Arial;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Hipersensitif</span><span style="font-family: Arial;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Efek</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">samping</span><span style="font-family: Arial;"> :</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Gangguan</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">lambung</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">seperti</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">mual</span><span style="font-family: Arial;">, </span><span style="font-family: Arial;">muntah</span><span style="font-family: Arial;">, </span><span style="font-family: Arial;">diare</span><span style="font-family: Arial;">, </span><span style="font-family: Arial;">kembung</span><span style="font-family: Arial;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Urtikaria</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">biasa</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">terjadi</span><span style="font-family: Arial;"> </span><span style="font-family: Arial;">karena</span><span style="font-family: Arial;"> sensitive
aspirin </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Arial;">Perdarahan</span><span style="font-family: Arial;">
gastrointestinal</span><span style="color: white; font-family: Arial; font-size: 18.0pt; language: en-US; mso-ascii-font-family: Arial; mso-color-index: 1; text-shadow: auto;"> </span></div>
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<span style="color: white; font-family: Arial; font-size: 18.0pt; language: en-US; mso-ascii-font-family: Arial; mso-color-index: 1; text-shadow: auto;"><br /></span></div>
</div>
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<span class="Apple-style-span" style="font-family: Garamond; font-size: large; line-height: 14px;"><b>PENGKAJIAN</b></span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Kaji</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">adanya</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">riwayat</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">alergi</span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Kehamilan</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">antikoagulan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">dapat</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">menyebabkan</span><span style="font-family: Garamond;"> problem </span><span style="font-family: Garamond;">serius</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">selama</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Garamond;">kehamilan</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">seperti</span><span style="font-family: Garamond;">: </span><span style="font-family: Garamond;">lahir</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">cacat</span><span style="font-family: Garamond;">, </span><span style="font-family: Garamond;">perdarahan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">pada</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">janin</span><span style="font-family: Garamond;">. </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Kaji</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">faktor-faktor</span><span style="font-family: Garamond;"> yang </span><span style="font-family: Garamond;">dapat</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">meningkatkan</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">resiko</span><span style="font-family: Garamond;"> </span><span style="font-family: Garamond;">perdarahan</span><span style="font-family: Garamond;"> ·</span><span style="font-family: Garamond;"> </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Kaji masalah-masalah kesehatan yang baru saja terjadi : </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Demam lebih dari
satu atau dua hari </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Diare berat atau
terus menerus </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Persalinan </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Perdarahan
menstruasi yang abnormal </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Pemasangan
intrauterine contraceptiver device (IUD)</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Pembedahan,
termasuk pembedahan yang berhubungan dengan gigi</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Pengobatan radiasi </span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Kaji faktor-faktor predisposisi yang mempengaruhi bekuan
darah :</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Obesitas </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Merokok </span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Pembedahan
kardiovaskular</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Gaya hidup</span><span style="font-family: Garamond;">
</span></div>
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<span style="font-family: Wingdings;">n</span><span style="font-family: Garamond;">Aritmia</span><span style="color: white; font-family: Garamond; font-size: 18.0pt; language: en-US; mso-ascii-font-family: Garamond; mso-color-index: 1; text-shadow: auto;"> </span></div>
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</div>Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-29338246127758681072011-11-01T07:42:00.000-07:002011-11-03T09:28:49.421-07:00NEW ACLS 2010 AHA GUIDELINES<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span class="Apple-style-span" style="font-size: x-large;">NEW ACLS 2010 AHA GUIDELINES</span></b></div>
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<b><span class="Apple-style-span" style="font-size: large;">2010 GUIDELINES FOR CPR VIDEO</span></b></div>
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<span class="Apple-style-span" style="font-size: large;"><b><br /></b></span><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/Y-UGqwuLIyo?feature=player_embedded' frameborder='0'></iframe></div>
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<b><span class="Apple-style-span" style="font-size: large;">ACLS 2010 AHA ECC VIDEO 1</span></b></div>
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<span style="font-family: Arial; font-size: 16pt; font-weight: bold;">ACLS
Cardiac Arrest Algorithm.</span></div>
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<span style="font-family: Arial; font-size: 16pt; font-weight: bold;">Bradycardia</span><span style="font-family: Arial; font-size: 16pt; font-weight: bold;"> Algorithm.</span></div>
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<b><span class="Apple-style-span" style="font-size: x-large;">Tachycardia Alogarithm</span></b></div>
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<br /></div>Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-80738713209266347702011-10-26T20:46:00.000-07:002011-10-26T20:46:50.690-07:00PATHFLOW GAGAL NAFAS LENGKAP<div dir="ltr" style="text-align: left;" trbidi="on">
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PATHFLOW GAGAL NAFAS LENGKAP</div>
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<br /></div>Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-58814050913839946592011-10-26T08:29:00.000-07:002011-10-26T08:29:45.341-07:00PATHOFLOW ENDOKARDITIS<div dir="ltr" style="text-align: left;" trbidi="on">
PATHOFLOW ENDOKARDITIS<br />
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<br /></div>Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-54194313498799050352011-10-26T07:56:00.000-07:002011-10-26T07:56:21.987-07:00PATHOFLOW AORTA STENOSIS<div dir="ltr" style="text-align: left;" trbidi="on">
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<br /></div>Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-47608683025397343942011-10-26T06:35:00.000-07:002011-10-26T06:35:16.191-07:00PATOFLOW TETRALOGI OF FALOT (TOF)<div dir="ltr" style="text-align: left;" trbidi="on">
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Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-40001264128711038892011-10-11T06:12:00.000-07:002011-10-11T06:12:41.492-07:00BICARBONAT THERAPY / THERAPI BICARBONAT (BICNAT) MENURUT ACLS 2010<div dir="ltr" style="text-align: left;" trbidi="on">
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Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-35955897175103818062011-10-11T06:10:00.000-07:002011-10-11T06:10:36.701-07:00BLOOD PRESSURE MANAGEMENT / PENATALAKSANAAN PERUBAHAN TEKANAN DARAH (HYPOTENSION AND HIPERTENSION) SESUAI ACLS 2010<div dir="ltr" style="text-align: left;" trbidi="on">
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Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-73165118895269837272011-10-11T06:07:00.000-07:002011-10-11T06:07:30.238-07:00EPINEPHRINE DOSES BY AGE MENURUT USIA SESUAI ACLS 2010<div dir="ltr" style="text-align: left;" trbidi="on">
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Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-47974373730352677202011-10-11T06:04:00.000-07:002011-10-11T06:04:36.118-07:00PENATALAKSANAAN PASIEN DENGAN PULMONARY EDEMA / ALO (ACUT LUNG OEDEMA) MENURUT ACLS 2010<div dir="ltr" style="text-align: left;" trbidi="on">
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Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-33901365734516098442011-10-10T07:13:00.000-07:002011-10-10T07:13:41.999-07:00PENATALAKSANAAN PASIEN DENGAN VENTRIKULAR TAHIKADI (VT) SESUAI ACLS 2010<div dir="ltr" style="text-align: left;" trbidi="on">
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Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-7332574855283885052011-10-10T07:10:00.000-07:002011-10-10T07:10:44.746-07:00PEDOMAN CARDIO PULMONAL RESUSITATION (CPR) / RESUSITASI JANTUNG PARU (RJP) TERBARU<div dir="ltr" style="text-align: left;" trbidi="on">
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Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-26087688899849494502011-10-10T07:07:00.000-07:002011-10-10T07:07:18.770-07:00PENATALAKSANAAN PASIEN DENGAN BRADIKARDI DENGAN NADI PADA ANAK (PEDIATRIK) SESUAI ACLS 2010<div dir="ltr" style="text-align: left;" trbidi="on">
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Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-53610010402244570102011-10-10T07:03:00.000-07:002011-10-10T07:03:39.878-07:00PENATALAKSANAAN PASIEN DENGAN BRADIKARDI DENGAN NADI SESUAI ACLS 2010<div dir="ltr" style="text-align: left;" trbidi="on">
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Anonymoushttp://www.blogger.com/profile/14204103053353577766noreply@blogger.com0tag:blogger.com,1999:blog-5043201568524414964.post-39355067779458024482011-10-10T07:01:00.000-07:002011-10-10T07:01:49.067-07:00PENATALAKSANAAN PASIEN DENGAN ASYSTOLE DAN PEA PULSELESS ELECTRYCAL ACTIVITY PADA PEDRIATIC (ANAK) SESUAI ACLS 2010<div dir="ltr" style="text-align: left;" trbidi="on">
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