Penerapan kombinasi water tepid sponge dan antipiretik pada anak dengan hipertermia akibat infeksi saluran kemih - Rani Syafitri; Widia Sari; Titin Nurmaningsih (Indonesian Public Health-Observer Information Forum (IPHORR) Kerja sama dengan: Unit Penelitian dan Pengabdian Kep Akademi Keperawatan Baitul Hikmah, 2026)
Background: Urinary tract infection (UTI) is a common bacterial infection in early childhood and is often accompanied by fever that can progress to hyperthermia, a priority nursing problem that carries the risk of febrile seizures, dehydration, and metabolic disorders if not adequately treated. Purpose: To describe and evaluate the implementation of hyperthermia nursing care in children with febrile UTI using a combination of water tepid sponge (WTS) and antipyretics. Method: A descriptive case study was conducted on January 21-22, 2026, in the Ade Irma Suryani Pavilion Room, 2nd Floor, Gatot Soebroto Army Hospital, Jakarta, on one pediatric patient (An. T, female, 8 years 4 months, 25 kg) with febrile UTI who experienced hyperthermia. The intervention consisted of a combination of intravenous paracetamol (15 mg/kgBW) and WTS using water at a temperature of 32-35°C for 15-20 minutes, implemented in three sessions over two days. Axillary temperature was measured using a calibrated digital thermometer by the same nurse at T0 (before intervention), T1 (30 minutes), T2 (60 minutes), and T3 (120 minutes). In addition to body temperature, observations of vital signs, skin and facial conditions, and the patient's subjective responses were also conducted at each session using the SOAP (Subjective, Objective, Assessment, Planning) documentation format. Data analysis was conducted descriptively through a systematic and chronological clinical narrative, by comparing the temperature measurements at T0-T3 in each session and changes in the patient's condition before and after the intervention. Results: The largest temperature decrease occurred in session 3, at 1.5°C, while the smallest decrease occurred in session 1, at 1.2°C. Across all three sessions, the sharpest temperature decrease occurred in the T2-T3 interval (60-120 minutes after intervention). Observations in session 1 also showed the child appeared slightly calmer, although his face remained red, suggesting the hyperthermia problem was not yet resolved. Session 2 showed a less red face and reduced anxiety; the patient's mother reported that the child was drinking a little. Session 3 showed the child appeared active and cooperative. The mother reported that the child was not fussy, was eating, and was playing. Conclusion: The application of a combination of water tepid sponge (WTS) and antipyretics to a pediatric patient with fever and urinary tract infection showed a significant decrease in body temperature in three intervention sessions over two days of care, accompanied by improvements in comfort and vital signs. All outcome criteria for improved thermoregulation were achieved at the final evaluation, and the nursing diagnosis of hyperthermia was declared resolved. The combination of WTS and antipyretics can help reduce body temperature in children with fever. Suggestion: For healthcare workers, particularly pediatric nurses, the combination of WTS and antipyretics can be considered as a non-pharmacological complementary intervention in hyperthermia management, taking into account water temperature (32-35°C), duration of the procedure, and the child's comfort during the procedure. Hospitals are advised to develop a standardized WTS protocol to guide practice in pediatric wards. Keywords: Children; Hyperthermia; Nursing care; Urinary tract infection; Water tepid sponge Pendahuluan: Infeksi saluran kemih (ISK) merupakan salah satu infeksi bakteri yang sering terjadi pada anak usia dini dan sering disertai demam yang dapat berkembang menjadi hipertermia, suatu masalah keperawatan prioritas yang berisiko menimbulkan kejang demam, dehidrasi, dan gangguan metabolik apabila tidak ditangani secara adekuat. Tujuan: Untuk memberikan mendeskripsikan dan mengevaluasi penerapan asuhan keperawatan hipertermia pada anak dengan febris ec ISK melalui kombinasi water tepid sponge (WTS) dan antipiretik. Metode: Studi kasus deskriptif dilaksanakan pada 21-22 Januari 2026 di Ruang Paviliun Ade Irma Suryani Lt. 2 RSPAD Gatot Soebroto, Jakarta, pada satu pasien anak (An. T, perempuan, 8 tahun 4 bulan, 25 kg) dengan febris ec ISK yang mengalami hipertermia. Intervensi berupa kombinasi paracetamol intravena (15 mg/kgBB) dan WTS menggunakan air bersuhu 32-35°C selama 15-20 menit, dilaksanakan dalam tiga sesi selama dua hari. Suhu aksila diukur menggunakan termometer digital terkalibrasi oleh perawat yang sama pada T0 (sebelum intervensi), T1 (30 menit), T2 (60 menit), dan T3 (120 menit). Selain suhu tubuh, dilakukan pula observasi tanda vital, kondisi kulit dan wajah, serta respons subjektif pasien pada setiap sesi menggunakan format dokumentasi SOAP (Subjective, Objective, Assessment, Planning). Analisis data dilakukan secara deskriptif melalui narasi klinis yang sistematis dan kronologis, dengan membandingkan hasil pengukuran suhu pada T0-T3 di setiap sesi serta perubahan kondisi pasien sebelum dan sesudah intervensi. Hasil: Penurunan suhu terbesar terjadi pada sesi 3 yaitu 1.5°C, sedangkan penurunan terkecil terjadi pada sesi 1 yaitu 1.2°C. Pada ketiga sesi, penurunan suhu paling tajam terjadi pada interval T2-T3 (60-120 menit setelah intervensi). Berdasarkan observasi pada sesi 1 juga menunjukkan anak tampak sedikit lebih tenang, meskipun wajah masih tampak kemerahan, sehingga masalah hipertermia dinilai belum teratasi, pada sesi 2 menunjukkan wajah tidak terlalu merah, dan rasa gelisah berkurang; ibu pasien melaporkan anak sudah mau minum sedikit kemudian pada sesi 3 menunjukkan anak tampak aktif serta kooperatif, ibu pasien melaporkan anak tidak rewel, mau makan, dan bermain. Simpulan: Penerapan kombinasi water tepid sponge (WTS) dan antipiretik pada pasien anak dengan febris ec infeksi saluran kemih menunjukkan penurunan suhu tubuh yang signifikan dalam tiga sesi intervensi selama dua hari perawatan, disertai perbaikan kenyamanan dan tanda vital. Seluruh kriteria luaran termoregulasi membaik tercapai pada evaluasi akhir, dan diagnosis keperawatan hipertermia dinyatakan teratasi. Kombinasi WTS dan antipiretik dapat membantu menurunkan suhu tubuh anak dengan demam. Saran: Bagi tenaga kesehatan, khususnya perawat anak, kombinasi WTS dan antipiretik dapat dipertimbangkan sebagai salah satu intervensi pendamping non-farmakologis dalam manajemen hipertermia, dengan memperhatikan suhu air (32-35°C), durasi tindakan, serta kenyamanan anak selama prosedur. Bagi institusi rumah sakit, disarankan menyusun protokol WTS yang terstandar sebagai panduan praktik di ruang rawat anak.