Repository Poltekkes Kemenkes Palangka Raya

Puspita Sari, Elisa Dian (2026) Studi kasus asuhan keperawatan pada pasien dengan intracerebral hemorrhage dengan penyakit penyerta chronic kidney disease, hipertensi, dan diabetes mellitus di RSUD dr. Doris Sylvanus Kalimantan Tengah. Karya Tulis Ilmiah thesis, Poltekkes Kemenkes Palangka Raya.

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Abstract

Latar Belakang: Intracerebral Hemorrhage (ICH) merupakan stroke hemoragik dengan angka morbiditas dan mortalitas tinggi. Penatalaksanaan menjadi lebih kompleks bila disertai Chronic Kidney Disease (CKD), hipertensi, dan Diabetes Mellitus (DM). Tujuan Penelitian: Menggambarkan penerapan asuhan keperawatan pada pasien ICH dengan komorbiditas CKD, hipertensi, dan DM di RSUD dr. Doris Sylvanus Palangka Raya. Metode: Studi kasus deskriptif pada dua pasien Tn. A dan Tn. K dengan diagnosis medis ICH disertai CKD, hipertensi, dan DM. Data dikumpulkan melalui wawancara, Observasi, pemeriksaan fisik, dan studi dokumentasi selama 3x8 jam. Asuhan keperawatan mengacu pada SDKI, SLKI, dan SIKI. Hasil Penelitian: Intracerebral Hemorrhage (ICH) merupakan stroke hemoragik dengan morbiditas dan mortalitas tinggi; penatalaksanaannya semakin kompleks bila disertai Chronic Kidney Disease (CKD), hipertensi, dan Diabetes Mellitus (DM). Penelitian bertujuan menggambarkan penerapan asuhan keperawatan pada pasien ICH dengan komorbiditas CKD, hipertensi, dan DM di RSUD dr. Doris Sylvanus Palangka Raya. Metode berupa studi kasus deskriptif pada dua pasien, Tn. A dan Tn. K, dengan data dikumpulkan melalui wawancara, Observasi, pemeriksaan fisik, dan studi dokumentasi selama 3x8 jam mengacu pada SDKI, SLKI, dan SIKI. Delapan diagnosis keperawatan ditegakkan: Penurunan Kapasitas Adaptif Intrakranial, Defisit Nutrisi, Gangguan Mobilitas Fisik, dan Defisit Perawatan Diri pada kedua pasien; Perfusi Perifer Tidak Efektif pada Tn. A; serta Bersihan Jalan Napas Tidak Efektif, Risiko Perfusi Renal Tidak Efektif, dan Risiko Infeksi pada Tn. K akibat komorbiditas ginjal yang lebih berat. Intervensi mencakup pemantauan neurologis dan tanda vital, manajemen jalan napas, posisi kepala 30°, nutrisi enteral, ROM pasif, dan pencegahan infeksi akses invasif. Setelah 3x8 jam, kedua pasien menunjukkan perbaikan bermakna pada stabilitas tanda vital dan kesadaran, meski sebagian besar masalah keperawatan teratasi sebagian akibat beratnya komorbiditas multi-organ. Asuhan keperawatan berbasis SDKI, SLKI, dan SIKI efektif mempertahankan perfusi serebral dan mencegah komplikasi pada pasien ICH dengan komorbiditas ginjal, hipertensi, dan diabetes. Kesimpulan: Asuhan keperawatan komprehensif berbasis SDKI, SLKI, SIKI efektif dalam mempertahankan perfusi serebral dan mencegah komplikasi pada pasien ICH dengan komorbiditas Kata Kunci: Asuhan Keperawatan, Intracerebral Hemorrhage (ICH), Chronic Kidney Disease (CKD), Hipertensi, Diabetes Mellitus Background: Intracerebral Hemorrhage (ICH) is a hemorrhagic stroke with high morbidity and mortality rates. Management becomes more complex when accompanied by chronic kidney disease (CKD), hypertension, and Diabetes Mellitus (DM). Research Objective: To describe the implementation of nursing care for ICH patients with comorbidities of CKD, hypertension, and DM at dr. Doris Sylvanus General Hospital, Palangka Raya. Methods: A descriptive case study of two patients, Mr. A and Mr. K, with a medical diagnosis of ICH accompanied by CKD, hypertension, and DM. Data were collected through interviews, observations, physical examinations, and review of medical records over a 3x8-hour period. Nursing care was based on the Indonesian Standards for Clinical Nursing (SDKI), Indonesian Standards for Nursing practice (SLKI), and Indonesian Standards for Nursing Care (SIKI). Results: Eight principal nursing diagnoses were established: Decreased Intracranial Adaptive Capacity, Nutritional Deficit, Impaired Physical Mobility, and Self-Care Deficit in both patients; Ineffective Peripheral Perfusion exclusively in Mr. A; and Ineffective Airway Clearance, Risk for Ineffective Renal Perfusion, and Risk for Infection exclusively in Mr. K, reflecting his heavier renal comorbidity burden. Interventions included neurological and vital sign monitoring, airway management, 30° head-of-bed elevation, enteral nutrition management, passive range-of-motion (ROM) exercises, and infection prevention at invasive access sites. After 3x8 hours of care, both patients showed meaningful improvement in vital sign stability and level of consciousness, although most nursing problems remained only partially resolved due to the severity of their multi-organ comorbidities. Conclusion: Comprehensive nursing care based on SDKI, SLKI, and SIKI is effective in maintaining cerebral perfusion and preventing complications in patients with ICH and comorbidities. Keywords: Nursing Care, Intracerebral Hemorrhage (ICH), Chronic Kidney Disease (CKD), Hypertension, Diabetes Mellitus

Item Type:	Laporan Tugas Akhir / Karya Tulis Ilmiah / Laporan Praktek Asuhan Kebidanan (stase 9) / Skripsi / Tesis / Disertasi (Karya Tulis Ilmiah)
Uncontrolled Keywords:	Asuhan Keperawatan, Intracerebral Hemorrhage (ICH), Chronic Kidney Disease (CKD), Hipertensi, Diabetes Mellitus
Subjects:	11 MEDICAL AND HEALTH SCIENCES > 1109 Neurosciences > 110904 Neurology and Neuromuscular Diseases 11 MEDICAL AND HEALTH SCIENCES > 1110 Nursing > 111009 Nursing Research 11 MEDICAL AND HEALTH SCIENCES > 1110 Nursing
Divisions:	Jurusan Keperawatan > Program Studi Diploma III Keperawatan
Depositing User:	Mahasiswa D3 Keperawatan
Date Deposited:	23 Jul 2026 03:48
Last Modified:	23 Jul 2026 03:48
URI:	http://repo.polkesraya.ac.id/id/eprint/3638

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