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Peningkatan Penyembuhan Luka dan Stabilitas Glikemik pada Pasien Diabetes Melitus Tipe 2 dengan Fasciitis Nekrotikan: Laporan Kasus: Improvement in Wound Healing and Glycemic Stability in a Patient with Type 2 Diabetes Mellitus and Necrotizing Fasciitis: A Case Report Xavier, Julieta de Carvalho; Luruk, Ricardo Correia; Bangun, Argi Virgona; Marpaung, Lilis Suryani
Jurnal Abdi Keperawatan dan Kedokteran Vol 5 No 2 (2026): Jurnal Abdi Kesehatan dan Kedokteran
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/jakk.v5i2.185

Abstract

Diabetes Mellitus (DM) is a chronic metabolic disease that frequently leads to serious complications, including severe soft tissue infections such as necrotizing fasciitis. Chronic hyperglycemia contributes to impaired tissue perfusion, decreased immune response, and delayed wound healing, thereby increasing the risk of severe infection and poor clinical outcomes. This case report describes the implementation of comprehensive nursing care for a patient with Type 2 Diabetes Mellitus complicated by necrotizing fasciitis. This study employed a descriptive case report design involving a 72-year-old male patient diagnosed with necrotizing fasciitis of the left lower extremity, accompanied by Type 2 Diabetes Mellitus and systemic complications. Nursing care was delivered using the nursing process approach, including assessment, nursing diagnosis, planning, implementation, and evaluation. The main nursing variables addressed were skin/tissue integrity, infection risk, and blood glucose stability. Data were collected through patient interviews, physical examination, wound observation, blood glucose monitoring, and review of medical and nursing records. The primary nursing diagnoses identified were impaired skin/tissue integrity, risk of infection, and unstable blood glucose levels. Nursing interventions focused on aseptic wound care, glycemic control management, infection prevention, pain management, and patient education. Evaluation outcomes demonstrated improvement in wound condition, reduced purulent exudate, stabilization of blood glucose levels, and decreased pain intensity during the course of nursing care. This case report indicates that comprehensive and evidence-based nursing care, particularly strict glycemic control combined with appropriate wound management, plays a critical role in supporting wound healing and preventing further complications in patients with Type 2 Diabetes Mellitus and necrotizing fasciitis.
Penerapan Posisi Semi Fowler dalam Meningkatkan Kualitas Tidur dan Mengurangi Sesak Napas pada Pasien Congestive Heart Failure : Studi Kasus Berbasis Evidence-Based Nursing: Implementation of Semi-Fowler Position to Improve Sleep Quality and Reduce Dyspnea in Patients with Congestive Heart Failure : An Evidence-Based Nursing Case Study Luruk, Ricardo Correia; Xavier, Julieta de Carvalho; Bangun, Argi Virgona; Marpaung, Lilis Suryani
Jurnal Abdi Keperawatan dan Kedokteran Vol 5 No 2 (2026): Jurnal Abdi Kesehatan dan Kedokteran
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/jakk.v5i2.188

Abstract

Congestive Heart Failure (CHF) is a chronic cardiovascular condition frequently accompanied by dyspnea and impaired sleep quality as a result of pulmonary congestion and reduced cardiac output. These symptoms significantly affect patient comfort and quality of life, highlighting the need for effective non-pharmacological nursing interventions. This study aimed to describe the implementation of the semi-Fowler position as an Evidence-Based Nursing (EBN) intervention to reduce dyspnea and improve sleep quality in patients with CHF. This study employed an Evidence-Based Nursing case study design involving one patient diagnosed with CHF who was hospitalized at Immanuel Hospital Bandung. The patient experienced dyspnea and sleep disturbances but was hemodynamically stable and fully conscious. The intervention consisted of positioning the patient in a semi-Fowler position with head-of-bed elevation of 30–45 degrees for approximately 15 minutes once daily over three consecutive days. Data were collected through nursing assessments, direct clinical observation, and evaluation of patient responses before and after the intervention. The findings demonstrated a positive clinical response following the implementation of the semi-Fowler position. The patient reported reduced dyspnea, improved respiratory comfort, and decreased use of accessory muscles during breathing. In addition, improvements were observed in sleep duration and perceived sleep quality, with fewer nocturnal awakenings related to shortness of breath. In conclusion, the semi-Fowler position is an effective, simple, and safe non-pharmacological nursing intervention for reducing dyspnea and improving sleep quality in patients with Congestive Heart Failure . This intervention can be integrated into routine nursing care as part of Evidence-Based Nursing practice to enhance patient comfort and overall quality of life.