Repository Poltekkes Kemenkes Palangka Raya

ADHA, FAJAR SAYIDI (2026) Studi kasus perbandingan prognosis berdasarkan waktu pemulihan kesadaran pada pasien cedera otak sedang di RSUD dr. Doris Sylvanus. Karya Tulis Ilmiah thesis, Poltekkes Kemenkes Palangka Raya.

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Abstract

Latar Belakang: Cedera Otak Sedang (COS) akibat trauma mekanik memiliki risiko tinggi memicu cedera otak sekunder akibat adanya lonjakan Tekanan Intrakranial (TIK). Penanganan fase akut membutuhkan asuhan keperawatan neuroprotektif yang komprehensif, di mana tindakan observasi melalui manajemen pemantauan TIK dan monitoring Mean Arterial Pressure (MAP) menjadi pilar utama untuk mendeteksi gangguan regulasi serebral serta mencegah iskemia global. Tujuan Penelitian: Studi kasus ini bertujuan untuk mengidentifikasi, merumuskan, dan mengelola asuhan keperawatan pada pasien Cedera Otak Sedang (COS) dengan fokus intervensi pada tindakan pemantauan TIK serta monitoring nilai MAP guna mengoptimalkan perfusi jaringan serebral. Metode Penelitian: Penelitian ini menggunakan metode deskriptif komparatif dengan pendekatan studi kasus yang mengeksplorasi penerapan asuhan keperawatan pada dua pasien COS (subjek dewasa dan pediatrik) di RSUD dr. Doris Sylvanus Palangka Raya. Hasil Penelitian: Hasil observasi klinis secara kontinu menunjukkan adanya peningkatan kapasitas adaptif intrakranial dan stabilitas hemodinamik serebral pada kedua kasus. Pada Kasus 1 (Tn. J), pemantauan intensif berhasil mengontrol sirkulasi vaskular darah otak yang ditandai dengan penurunan nilai MAP dari angka ekstrem fokal 134 mmHg menjadi stabil di kisaran 100,3–101,3 mmHg disertai dimulainya pemulihan respons verbal pasien. Sementara pada Kasus 2 (An. R) di ruang ICU, kapasitas intrakranial pulih secara optimal ditandai dengan keberhasilan proses penyapihan (weaning) hingga tindakan ekstubasi dari ventilator mekanik, kembalinya pola napas spontan yang adekuat (24 x/menit), serta peningkatan status neurologis menuju kesadaran penuh atau compos mentis (GCS 15). Kesimpulan: Implementasi asuhan keperawatan yang berfokus pada manajemen peningkatan TIK dan monitoring nilai MAP terbukti efektif dalam mempertahankan keadekuatan tekanan perfusi serebral, meminimalkan gejala klinis Trias Cushing, serta memfasilitasi percepatan pemulihan kesadaran spontan pada pasien Cedera Otak Sedang (COS). Kata Kunci: Asuhan Keperawatan, Cedera Otak Sedang (COS), Pemantauan TIK. Background: Moderate Traumatic Brain Injury (MTBI) due to mechanical trauma carries a high risk of triggering secondary brain injury caused by a sudden surge in Intracranial Pressure (ICP). Acute phase management requires comprehensive neuroprotective nursing care, in which observational actions through ICP monitoring management and Mean Arterial Pressure (MAP) monitoring serve as the primary pillars to detect cerebral regulation disorders and prevent global ischemia. Objective: This case study aims to identify, formulate, and manage nursing care for patients with Moderate Traumatic Brain Injury (MTBI) with an intervention focus on ICP monitoring and MAP value tracking to optimize cerebral tissue perfusion. Methods: This study used a comparative descriptive method with a case study approach exploring the application of nursing care in two MTBI patients (adult and pediatric subjects) at RSUD dr. Doris Sylvanus Palangka Raya. Results: Continuous clinical observation results showed an increase in intracranial adaptive capacity and cerebral hemodynamic stability in both cases. In Case 1 (Mr. J), intensive monitoring successfully controlled cerebral vascular circulation, characterized by a decrease in MAP values from a focal extreme of 134 mmHg to a sTabel range of 100.3–101.3 mmHg, accompanied by the initiation of the patient's verbal response recovery. Meanwhile, in Case 2 (Child R) in the ICU, intracranial capacity recovered optimally, marked by the success of the weaning process leading to extubation from the mechanical ventilator, the return of adequate spontaneous breathing (24 breaths/minute), and an increase in neurological status towards full consciousness or compos mentis (GCS 15). Conclusion: The implementation of nursing care focusing on ICP elevation management and MAP value monitoring proved effective in maintaining adequate cerebral perfusion pressure, minimizing Cushing's Triad clinical symptoms, and facilitating the acceleration of spontaneous consciousness recovery in patients with Moderate Traumatic Brain Injury (MTBI). Keywords: ICP Monitoring, Moderate Traumatic Brain Injury (MTBI), Nursing Care.

Item Type:	Laporan Tugas Akhir / Karya Tulis Ilmiah / Laporan Praktek Asuhan Kebidanan (stase 9) / Skripsi / Tesis / Disertasi (Karya Tulis Ilmiah)
Uncontrolled Keywords:	Asuhan Keperawatan, Cedera Otak Sedang (COS), Pemantauan TIK.
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 01:49
Last Modified:	24 Jul 2026 01:49
URI:	http://repo.polkesraya.ac.id/id/eprint/3649

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