1.

Pendidikan Kesehatan

SATUAN ACARA PENYULUHAN (SAP)

Tema Sub Tema Sasaran Tempat Hari/Tanggal Waktu

: Penyakit Cor Pulmonal : Perawatan Penyakit Cor Pulmonal : Bp. X : Rumah Sakit H : Jumat, 5 Desember 2012 : 30 Menit

A. Tujuan Instruksional Umum Setelah mengikuti penyuluhan selama 30 menit, diharapkan Bp. H dapat menjelaskan penyakit Cor Pulmonal.

B. Tujuan Instruksional Khusus Setelah mengikuti penyuluhan selama 30 menit, diharapkan Klien dapat: 1. Menjelaskan pengertian penyakit Cor Pulmonal dengan benar

2. Menyebutkan faktor penyebab yang dapat menimbulkan penyakit Cor Pulmonal 3. Menyebutkan tanda/gejala dari penyakit Cor Pulmonal 4. Menjelaskan penatalaksanaan penyakit Cor Pulmonal 5. Menjelaskan patofisiologi penyakit Cor Pulmonal C. Materi 1. Pengertian penyakit Cor Pulmonal 2. Faktor penyebab dari penyakit Cor Pulmonal 3. Tanda/gejala penyakit Cor Pulmonal 4. Penatalaksanaan penyakit Cor Pulmonal 5. Patofisiologi penyakit Cor Pulmonal

D. Metode 1. Ceramah 2. Tanya jawab

E. Kegiatan Penyuluhan No Kegiatan 1. Pembukaan Penyuluh Salam pembuka Peserta Menjawab salam Menyimak, Mendengarkan, menjawab pertanyaan Waktu

Menyampaikan tujuan penyuluhan

5 Menit

2.

Kerja/ isi

Penjelasan pengertian, penyebab, penatalaksanaan Cor Pulmonal gejala, dan

Mendengarkan dengan penuh perhatian

patofisiologi penyakit Menanyakan hal-hal 15 menit dari

Memberi kesempatan peserta untuk bertanya Menjawab pertanyaan Evaluasi 3. Penutup Salam penutup Menyimpulkan

yang belum jelas Memperhatikan jawaban penceramah Menjawab pertanyaan

Mendengarkan Menjawab salam

10 Menit

F. Media Leaflet: Tentang penyakit Cor Pulmonal

G. Sumber/Referensi a. Doenges, E. Marilynn. 2002. Rencana Asuhan Keperawatan Ed. 3. EGC : Jakarta. b. FKUI. 1999. Buku Ajar Ilmu Penyakit Dalam jilid 1. FKUI : Jakarta.

H. Evaluasi Formatif: 1. Klien dapat menjelaskan pengertian penyakit Cor Pulmonal

2. Klien mampu menjelaskan faktor penyebab dari penyakit Cor Pulmonal 3. Klien dapat menjelaskan tanda/gejala penyakit Cor Pulmonal 4. Klien mampu menjelaskan penatalaksanaan penyakit Cor Pulmonal 5. Klien mampu menjelaskan Patofisiologi penyakit Cor Pulmonal Sumatif: Klien dapat memahami penyakit Cor Pulmonal

Yogyakarta, 5 Desember 2012 Pembimbing Penyuluh

(Diah Pujiastuti, S. Kep., Ns)

(Ni Gusti Ayu Kadek D.)

2. Jurnal The association between obesity, mortality and filling pressures in pulmonary hypertension patients; the "obesity paradox" Zafrir B, Adir Y, Shehadeh W, Shteinberg M, Salman N, Amir O. A. Source Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel; The Heart Failure Center, Lin medical Center, Haifa, Israel. Electronic address: barakzmd @ gmail. com.

B. Abstract BACKGROUND: The term "obesity paradox", refers to lower mortality rates in obese patients, and is evident in various chronic cardiovascular disorders. There is however, only scarce data regarding the clinical implication of obesity and pulmonary hypertension (PH). Therefore, in the current study, we evaluated the possible prognostic implications of obesity in PH patients. METHODS: We assessed 105 consecutive PH patients for clinical and hemodynamic parameters, focusing on the possible association between Body Mass Index (BMI) and mortality. Follow-up period was 19 13 months. RESULTS: Sixty-one patients (58%) had pre-capillary PH and 39 patients (37%) out-ofproportion post-capillary PH. During follow-up period, 30 patients (29%) died. Death was associated with reduced functional-class, inverse-relation with BMI, higher pulmonary artery and right atrial pressures, pulmonary vascular resistance and signs of right ventricular failure. In multivariate analysis, obesity (BMI 30 kg/m), was the variable most significantly correlated with improved survival [H.R 0.2, 95% C.I 0.1-0.6; p = 0.004], even after adjustment for baseline characteristics. Obese and very-obese (BMI 35 kg/m) patients had significantly less mortality rates during followup (12% and 8%, respectively) than non-obese patients (41%), p = 0.01. The tendency of survival benefit for the obese vs. non-obese patients was maintained both in the pre-capillary (10% vs. 46% mortality, p = 0.008) and disproportional post-capillary PH patients (11% vs. 40% mortality, p = 0.04).

CONCLUSIONS: Obesity was significantly associated with lower mortality in both pre-capillary and disproportional post-capillary PH patients. It seems that in PH, similarly to other chronic clinical cardiovascular disease states, there may be a protective effect of obesity, compatible with the "obesity paradox".