Tutorial Ske C-23 Kel 4 2015 (1)

8/17/2019 Tutorial Ske C-23 Kel 4 2015 (1)

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A female bay was born at Moh Hoesin Hospital from 19 years old woman. Her

mother, Mrs. Nada, was hospitalized at Moh Hoesin Hospital due to contraction. It

was her rst prenancy. !he forot when her rst day of last period, but she thouht

that her prenancy was about " months. !he said that she ne#er had hypertension

or other illness durin her prenancy. !e#en hours after admitted, she deli#ered her

female baby spontaneously. $he labor process was %& minutes, and ruptured of membrane was three hour before deli#ery. $he baby was not cried spontaneously

after birth, and resuscitation was done. A'(A) score at 1 minute was 1 and *

minute was +, and 1& minutes was . -ne hour later the baby still runtin, and

cyanosis.

-n phisycal eamination/

0ody weiht was 1+&& rams, body lenth was & cm, and head circumference was

+& cm. $he muscle tone was decreased, she was poorly 2eed at the limbs, she has

thin s3in, more lanuo o#er the body and plantar creases 14+ anterior. At 1& minutes

of ae, she still had runtin and cyanosis of the whole body. $he respiratory ratewas 5" bpm, heart rate was 1*% bpm, and the temperature was +5,% o6. $here was

chest indrawin. -ther physical eaminations were within normal.

As eneral practitioner please analyze the problem and the manaement.

Klarifskasi Istilah

1. Contraction: 'emende3an atau penyusutan atau mende3at3an uterus

rinan, biasanya tida3 nyeri dan tida3 teratur selama masa 3ehamilan.

Intensitas dan fre3uensinya menin3at secara bertahap serta bertambah

ritmis selama trimester 3etia.2. Rupture o membrane: 'ecahnya selaput 3orioamnioti3 sebelum ter7adinya

persalinan3. APGAR core: !uatu metode untu3 menilai 3eadaan umum bayi setelah

3elahiran yan dinilai adalah fre3uensi 7antun, pernapasan, tonus otot,

warna 3ulit, dan rea3si terhadap ransan. 8a3ni denan memasu33an

3ateter 3e luban hidun sesudah 7alan napas dibersih3an.!. Gruntin": $anda adanya respiratory distress pada bayi yan baru lahir.#. C$anosis: 'erubahan warna 3ulit dan membrane mu3osa men7adi 3ebiruan.%. &anu"o: )ambut halus pada tubuh 7anin.'. Plantar Crease: ipatan pada telapa3 tanan.(. Chest in)ra*in": (ambaran tari3an dindin dada yan berlebihan saat

respirasi.+. ,irst -a$ o &ast perio): Hari pertama haid tera3hir: tanal ter7adinya

haid pertama 3ali dalam si3lus haid tera3hir 3ali sebelu ter7adi 3ehamilan.

'enhitunan hanya bisa dila3u3an pada ibu hamil denan si3lus haid teratur

se3itar %";+& hari.1. Resusitation: Memulih3an 3eadaan 7antun dan paru setelah

3eadaan henti 7antun atau 3ematian mendada3.


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I)entifkasi /asalah

1. A female bay was born at Moh Hoesin Hospital from 19 years old woman. Her

mother, Mrs. Nada, was hospitalized at Moh Hoesin Hospital due to

contraction. It was her rst prenancy. !he forot when her rst day of last

period, but she thouht that her prenancy was about " months. !he said

that she ne#er had hypertension or other illness durin her prenancy.2. !e#en hours after admitted, she deli#ered her female baby spontaneously.

$he labor process was %& minutes, and ruptured of membrane was three hour

before deli#ery.+. $he baby was not cried spontaneously after birth, and resuscitation was

done. A'(A) score at 1 minute was 1 and * minute was +, and 1& minutes

was . -ne hour later the baby still runtin, and cyanosis.. -n phisycal eamination/

0ody weiht was 1+&& rams, body lenth was & cm, and head

circumference was +& cm. $he muscle tone was decreased, she was poorly

2eed at the limbs, she has thin s3in, more lanuo o#er the body and plantar

creases 14+ anterior. At 1& minutes of ae, she still had runtin and cyanosis

of the whole body. $he respiratory rate was 5" bpm, heart rate was 1*% bpm,

and the temperature was +5,%o6. $here was chest indrawin. -ther physical

eaminations were within normal.

Analisis /asalah

1. A female bay was born at Moh Hoesin Hospital from 19 years old woman. Hermother, Mrs. Nada, was hospitalized at Moh Hoesin Hospital due to

contraction. It was her rst prenancy. !he forot when her rst day of last

period, but she thouht that her prenancy was about " months. !he said

that she ne#er had hypertension or other illness durin her prenancy.a. Hubunan usia dan 3ehamilan< 1, ", *b. 0aaimana me3anisme 3ontra3si pada 3ehamilan< %, 9, 5c. 0aaimana cara menhitun usia estasi pada ibu Nadia =selain H'H$>< +,

1&, ). Apa sa7a risi3o 3ehamilan pada usia muda< , 1, "e. Apa sa7a fa3tor risi3o 3ehamilan preterm< *, %, 9

. Apa sa7a 3ompli3asi dari 3elahiran premature< 5, +, 1&

2. !e#en hours after admitted, she deli#ered her female baby spontaneously.

$he labor process was %& minutes, and ruptured of membrane was three hour

before deli#ery.


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a. Apa ma3na 3elinis dari persalinan %& menit setelah 7am dan pecahnya

3etuban + 7am sebelum persalinan< , , 11b. Apa etioloi ruptured of membrane< ", *, 1c. 0aaimana me3anisme ter7adinya ruptured of membrane< 9, 5, %d. Apa 3ompli3asi dari ruptured of membrane terhadap ibu dan 7anin< 1&, ,

+

+. $he baby was not cried spontaneously after birth, and resuscitation was

done. A'(A) score at 1 minute was 1 and * minute was +, and 1& minutes

was . -ne hour later the baby still runtin, and cyanosis.a. Apa ma3na 3linis bayi tida3 menanis setelah lahir< 11, ", b. Apa interpretasi dari A'(A) score pada 3asus ini< 1, 9, *c. Apa etioloi dari cyanosis< %, 1&, 5d. Apa ma3na 3linis dari merintih dan cyanosis pada 3asus< +, 11, e. Apa indi3asi tinda3an resusitasi pada bayi baru lahir< , 1, "

. 'hysical eamination/

0ody weiht was 1+&& rams, body lenth was & cm, and head

circumference was +& cm. $he muscle tone was decreased, she was poorly

2eed at the limbs, she has thin s3in, more lanuo o#er the body and plantar

creases 14+ anterior. At 1& minutes of ae, she still had runtin and cyanosis

of the whole body. $he respiratory rate was 5" bpm, heart rate was 1*% bpm,

and the temperature was +5,%o6. $here was chest indrawin. -ther physical

eaminations were within normal.a. Apa interpretasi dan me3anisme abnormal<

; 0?, 0, H6/ *, %, 9; Muscle tone/ 5, +, 1&

; 'oorly 2eed at the limbs/ , , 11; $hin s3in/ ", *, 1; More lanuo o#er the body/ 9, 5, %; 'lantar creases 14+ anterior/ 1&, , +; At 1& minutes of ae still runtin/ 11, ", ; At 1& minutes of ae still cyanosis of whole body/ 1, 9, *; ))/ %, 1&, 5; H)/ +, 11, ; $emperature/ , 1, "; 6hest indrawin/ *, %, 9

b. 0aaimana ciri;ciri bayi prematur< 5, +, 1&

0ipotesisMrs. Nadia, (1'1A&, melahir3an bayi spontan preterm yan menalami

respiratory distress dan as3sia.

emplate1. How to dianose , , 1%. @@ ", *, %


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+. 'emeri3saan 'enun7an 9, 5, +. ?@ 1&, , *. tioloi 11, ", *5. pidemioloi 1, 9, 5. 'atosioloi %, 1&, ". $atala3sana =Ibu dan 0ayi> ;;; bayi yan se3aran dan edu3asi ibu untu3

3ehamilan beri3utnya 3arena ada 3ecenderunan berulan +, 11, "9. 're#entif dan du3asi , 1, 91&.Bompli3asi *, %, 1&11.'ronosis 5, +, 111%.!B@I , , 1

I

1. )espiratory distress 1, *, 9, 11, 5%. 00) %, 5, 1&, +, +. As3sia +, , 11, , ". 'enya3it Membran Hyalin , ", 1, *, 9

1. Abdil2. Izza

3. Aas

4. Indri5. Wawan

6. Gufron

7. Owen8. Yopi

9. oza!

1". #a!$ri11. %$ula!sana

&olon' di!er)a!an selen'!ap *un'!in dan

$arap se*ua &A+,A &--/0AI

*en'iri*!an )awaban uorial !erif!ia"6a$oo.o* dan

fa!$ri.alan'*ail.o*

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Tutorial Ske C-23 Kel 4 2015 (1)