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LAPORAN PENDAHULUAN HD

LAPORAN PENDAHULUAN HD

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Published by Tatat Permana

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Published by: Tatat Permana on Feb 26, 2010
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06/03/2013

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LAPORAN PENDAHULUAN
(LP)
HAEMODIALISA
2009
Cikampek
TatatPermana
[
RS.UMUM DAERAHKARAWANG
]
RUANG HAEMODIALISA
 
LAPORAN PENDAHULUAN
HAEMODIALISA
I.
Pengertian :
Proses perpindahan zat-zat tertentu dan darah melalui membran semipermiabel ( Carolyn M Hundak, Kep Kritis )II.
Perawatan Haemodialisa
Pre Haemodialisa@ Persiapan mesin@ Persiapan alat-alat@ Persiapan sirkulasi darah@ Menimbang BB@ Observasi K/U pasien@ Mengukur TTV@ Punksi2. On Haemodialisa / Intra Haemodialisa@ Pemantauan Pasien : K/U,TTV,pemberian heparin / obat-obat sesuaikebutuhan, tempat pungsi / penusukan@ Pemantauan mesin : konduktivitas, sirkulasi darah3. Post HaemodialisaPenekanan tempat pungsi K/U, TTV, timbang BB
III.Indikasi
1.Kesadaran menurun2.Gejala uremia,mual,muntah3.Ureum >200mg%4.Hyperlaemia .7 MEQ5.Asidosis PH darah >7 mg6.Azetemia Kreatinin >8 mg%7.An nuria > 5 hari8.CCT <5%
 
I.
Penatalaksanaan Haemodialisa
@ Skema pemantauan pembarian heparinHeparin 500 I V / jamFilter baikFilter cloth/bekuPerdarahan (-) perdarahan (+)Ganti filter (Dosis diubah)CT <120 CT >120 Maintenance Dosis heparinPerdarah stop Filter cloth@ Sarana hubungan sirkulasi / akses sirkulasia)Dengan internal A - V shunt / fistula aminob)Dengan external A – V shunt ( Schibner )c)Tanpa 1 dan 2 ( Femora dll )@ Fungsi Amino
Pasien sebelumnya dianjurkan cuci lengan dan tangan
 Tehnik aseptic + anti septic ( betadin + alkohol )
Anestesi lokal ( lidocain inj, procain inj )
Pungsi vena ( outlet ) dengan AV fistula no G 14 s/d G 16 / abocathkemudian fiksasi sertatutup dengan kassa steril
Berikan bolus heparin inj ( dosis awal )
Fungsi inlet ( fistula ) kemudian fiksasi lalu tutup dengan kassa steril@ Scribner1)Desinfektan2)Klem kanula arteri dan vena3)Bolus heparin inj ( dosis awal )@ Femoral

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