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7/21/2019 ASKEP TBC 2015
1/19
LAPORAN PENDAHULUAN
TUBERCULOSIS PARU (TB)
A. PENGERTIAN
1. Tubercolis pru !l" pe#$%i& 'e#ulr $# !p& 'e#$er#
sippu# (l%il%i* +#i&* &u &u #%#%). Pe#$%i& i#,e%si $#
!isebb%# ole" b%&eri -$cob%&eriu' &uberculosis. TBC &eru&'
'e#$er# prupru sebi &e'p& i#,e%si pri'er* seli# i&u TBC !p&
u 'e#$er# %uli&* %ele#r li',e* &ul# !# selpu& o&%.
/. Tuberculosis !l" su&u pe#$%i& 'e#ulr $# !isebb%# ole"
bsil 'i%robc&eriu'. Tuberculosis $# 'erup%# sl" s&u pe#$%i&
slur# per#ps# bi# b+" $# sebi# besr bsil &uberculosis
'su% %e!l' ri## pru 'ellui irbo#e !# sel#u$ 'e#l'i
proses $# !i%e#l sebi ,ocus pri'er !# "o#.
B ETIOLOGI
1. -icrobc&eriu' Tuberculose
/. -icrob%&eriu' bo0is
C. PATOISIOLOGI
Pe#$ebr# %u'# 'icrobc&eriu' Tuberculosis bis 'su% 'ellui
&i &e'p& $i&u slur# per#,s#* pe#cer## !# !#$ lu% p! %uli&.
I#,e%si %u'# i#i seri# &er!i 'ellui ir bo#e (u!r) $# cr
pe#ulr#$ !e## !rople& $# 'e##!u# %u'# !ri or# $#
&eri#,e%si sebelu'#$.
Pe#ulr# Tuberculosis pru &er!i %re# pe#!eri& TBC 'e'bu#
lu!" !# !"%#$ se'br## !e## cr !ib&u%%# &u !ibersi#%#
%elur llu !i&erb#%# #i# %e'#'# !# &u" %e" 'upu#
%el#&i ru'" $# %e'u!i# !i"irup ole" '#usi 'ellui prupru !#
bersr# ser& ber%e'b# bi% !i prupru.
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PATOISIO2OGI
-icrobc&eriu' TB
-su% l# #,s
Ti#l !i Al0eoli
T#p i#,e%si I#,l'si !isebr ole" li',e
ibrosis
3lsi,i%si
E%su!si
Ne%rosis
Se%re& $# 'e#e&p
B&u%
D$ &"# 'e#uru#
2
Si,& 4
B&u% Spu&u'
purule# He'op&isis BB &uru#
Ti'bul ri## i%&
Els&isi&s !# &ebl
Al0eolus &!% %e'bliS& e%spirsi
Gs &!% !p& ber!i,usiDe## bi%
G#u# per&u%r#s
3elel"# Ter%o#&'i#si ole"li#%u##
A#ore%sis
Resi%o &i#i i#,e%si
Perub"# %ebu&u"##u&risi
7/21/2019 ASKEP TBC 2015
3/19
D. 3LASII3ASI
1. Tuberculosis Pru
Tuberculosis pru !l" &uberculosis $# 'e#$er# ri## pru
&i!% &er'su% pleur (selpu& pru).
Ber!sr%# pe'eri%s# !"%* TB pru !ibi 'e#!i !u $i&u 4
. Tuberculosis pru BTA posi&i,.b. Tuberculosis pru BTA #e&i0e
/. Tuberculosis E%s&r pruTuberculosis e%s&r pru !l" &uberculosis $# 'e#$er# or#
&ubu" seli# ri## pru* 'isl#$ pleur (selpu& pru)* selpu&
o&%* selpu& #&u#* %ele#r li',e* &ul#* perse#!i#* %uli&* usus*
i#l* slur# %e#ci#* l& %el'i#* !# li#li#.
Ber!sr%# &i#%& %epr"#$* TB e%s&r pru !ibi 'e#!i !u
$i&u 4. Tuberculosis e%s&r pru ri##
-isl 2 TB %ele#r li',e* pleuri&is e%su!si u#il&erl* &ul#
(%eculi &ul# bel%#)* se#!i !# %ele#r !re#l.b. Tuberculosis e%s&r pru ber&
-isl 4 -e#i#i&is* 'ilier* peri%r!i&is* peri&o#i&is* pleuri&is* e%su!&i,
!uple%s* TB &ul# bel%#* TB usus* TB slur# %e#ci#
!# l& %el'i#.
E. TIPE PENDERITA1. 3sus bru
Pe#!eri& $# belu' per#" !iob&i !e## OAT 5 su!" per#"
'e#el# OAT %ur# !ri 1 bul# (67 !osis "ri#).
/. 3'bu" (Relps)Pe#!eri& TB $# sebelu'#$ per#" 'e#!p&%# &erpi TB !#
se&el" !i#$&%# se'bu" &u pe#ob le#%p* %e'u!i#
%e'bli li berob& !e## "sil pe'eri%s# BTA posi&i,.
6. Pi#!" (Tr#s,eri#)
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Pe#!eri& TB $# se!# 'e#!p&%# pe#ob !isu&u
%bup&e# li# !# %e'u!i# pi#!" berob& %e %bup&e# i#i*
pe#!eri& "rus 'e'b+ sur& ruu%#5pi#!"# (OR- TB 78).
9. 3sus berob& se&el" lli (pe#ob se&el" !e,ul&5!rop ou&).A!l" pe#!eri& TB $# %e'bli berob& !e## "sil pe'eri%s#
!"% BTA posi&i, se&el" pu&us berob& / bul#5lebi".
:. GlA!l" pe#!eri& BTA posi&i, $# 'si" &e&p posi&i, &u %e'bli
'e#!i posi&i, p! %"ir bul# %e : &u lebi".A!l" pe#!eri& BTA #e&i0e* ro#&e# posi&i, $# 'e#!i BTA
Posi&i, p! %"ir bul# %e / pe#ob.
;. Li# < li#Se'u pe#!eri& li# $# &i!% 'e'#u"i pers$r &ersebu& !i
&s. Ter'su% !l' %elo'po% i#i !l" %sus %ro#i% !l"
pe#!eri& $# 'si" BTA posi&i, se&el" 'e#$elesi%# pe#ob
ul# !e## %&eori /.
. TANDA DAN GE=ALA
1. Gel U'u'
De''* seri# %li su"u 'e#i#%& p! si# !# 'l' "ri.
-e#iil
3eri#& 'l' %# &i'bul bil proses %# &er!i
A#ore%sis
Le'" b!#
/. T#! ,isi% 3eli## pre#%i' $i&u %o#soli!si* ,ibrosis &ele%&sis.
3eli## slur# #,s berup r!# !# 'u%oss !iser&i !e##
pe#$e'pi* &er!i re%si pleur berup pe#ebl# &u #$eri
pleur.
G. GA-BARAN 3LINIS
Gel 3li#is 4
Ti!% ! %"s !# s#& ber0risi
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1. B&u%.
Gel b&u% &i'bul pli# !i#i !# 'erup%# #u# pli# seri#.
/. D"%
A+l#$ bersi,& 'u%osi& %e'u!i# 'u%opurule# s'pi purule# !#
berub" 'e#!i %e#&l.
6. B&u% re#
B&u% $# !i!eri& psie# $%#i b&u% re# $# &er!i lebi" !ri /
'i#u.
H. DIAGNOSA TUBERCULOSIS PADA ANA3
Di#osis pli# &ep& !l" !e## !i&e'u%##$ %u'# TB !ri b"#
$# !i'bil !ri pe#!eri&* 'isl#$ !"%* se"i# besr !i#osis TB
#% !i!sr%# &s 'br# %li#is.
I. 3O-PLI3ASI
1. -e#i#i&is
/. Spo#!eli&is
6. Plerubi&is
9. Bro#%op#eu'o#is
:. A&ele%&sis
=. PENATALA3SANAAN
Pror' DOTS (Direc&l$ Obser0e! Tre&'e#& S"or& Co'e)
Terpi -e!i%
1. Iso#i>i!
Di%e#l !e## INH* bersi,& b%&erisi& !p& 'e'bu#u" 87? popu%si
%u'# !l' beberp "ri per&' pe#ob. Ob& i#i s#& %&i,
&er"!p %u'# !l' 'e&bolic %&i,* $i&u %u'# $# se!#
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ber%e'b#. Dosis "ri# $# !i#ur%# : '5% BB* se!#%#
pe#ob i#&er'i&&e# 6@ se'i#u !iberi%#!l' !osis 17 '5%
BB.
/. Ri,'pisi#
Dosis#$ 17 < 1: '5% BB per "ri !iberi%# 1@ se"ri per orl
!i'i#u' !l' %e!# l'bu# %oso# sel' 1; < 18 '.
6. INH
Dosis#$ 17 < /7 '5% BB 5 "risel' 1 /9 bul#.
9. S&rep&o'ici#
Be%er !l' I- !osis#$ 67 < :7 ' 5 % BB 5 "ri.
:. Pir>i#'i!
Dosis#$ 67 6: ' 5 % BB 5 "ri* per orl /@ se"ri sel' 9; '.
;. E&'bu&"l
Dosis#$ 67 ' 5% BB 5 "ri !l' %e!# %oso# 1@ se"ri sel'
1 &"u#.
. Pr A#i'o Slsil&
Dosis#$ /77 < 677 ' 5 % BB 5 "ri !l' %e!# l'bu# %oso#
secr orl / < 6 @ 5 "ri.
3. PE-ERI3SAAN PENUN=ANG
1. Tes 5 ui &uberculi#
P! #%* ui &uberculi# 'erup%# pe'eri%s# pli#
ber'#,& u#&u% 'e#u#u%# se!#5per#" &eri#,e%si 'i%ro
bc&eriu' &uberculosis !# seri# !isu#%# !l' Scree#i# TBC
! beberp cr 'el%u%# ui &uberculi#* #'u# s'pi se%r#
cr '#&ou@ lebi" seri# !iu#%#.
Lo%si pe#$u#&i%# ui '#&ou@ u'u'#$ p! se&e#" bi# &s
le## b+" %iri bi# !ep#* !isu#&i%# i#&r%u (%e !l' %uli&).
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Pe#ili# ui &uberculi# !il%u%# 9 < / ' se&el" pe#$u#&i%# !#
!iu%ur !i'e&er !ri pe'be#%%# (i#!ursi) $# &er!i 4
) Pe'be#%%# (i#!ursi) 7 < 9 ''* ui '#&ou@ #e&i0e r&i %li#is
&i!% ! i#,e%si 'i%robc&eriu' &uberculose.b) Pe'be#%%# (i#!ursi) 6 < 8 ''* ui '#&ou@ 'eru%#* "l i#i
bis %re# %esl"# &e%#i%. Re%si sil# !e##
'i%robc&eriu' o&ipi% &u se&el" 0%si#si BCG.c) Pe'be#%%# (i#!ursi) 17 ''* ui '#&ou@ posi&i, r&i %li#is
se!# 5 per#" &eri#,e%si 'i%robc&eriu' &uberculose.
/. o&o Ro#&e#P! ,o&o &"or@ &er!p& b$## &erle&% !ilp## &s pru &u
se'e# picl lo&us b+"* b$## ber+# 5 berc%.
6. Tes re%si cep& BCG.Bil !l' pe#$u#&i%# BCG &er!i re%si cep& berup %e'er"#
!# (i#!ursi) : ''* '% bis !icurii &el" &eri#,e%si 'i%rob%&eriu'
&uberculose.
L. PENANGANAN1. r'%oloi 5 r'%o&erpi.
Pe#ob !iberi%# se&el" pe#!eri& !i#$&%# posi&i, 'e#!eri&
TBC ole" !o%&er 5 pe&us %ese" !ri "sil !i&e'u%# %u'#
'i%robc&eriu' TBC (BTA ) &u (BTA ) !e## ro#&e# posi&i,. Pe#!eri&
TBC pru (BTA ) $# &i!% ''pu %# p%e& ob& secr r&is !e##
s$r& "rus ! seor# P-O (Pe#+s -i#u' Ob&) $%#i pe&us
%ese" &u or# $# !iperc$ !# !e%& !e## pe#!eri&* 'i#u'
ob& sebelu' !i#ur%# ole" !o&er#$.Or# !i li#%u## pe#!eri& TBC (&eru&' !e## BTA ) !isr#%#
u#&u% 'e'eri%s%# !iri.Pe#!eri& !i#$&%# se'bu" se&el" pe#ob berl# sel' ; bul#
secr &er&ur !# bul# &er%"ir !il%u%# pe'eri%s# ul# !"% / %li.
Apbil "sil pe'eri%s# %e!u (BTA ) '% pe#!eri& !i#&%# se'bu".
Ob& $# !iu#%# u#&u% TBC !ibi 'e#!i / $i&u 4) Ob& Pri'er 4 Isc"#isi! (INH)* Ri,'isi#*
Pr>i#'i!* S&ep&o'isi#* E&"'bu&olb) Ob& se%u#!er 2 E@io#'i!* pr #i'o
slisil&* si%loseri#* 'i%si#* %#o'isi#*
%preo'isi#.
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=e#is < e#is ob&ob $# seri# !iu#%# !l' pe#ob TBC
$i&u 4) Ri','isi# (R) !e## !osis 17 < 1: ' 5 % BB 5 "ri* !iberi%#
1 %li se"ri per orl !iberi%# sel' ; < 8 bul#* !i'i#u'
sebelu' '%#.b) INH (H) 5 Iso#i>i!* be%er b%&erisi!ol &er"!p bsil $#
ber%e'b# %&i, e%s&rseluler !# bsil !i !l' '%ro,o.
Dosis 17 < /7 ' 5 % BB 5 "ri per orl* l' pe'beri# 1 < /9
bul#.c) S&rep&o'isi#* be%er b%&erisi!ol "#$ &er"!p bsil $#
&u'bu" %&i, e%s&rseluler* cr 'e'beri%#$ I- !e## !osis
67 < :7 ' 5 % BB 5 "ri '%si'u' :7 ' 5 "ri* !iberi%#
se&ip "ri sel' 1 < 6 bul#* !il#u&%# / < 6 %li se'i#u
sel' 1 < 6 bul# li.!) Pir>i#'i! (/)* be%er b%&erisi!ol &er"!p bsil i#&rseluler*
!osis 67 6: ' 5 % BB 5 "ri per orl / %li sel' 9 < ; bul#.e) E&'bu&ol be%er b%&erisi!ol !osis /7 ' 5 % BB 5 "ri / %li
sel' 1 &"u#.,) 3or&i%os&eroi! !p& !iberi%# p! 'e#i#i&is* TB* pleuri&is TB*
peri%r!i&is TB.
U#&u% !osis #% p! pe'beri# ob& #&i&uberculosis (OAT) !l' #%
pe#!e% ; < 8 bul#.
) / HR 5 H/R/ F INH Ri,'isi# se&ip "ri sel' / "ri bul#
per&'* %e'u!i# INH Ri,'isi# se&ip "ri 5 / @ se'i#u
sel' ; bul# (!i&'b" e&'bu&ol i% &er!p& resis&e#
&er"!p INH).b) / HR/ 5 9 H/R/ F INH Ri,'isi# se&ip "ri sel' / bul#
per&'* %e'u!i# INH Ri,'isi# se&ip "ri 5 / 'i#u sel'
9 bul#.
Pe#ob TBC p! #% i% INH !# Ri,'isi# !iberi%# bers'#*
!osis '%si'u' per"ri INH 17 ' 5 % BB* !# Ri,'isi# 1: ' 5 % BB.
Dosis #% i% INH !# Ri,'isi# $# !iberi%# 4) TBC &i!% ber&
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INH F : ' 5 % BB 5 "riRi,'isi# F 17 ' 5 % BB 5 "ri
b) TBC ber& ('e#i#i&is TB)INH F 17 ' 5 % BB 5 "riRi,'isi# F 1: ' 5 % BB 5 "ri
Pre!#iso# F 1 < / ' 5 % BB 5 "ri ('@ ;7 ')
/. Pe#ce"# pe#ulr# TBC-e#ce" pe#ulr# TBC 'e'# cu%up suli& &pi p! !sr#$ bis
%i& 'uli 'ellui Hi!up se"& !e## cr 4) =i% b&u% &u&upl" 'ulu& !e## spu# 5 &issue.b) =i% b&u% ber!"% r !"%#$ !i&'pu# !l' po& berisi
lisol : ? &u !"% !i&i'bu# !e## ".c) =i% su!" els !l' pe'eri%s# lbor&oriu' BTA (B%&eri
T"# As') posi&i,* '% seerl" berob& secr &er&ur sel'; bul#.
!) Pe#!eri& TB pru !i#ur%# &i!% &i!ur s&u %'r !e##
%elur* &eru&' sel' / bul# pe#ob per&'.e) 3elur pe#!eri& sebi%#$ 'e'ri%s%# !iri %e Pus%es's.,) Bil ! b$i "rus 'e#!p& i'u#issi BCG* se&el" !i&es
&uberculosis.) U#&u% 'e'per&i#i !$ &"# &ubu"* '%#l" '%## beri>i
$# &er#%u* 'isl#$ &"u* &e'pe* i%# si#* s$ur < s!$ur#
!# bu"bu"#.") Is&ir"& $# cu%up.
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3ONSEP ASUHAN 3EPERAATAN
A. PENG3A=IAN 3EPERAATAN
1. I!e#&i&s %lie#
/. 3elu"# u&'
6. Ri+$& pe#$%i& se%r#
9. Ri+$& pe#$%i& !"ulu
:. Ri+$& socil e%o#o'i !# li#%u##
;. pol ,u#si %ese"
) Pol persepsi se"& 4 leri* %ebis#* i'u#issi.
b) Pol Nu&risi 4 #ore%si* 'ul* &i!% e#% !i peru&* BB
'e#uru#* &uror %uli& %eri# !#
%e"il## le'% sub%u.
c) Pol eli'i#si 4
Perub"# %r%&eris&i% ,eses !# uri#e
N$eri &e%# p! %u!r# %## &s "ep&o'eli
N$eri &e%# p! sple#o'eli.
!) Pol %&i0i&s !# is&ir"& 4
Rs le'" cep& lel"* %&i0i&s ber& &i'bul* ses% (#,s
pe#!e%)* suli& &i!ur* !e''* 'e#iil* ber%eri#& p!
'l' "ri.
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T%i%r!i* &%ip#e 5 !ips#e s& %er* irri&ble* ses% (&"p
l#u&* i#,i&rsi r!# s'pi se&e#" pru)* !e''
sub,ebris (97 < 917 c) "il# &i'bul.
e) Respi#si
B&u% pro!u%&i, 5 #o# pro!u%&i, ses% #,s* s%i& !!.
-uli b&u% %eri# s'pi b&u% !e## spu&u' "iu 5
purule#&* 'u%oi! %u#i# &u berc% !r"* pe'be#%%#
%ele#r li',e* &er!e#r bu#$i ro#&c"i bs"* %sr !i!er"
pe%s pru &o%rp#eu (pe#$%i& lus &u ,ibrosis pre#%i'
pru !# pleurl)* per%usi pe%% !# pe#uru## ,re'i&us
(cir# pleurl) !e0rsi ,r%el (pe#$ebr# ro#%oe#i%).
,) Rs #$'# 5 #$eri
N$eri !! 'e#i#%& %re# b&u% berul#.
Ber"ri < "ri p! re $# s%i&* peril%u !is&r&esi*
elis"* #$eri bis &i'bul bil i#,il&rsi r!# s'pi %e pleur
se"i# &i'bul pleuri&is.
) I#&eri&s eo
%&or S&res l'* 'sl" %eu##* pers# &i!%
ber!$ 5 &i!% ! "rp#* 'e#$#%l* #sie&s* %e&%u*
'u!" &ersi#u#.
B. PE-ERI3SAAN ISI3
1. De'' 4 sub,ibril* ,ibril (97 < 91c) "il# &i'bul.
B&u% 4 Ro#c"i bs"* %sr !# #$ri#.
Ses% #,s 4 Hipers#or 5 &$'p#i
N$eri !! 4 A&ropi !# re&r%si i#&ercos&e p! %e!# l#u&.
-lise 4 Bil 'e#e#i pleur &er!i e,usi pleur.
/. Pe'besr# %ele#r bis#$ 'ul&iple.
6. Be#ol# pe'besr# %ele#r p! le"er (ser0i%l) @ill*
sub'#!ibol.
9. 3!# &er!i bses.
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C. PE-ERI3SAAN DIAGNOSTI3
1. Ui &uberculi#
/. o&o ro#&e#
6. Pe'eri%s# 'i%robiolois
9. Pe'eri%s# !r" &epi.
:. Pe'eri%s# #loi% #&o'i.
;. Su'ber i#,e%si.
D. PENGOBATAN
1. Pe#$ulu"#
/. Pe#ce"#.
6. Pe'beri# ob&ob.
OAT (Ob& A#&i Tuberculosis).
Bro#co!il&or.
E@spe%&or#
OBH
Ji&'i#
A#&ibio&i%
9. Opersi u#&u% 'e#elur%# %ele#r $# besr.
E. DIAGNOSA 3EPERAATAN
1. G#u# per&u%r# s ber"ubu## !e## !#$ ,c&or resi%o
$# !i!i !e## 4
Ber%ur##$ %ee,e%&i,# per'u%# pru* &ele%&sis.
3erus%#$ 'e'br#e l0eolr %piler.
Se%re& $# %e#&l
E!e' bro#c"il.
Tuu# 4 per&u%r# s e,e%&i,.
3re&eri "sil 4
-e'perli"&%# ,re%+e#si per#,s# $# e,e%&i,. -e#l'i perbi%# per&u%r# s p! pru. A!p&i0e 'e#&si ,c&or,%&or pe#$ebb.
I#&er0e#si 4) Beri%# posisi $# #$'# p! psie#* pe#i#i# %epl
&e'p& &i!ur.
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R 5 -e#i#%&%# i#spirsi '%si'l* e%sp#si pru !# 0er&ilsi
p! sisi $# s%i&.b) Obser0si ,u#si per#,s#* c&& ,re%+e#si per#,s#* !isp#e.
R 5 !p& 'e#e&"ui !# 'e##&isipsi pbil ! !!
$# 'e#u#u%# &er!i#$ s$oc% se"ubu## !e## "[email protected]) =els%# p! psie# pe#$ebb 5pe#ce&us !#$ ses% 5 %olps
p! pru.R 5 Ar psie# !p& 'e#e&"ui pe#$ebb ses% $#
!i!eri$.!) B#&u psie# u#&u% &e## !# 'e#o#&rol !iri !e##
'e#u#%# per#,s# lebi" l'b& !# !l'.R 5 -e'b#&u psie# 'e#l'i e,e% "ipo%si $# !p&
!i'#i,es&si%# sebi %e&%u 5 #sie&s.
e) 3olborsi !e## &i' %ese" li#.R 5 Pe'beri# &erpi u#&u% %ese'bu"# pe#$%i& psie#.
/. Perub"# %ebu&u"# #u&risi ber"ubu## !e## pe#i#%
pro!u%si spu&u' 5 b&u%* !$ps#e 5 #ore%si.Tuu# 4 3ebu&u"# #u&risi !e%u&.3ri&eri "sil 4 -e#$ebu&%# '%## $# &i#i pro&ei# !# %lori. -e#u '%## $# !isi%# "bis. Pe#i#% ber& b!# p pe#i#% e!e'.
I#&er0e#si 4
) 3i !# %o'u#i%si%# s&&us #u&risi %lie# !# %elur seper&i
$# !i#ur%# C&& &uror %uli& Ti'b# ber& b!# I#&eri&s 'u%os 'ulu&* %e''pu# !# %e&i!%''pu# 'e#el#*
!#$ bisi# usus* ri+$& #use* 0o'i&i# 5 !ire.R 5 !iu#%# u#&u% 'e#!e,i#isi%# &i#%& 'sl" !# i#&er0e#si.
b) -e#%i pol !ie& %lie# $# !isu%i 5 &i!% !isu%i.
R 5 -e'b#&u i#&er0e#si %ebu&u"# $# spesi,i%* 'e#i#%&%#
i#&%e !ie& %lie#.c) -e'o#i&or i#&%e !# ou&pu& secr perio!ic.
R 5 -e#u%ur %ee,e%&i,# #u&risi !# cir#.!) C& !#$ #ore%si* #use* 0o'i&i# !# &e&p%# i% !
"ubu###$ !e## 'e!i%si* 'o#i&or 0olu'e* ,re%+e#si*
%o#sis&e# BAB.R 5 !p& 'e#e#&u%# e#is !ie& !# 'e#i!e#&i,i%si pe'ec"#
'sl" u#&u% 'e#i#%&%# i#&%e #u&risi.e) A#ur%# be!res&
13
7/21/2019 ASKEP TBC 2015
14/19
R 5 -e'b#&u 'e#"e'& e#er$ %"usu#$ &er!i#$ 'e&bolic
s& !e''.,) L%u%# per+ orl sebelu' !# sesu!" &erpi respirsi.
R 5 'e#ur#i rs $# &i!% e#% !ri spu&u' &u ob&ob&
$# !iu#%# u#&u% pe#ob $# !p& 'er#s#
0o'i&i#.
6. Resi%o &i#i i#,e%si !# pe#$ebr# i#,e%si ber"ubu## !e## 2 !$ &"# &ubu" 'e#uru#* ,u#si sli0 'e#uru#* secre& $#
'e#e&p. 3erus%# ri## %ib& i#,e%si $# 'e#$ebr. -l#u&risiTuu# 4 D$ &"# &ubu" 'e#i#%&* res&i i#,e%si 'e#uru#.3ri&eri "si% 4
D$ &"# &ubu" 'e#i#%&* ,u#si sli0 'e#i#%&* &i!% !
secre&. 3erus%# ri## %ib& i#,e%si $# 'e#$ebr. Ti!% &er!i #u# #u&risi.
I#&er0e#si 4
) =els%# p! psie# pe#$ebb &er!i#$ i#,e%si.R 5 Ar psie# 'e#er&i pe#$ebb &er!i#$ i#,e%si.
b) A#ur%# %lie# u#&u% 'e#'pu# !"% s& b&u%.R 5 A#ur%# %lie# %ebis# i#i u#&u% 'e#ce" &er!i#$
pe#ulr# i#,e%si.c) Gu#%# 's%er se&ip 'el%u%# &i#!%#.
R 5 U#&u% 'e#ur#i resi%o pe#$ebr# i#,e%si.!) Obser0si su"u %lie# bil &er!i ,ebris.
R 5 3re# ,ebris 'erup%# i#!i%si i#,e%si.
DATAR PUSTA3A
1. -r%'* A.H* Bu%u Ar Il'u 3ese" A#% =ili! I* Bli Pe#erbi&
3UI* =%r&* 1881./. -#soer* rie,* !%%* /777* 3pi& Sele%& 3e!o%&er#* E!isi 6* -e!is
Aesculp&us* =%r&.
14
7/21/2019 ASKEP TBC 2015
15/19
6. Ns&i$"* Per+ A#% S%i&* EGC* =%r&* 188.9. Nelso# /777* Il'u 3ese" A#%* 0olu'e /* E!isi 1:* EGC* =%r&.:. "&&p 5+++ 'e!is&ore.co'
ASUHAN 3EPERAATAN
PASIEN DENGAN TB PARU
DI POLI ANA3
N' 4 D+i Sri#!$#i
NI- 4
Ru## 4 Poli A#%
15
7/21/2019 ASKEP TBC 2015
16/19
Pe#%i# 4 7/ Aus&us /711
=' 4 17.77 IB
A. PENG3A=IAN
1. Bio!& #%
N' 4 A#. -ul#
U'ur 4 17 &"u#
=e#is %el'i# 4 L%il%i
A' 4 Isl'
Pe#!i!i%# 4 Se%ol" Dsr
Al'& 4 -ersri Si!oro
No. Re 4 17;:8
/. Bio!& Or# &u
N' A$" 4 T# A
U'ur 4 68 T"u#
Su%u b#s 4 =+ I#!o#esi
A' 4 Isl'
Pe#!i!i%# 4 S-3
Pe%er# 4 S+s&
Al'& 4 -ersri Si!oro
6. 3elu"# U&'
Ibu psie# 'e#&%# i#i# co#&rol TB bul# %e : !# psie# 'si"
b&u% !# %!# ses%.
9. Ri+$& pe#$%i& se%r#
Ibu psie# 'e#&%# psie# &i!% ! %elu"# li# seli# b&u%*
psie# "#$ i#i# co#&rol TB bul# %e ;* Ibu psie# 'e#&%#
b"+ psie# su!" 'e#l'i %e#i%# ber& b!# seb#$% 1 %
sel' 1 bul#.
:. Ri+$& pe#$%i& 's l'pu
16
7/21/2019 ASKEP TBC 2015
17/19
) Ibu psie# 'e#&%# psie# &i!% per#" 'e#l'i pe#$%i&
TB sebelu'#$.
b) Ri+$& %e"'il# !# %el"ir#.
Ri+$& A#&e #&l
Sel' "'il ibu psie#ru&i# 'e'eri%s%# %e"'il#$ %e
bi!# &er!e%&. P! +%&u "'il ibu psie# &i!% per#"
'e#!eri& pe#$%i& ppu# !# &i!% 'e'pu#$i pe#$%i&
%e&uru##.
Ri+$& N&l
U'ur %el"ir# 4 6 'i#u
Cr %el"ir# 4 Nor'l
L' %el"ir# 4 6: 'e#i&
BB p! +%&u l"ir 4 6./:7 r'
Apr score 4 < 8
Ri+$& pre#&l
Ibu 'e#&%# psie# !iberi ASI !# !iseli#i susu ,or'ul
;. Ri+$& %elur
Ibu psie# 'e#&%# &i!% 'e'pu#$i pe#$%i& 'e#ulr !#
'e#uru#.
. Ri+$& &u'bu" %e'b#
) -e##%& %epl 4
b) Te#%urp 4
c) Du!u% 4
!) -er#%% 4
e) Ber!iri 4
,) Berl# 4
) Ti!ur 'e#o'pol 4
") Per&u'bu"# ii 4
i) G#u# $# !il'i &i!% !.
. Pol se"ri < "ri
) Pol Nu&risi 4
17
7/21/2019 ASKEP TBC 2015
18/19
Psie# '%# #si
BB 'e#i#%& 1 %
3o'posisi 4 #si* lu% pu%* s$ur* bu"* ir pu&i"* &er%!#
s#c%* es !ll.
b) Pol eli'i#si 4
BAB 1@ 5 "ri* %o#sis&e#si 4 le'be%* %u#i# %eco%l.
BA3 : < ; @ 5 "ri* %o#sis&e#si 4 %u#i# er#i"* bu %"s.
c) Pol is&ir"& 4
Ti!ur si# 16.77 < 1;.67 IB
-l' /7.77 < 7:.77
!) Pol %&i0i&s 4 Psie# ber%&i0i&s seper&i bis.
e) Pol perso#l "$ie#e 4
-#!i /@ 5 "ri* #&i bu /@ 5 "ri* oso% ii /@ 5 "ri* %er's
6@ < 9@ 5 'i#u.
B. DATA OBKE3TI
1. T#! 0i&l 4
S 4 6; c
N 4 / @ 5 'e#i&
RR 4 // @ 5 'e#i&
/. Pe'eri%s# ,isi%
) BB 4 /7 %
b) TB 4 &i!% &er%i
c) 3e!# u'u' 4 cu%up bi%
!) Pos&ur &ubu" 4 Te%
e) 3epl !# r'bu& 4 R'bu& &i!% ro#&o%* &i!% ! be#ol#
,) -& 4 Iso%or* %o#o#&i0 &!% #e'is* scler &!%ic"&erus
) Hi!u# 4 Si'e&ris* ,u#si pe#ciu'# bi%.
") -ulu& 4 Ti!% s&o'&i&is.
i) Teli# 4 Si'e&ris* &!% ! seru'e#* ,u#si pe#!e#r#
bi%
) D! 4 si'e&ris* &!% ! lesi* bu#$i #&u# #or'l* sur
pru ro#c"i
18
7/21/2019 ASKEP TBC 2015
19/19
%) Peru&5b!o'e# 4 Ti!% ! pe'besr# or#* #$eri &e%#
( )* brui& usus 17 @ 5 'e#i&.
l) Al& %el'i# 4 &i!% &er%i
6. Pe'eri%s# pe#u## : bul# $# llu
) Lbor&oriu' 4 LED : < 177 ''
b) o&o &"or@ 2 Ter!p& berc%berc% pu&i"
c) Ui &uberculi# 4 '#&ou@ &es& ( ) !# i#!ursi 17 ''
!) Terpi 4 INH 177 '
Ri,'pisi# 1 @ 177 '.
C. ANALISA DATA
N
O
DATA ETIOLOGI -ASALAH
1
19