Repository Poltekkes Kemenkes Palangka Raya

Fitriani, Shindytia Nubia (2026) Asuhan keperawatan pada pasien Ny. H dan Tn. A dengan infark serebri di RSUD Ulin Banjarmasin. Karya Tulis Ilmiah thesis, Poltekkes Kemenkes Palangka Raya.

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Abstract

Latar Belakang : Infark serebri terjadi akibat oklusi pembuluh darah otak oleh trombus atau emboli sehingga menyebabkan iskemia dan nekrosis jaringan saraf. Secara global, infark serebri menyumbang 62,4% dari seluruh kejadian stroke (Feigin et al., 2024). Di Indonesia, prevalensi stroke 8,3 per 1.000 penduduk (SKI 2023), berkontribusi terhadap 11,2% kecacatan dan 18,5% kematian nasional. Di Kalimantan Selatan, RSUD Ulin Banjarmasin sebagai rumah sakit rujukan tipe A mencatat 691 kasus infark serebri dan 556 kasus hemiparesis sepanjang 2025, sehingga diperlukan asuhan keperawatan terstandar berbasis SDKI, SIKI, dan SLKI. Tujuan Penelitian : Menerapkan asuhan keperawatan komprehensif meliputi pengkajian, penetapan diagnosis, perencanaan, implementasi, dan evaluasi pada pasien infark serebri di RSUD Ulin Banjarmasin. Metode Penelitian : Studi kasus deskriptif pada dua pasien infark serebri di Ruang Stroke Center RSUD Ulin Banjarmasin. Pengambilan data dilaksanakan selama tiga hari berturut-turut, yaitu Ny. H pada 30 Maret–2 April 2026 dan Tn. A pada 7–10 April 2026, melalui wawancara, observasi, pemeriksaan fisik, dan dokumentasi rekam medis. Hasil Penelitian : Tiga diagnosis ditegakkan: (1) Gangguan Menelan b.d. gangguan saraf kranialis; (2) Risiko Perfusi Serebral Tidak Efektif b.d. peningkatan TIK (Ny. H) dan gangguan aliran darah serebral (Tn. A); (3) Gangguan Mobilitas Fisik b.d. gangguan neuromuskuler. Setelah tiga hari intervensi, GCS meningkat dari 11 menjadi 13 pada kedua pasien; kekuatan otot kiri Ny. H dari 1/5 menjadi 2/5 dan Tn. A dari 2/5 menjadi 3/5; tidak ditemukan aspirasi, luka tekan, maupun kontraktur. Kesimpulan : Ketiga diagnosis, yaitu Gangguan Menelan, Risiko Perfusi Serebral Tidak Efektif, dan Gangguan Mobilitas Fisik, teratasi sebagian. Manajemen peningkatan TIK, pencegahan aspirasi melalui NGT dan posisi Head Up 30°, serta latihan Range of Motion (ROM) terbukti meningkatkan perfusi serebral, mencegah komplikasi, dan memperbaiki kekuatan otot pasien infark serebri. Kata Kunci: Infark Serebri, Hemiparesis, Asuhan Keperawatan, Studi Kasus Background : Cerebral infarction occurs due to occlusion of cerebral blood vessels by thrombus or embolism, causing ischemia and neuronal tissue necrosis. Globally, cerebral infarction accounts for 62.4% of all stroke cases (Feigin et al., 2024). In Indonesia, stroke prevalence is 8.3 per 1,000 population (National Health Survey 2023), contributing to 11.2% of disability and 18.5% of national mortality. In South Kalimantan, RSUD Ulin Banjarmasin, a type-A referral hospital, recorded 691 cerebral infarction cases and 556 hemiparesis cases in 2025, requiring standardized nursing care based on SDKI, SIKI, and SLKI. Objective : To implement comprehensive nursing care covering assessment, diagnosis, planning, implementation, and evaluation for cerebral infarction patients at RSUD Ulin Banjarmasin. Methods : A descriptive case study on two cerebral infarction patients in the Stroke Center Ward of RSUD Ulin Banjarmasin. Data were collected over three consecutive days: Mrs. H from 30 March to 2 April 2026 and Mr. A from 7 to 10 April 2026, through interviews, observation, physical examination, and medical record documentation. Results : Three nursing diagnoses were established: (1) Impaired Swallowing related to cranial nerve disorders; (2) Ineffective Cerebral Perfusion Risk related to increased ICP (Mrs. H) and impaired cerebral blood flow (Mr. A); (3) Impaired Physical Mobility related to neuromuscular dysfunction. After three days, GCS improved from 11 to 13 in both patients; left extremity muscle strength improved from 1/5 to 2/5 in Mrs. H and from 2/5 to 3/5 in Mr. A; no aspiration, pressure injuries, or contractures were found. Conclusion : All three diagnoses—Impaired Swallowing, Ineffective Cerebral Perfusion Risk, and Impaired Physical Mobility—were partially resolved. Intracranial pressure management, aspiration prevention via NGT and Head Up 30° positioning, and Range of Motion (ROM) exercises proved effective in improving cerebral perfusion, preventing complications, and enhancing muscle strength in cerebral infarction patients. Keywords: Cerebral Infarction, Hemiparesis, Nursing Care, Case Study

Item Type:	Laporan Tugas Akhir / Karya Tulis Ilmiah / Laporan Praktek Asuhan Kebidanan (stase 9) / Skripsi / Tesis / Disertasi (Karya Tulis Ilmiah)
Uncontrolled Keywords:	Infark Serebri, Hemiparesis, Asuhan Keperawatan, Studi Kasus
Subjects:	11 MEDICAL AND HEALTH SCIENCES > 1110 Nursing > 111003 Clinical Nursing - Secondary (Acute Care) 11 MEDICAL AND HEALTH SCIENCES > 1110 Nursing > 111008 Nursing Practical 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:	24 Jul 2026 01:42
Last Modified:	24 Jul 2026 01:42
URI:	http://repo.polkesraya.ac.id/id/eprint/3648

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