Skenario C Blok 24 Tahun 2014 Mrs. Minah, 63 years old female, complains of !o episodes of urinary incon inence.

"n #o h occasions she !as una#le o reach a #a hroom in ime o pre$en loss of urine. The firs episode occurred !hen she !as in her car and he second !hile she !as in a shoppin% mall. She is reluc an o %o ou #ecause of his pro#lem ur%e incon inence. She has no mens rual period since she !as &0. 'i hin he las mon h, her hus#and died and e$er since she s ayed !i h a housemaid. (hysical e)amina ion found he #ody !ei%h is *& k%, hei%h is 1&6 cm, he #lood pressure is 1&0+,0 mm-%, here is apical.radial pulse defici , #ody empera ure is 36,&0C, here is no e)er ional dyspnea, fa i%ue, and headache. /a#ora ory findin% is !i hin normal limi . /um#al densi ome ry is .3,0 and femoral densi ome ry is .2,*. 0eria ric 1epression Scale 201S3 6. MMS4 score is 26. Mrs. Minah so far !as in rea men of cap opril 12,& m%, !o imes daily. 5. 6/7859567S5 5ST5/71. 9a i%ue: keadaan menin%ka nya ke idaknyamanan dan menurunnya efisiensi aki#a ker;a yan% #erkepan;an%an a au #erle#ihan a au kehilan%an ena%a a au kemampuan un uk men;a!a# ran%san%an. 2. -eadache: nyeri di kepala. 3. 1ensi ome ry: penen uan #er#a%ai $ariasi ke e#alan ulan% melalui per#andin%an den%an #ahan lain a au s andar er en u. 4. <rine incon inence: keluarnya urine yan% idak erkendali pada !ak u yan% idak dikehendaki anpa memperha ikan frekuensi dan ;umlahnya yan% men%aki#a kan masalah sosial dan hy%iene penderi a &. 4)er ional dyspnea: sesak nafas yan% diaki#a kan oleh ak i$i as. 6. 01S: %eria ric depression scale, laporan penilaian diri yan% erdiri dari 30 i em yan% dirancan% khusus un uk men%iden ifikasi depresi pada oran% ua. *. MMS4: mini men al s a e e)amina ion, yai u me ode pemeriksaan un uk menilai fun%si ko%ni if. ,. Cap opril: sua u 7C4 inhi#i or yan% di%unakan un uk pen%o#a an hiper ensi a au ;an un% kon%es if dan disfun%si $en rikel kiri pasca infark miokard. =. <r%e incon inence: inkon inensia urine yan% didahului oleh kein%inan un uk men%eluarkan yan% idak erkon rol. 514>T59567S5 M7S7/71. Mrs. Minah, 63 years old female, complains of !o episodes of urinary incon inence. "n #o h occasions she !as una#le o reach a #a hroom in ime o pre$en loss of urine. The firs episode occurred !hen she !as in her car and he second !hile she !as in a shoppin% mall. 2. She is reluc an o %o ou #ecause of his pro#lem ur%e incon inence. 3. She has no mens rual period since she !as &0. 4. 'i hin he las mon h, her hus#and died and e$er since she s ayed !i h a housemaid. &. (emeriksaan fisik 6. (emeriksaan penun;an% *. 8i!aya pen%o#a an

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7>7/5S5S M7S7/7Masalah 1 1. Ba%aimana fisiolo%i #erkemih? 2di;elaskan ana omi yan% #erperan ;u%a3 1 2. Ba%aimana hu#un%an usia, ;enis kelamin, dan keluhan u ama? 2 3. Ba%aimana peru#ahan fisiolo%i #erkemih pada oran% ua? 3 4. Ba%aimana klasifikasi inkon inensia urine? 4 &. 4 iolo%i dan mekanisme idak #isa menahan B76? & 6. Ba%aimana pen%aruh ak i$i as 2di mo#il dan di mall3 erhadap keluhan u ama? 6 Masalah 2 1. 7pa dampak dari inkon inensia ur%ensi secara umum?2hu#un%in ke reluc an 3 * 2. Ba%aimana e iolo%i dan mekanisme inkon inensia ur%ensi? 1 Masalah 3 1. Ba%aimana hu#un%an ri!aya menopause dan inkon inensia urine? 2 Masalah 4 1. Ba%aimana hu#un%an kondisi keluar%a den%an kondisi psikis dan keluhan inkon inensia urine ur%ensi? 3 Masalah & 1. Ba%aimana in erpre asi dan mekanisme a#normal dari: . BB, TB 4 . T1, apical.radial pulse defici & . Tempera ur, no e)er ional dyspea, fa i%ue, headache 6 Masalah 6 1. Ba%aimana in erpre asi dan mekanisme a#normal dari: . /um#al densi ome ry dan femoral densi ome ry 2dihu#un%kan den%an menopause3 * . 01S dan MMS4 1 2. Ba%aimana cara pemeriksaan: . /um#al densi ome ry dan femoral densi ome ry 2 . 01S dan MMS4 3 Masalah * 1. Ba%aimana hu#un%an pem#erian cap opril dan inkon inensia urine? 4 2. Ba%aimana farmakolo%i cap opril? 2indikasi, kon raindikasi, dosis, efek sampin%, farmakokine ik, farmakodinamik3 & Masalah , 1. Cara pene%akan dia%nosis dan pemeriksaan penun;an%? 6 2. 11 dan '1? * 3. 4pidemiolo%i 1 4. 4 iolo%i dan fak or risiko 2 &. (a ofisiolo%i 3

6. Manifes asi klinis 4 *. (ena alaksanaan . 5nkon inensia urine & . -iper ensi pada inkon inensia urine 6 . "#esi as * . "s eoporosis 1 . S ress 2 ,. 6omplikasi 3 =. (ence%ahan dan edukasi 4 10. (ro%nosis & 11. S615 6 5@. -5("T4S5S >y. Minah, 63 ahun, men%alami inkon inensia urine ipe ur%ensi den%an suspek o#esi as, s ress, hiper ensi, a rial fi#rilasi, os eoporosis. /478>5>0 5SS<4 1. 7na omi dan fisiolo%i #erkemih 1, 2, 3 2. 5nkon inensia urine 4, &, 6 3. (siko%eria ri *

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6irim erakhir hari Selasa ;am 3 sore. 6elompok sama kayak min%%u lalu. Aan%an lupa daf ar pus aka. 8apiin.