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All Journal Jurnal Keperawatan Jiwa (JKJ): Persatuan Perawat Nasional Indonesia Jurnal NERS Journal Of Nursing Practice Jurnal Ilmu Kesehatan Journals of Ners Community Indonesian Journal for Health Sciences (IJHS) JURNAL ILKES (Jurnal Ilmu Kesehatan) JAIM (Jurnal Abdi Masyarakat) Adi Husada Nursing Journal Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal The Indonesian Journal of Health Science Jurnal Peduli Masyarakat Jurnal Ilmiah Pamenang (JIP) Jurnal Keperawatan Jurnal Pengabdian Kepada Masyarakat: Kesehatan (JPKMK) Indonesian Health Literacy Journal (IHLJ) Jurnal Abdimas Pamenang Journal of Community Engagement in Health Strada Jurnal Ilmiah Kesehatan (SJIK)
Dwi Rahayu
STIKES Pamenang
Humanities Dentistry Economics, Econometrics & Finance Education Health Professions Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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ASUHAN KEPERAWATAN GAWAT DARURAT PADA PASIEN PENDERITA CEREBROVASCULAR ACCIDENT BLEEDING DENGAN MASALAH KEPERAWATAN PENURUNAN KAPASITAS ADAPTIF INTRAKRANIAL: EMERGENCY NURSING CARE FOR PATIENTS EXPERIENCING CEREBROVASCULAR ACCIDENT BLEEDING WITH NURSING PROBLEMS OF DECREASED INTRACRANIAL ADAPTIVE CAPACITY Firnanda Amelia Putri; Dwi Rahayu
Jurnal Ilmiah Pamenang Vol. 7 No. 2 (2025): Jurnal Imiah Pamenang (JIP)
Publisher : Stikes Pamenang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53599/jip.v7i2.356

Abstract

Abstrak Introduksi: Cerebrovascular Accident Bleeding (CVA Bleeding) menyumbang Disability-Adjusted Life Years sebesar 49,6% dari stroke secara keseluruhan. CVA Bleeding terjadi ketika pembuluh darah di otak pecah kemudian menyebabkan peningkatan tekanan intrakranial (PTIK) sehingga terjadi penurunan kapasitas adaptif intrakranial. Tindakan yang perlu dilakukan adalah manajemen PTIK. Tujuan studi kasus ini untuk mendiskripsikan asuhan keperawatan gawat darurat pada pasien CVA Bleeding dengan masalah keperawatan penurunan kapasitas adaptif intrakranial. Metode: Metode yang digunakan adalah deskriptif karena mampu menggambarkan kondisi perkembangan pasien secara rinci. Tindakan diberikan kepada dua pasien di Ruang HCU Mahakam RSUD Dr. Saiful Anwar Provinsi Jawa Timur. Hasil: Hasil pengkajian didapatkan dua pasien CVA Bleeding mengalami Triad Cushing, kesadaran menurun, pupil anisokor, agitasi ringan, dan terdapat reflek Babinski. Masalah keperawatan yang muncul yaitu penurunan kapasitas adaptif intrakranial. Tindakan yang dilakukan berupa memonitor tanda dan gejala PTIK, meminimalisir stimulus lingkungan, memposisikan head up 30°, dan memberikan terapi farmakologis. Evaluasi hari terakhir menunjukkan perbaikan kondisi pada kedua pasien dimana Triad Chusing membaik dan kesadaran meningkat sehingga masalah keperawatan teratasi sebagian. Analisis: Manajemen PTIK dengan pengaturan posisi head up 30° dapat meningkatkan aliran balik vena serebral sehingga oksigenasi serebral tercukupi dan mencegah herniasi yang pada akhirnya tanda-tanda PTIK berkurang. Discuss: Tindakan manajemen PTIK dengan pengaturan posisi head up 30° mampu mengurangi PTIK sehingga penurunan kapasitas adaptif intrakranial dapat dikendalikan. Rekomendasi: Studi kasus ini belum menyajikan nilai TIK. Studi selanjutnya diharapkan menyajikan nilai TIK sebagai parameter objektif dan memperluas jumlah kasus guna meningkatkan generalisasi hasil.   Abstract Introduction: Cerebrovascular Accident Bleeding (CVA Bleeding) contributes to 49.6% of Disability-Adjusted Life Years from strokes. CVA Bleeding occurs when the brain's blood vessels rupture, causing an increase in intracranial pressure (ICP), which results in decreased intracranial adaptive capacity. The necessary intervention is ICP management. This case study aims to describe emergency nursing care for patients with CVA bleeding and decreased intracranial adaptive capacity. Methods: A descriptive approach to describe patient progress in detail. The study involved two patients in HCU Mahakam, Dr. Saiful Anwar Regional Hospital, East Java Province. Results: The assessment showed that two patients with CVA Bleeding experienced Cushing's Triad, decreased consciousness, anisocoria pupils, mild agitation, and positive Babinski reflexes. The identified nursing problem was decreased adaptive intracranial capacity. Implementations included monitoring signs and symptoms of increased ICP, minimizing environmental stimuli, positioning the head up 30°, and providing pharmacological therapy. The final day's evaluation showed improvement in Cushing's Triad and increased consciousness, partially resolving the nursing problem. Analysis: Management of increased ICP by positioning the head up 30° can enhance cerebral venous return, ensuring adequate cerebral oxygenation, preventing herniation, and ultimately reducing signs of increased ICP. Discussion: Management of increased ICP by positioning the head up 30° can reduce the increase in ICP, thereby controlling the decrease in intracranial adaptive capacity. Recommendation: This case study lacked ICP values. Future research should include them as an objective parameter and expand the sample size to improve the generalizability of outcomes
Co-Authors Alimansur, Moh Ani Andriyani Astri Yunita Astri Yunita Atik Setiawan Wahyuningsih Atmojo, Didik Budi Santoso Didik Susetiyanto Atmojo Elfi Quyumi Rahmawati Erna Susilowati Erni Rahmawati Erni Rahmawati Erwin Yektiningsih, Erwin Esti Yunitasari Fajar Rinawati Fannindya Hamdani Zeho Fauziyah, Nurin Firnanda Amelia Putri Fresty Africia Hengky Irawan Heny Kristanto Jaya, Susanti Tria Krisnawati, Dyah Ika Luluk Susiloningtyas Mohammad Ikhwan Khosasih Nirmala KS NURIN FAUZIYAH Pratiwi Yuliansari Puguh Santoso Puguh Santoso Ratna Feti Wulandari Sucipto Wiseno, Bambang Yunarsih