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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 Apr 18, 2010
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06/03/2013

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LAPORAN PENDAHULUAN
(LP)
HAEMODIALISA
 
2009
Cikampek
Tatat
Perm
ana
 
[
RS.UMUM DAERAH KARAWANG
] 
RUANG HAEMODIALISA
 
 
LAPORAN PENDAHULUAN
HAEMODIALISA
I.
 
Pe
ng
er
tian
:
Pros
e
s
pe
r
pindahan zat-zat te
r
tentu dan da
r
ah melalui memb
r
an
s
emipe
r
miabel ( Ca
ro
lyn M Hundak, Kep K
r
iti
s
)
II.
 
Per
awatan
H
a
emod
ialisa
 
Pr
e Haem
o
diali
s
a@
P
e
rs
iapan me
s
in@
P
e
rs
iapan alat-alat@
P
e
rs
iapan
s
i
r
kula
s
i da
r
ah@ Menimbang BB@ Ob
s
e
rv
a
s
i K/U pa
s
ien@ Menguku
r
TTV@
P
unk
s
i2. On Haem
o
diali
s
a / Int
r
a Haem
o
diali
s
a@
P
emantauan
P
a
s
ien : K/U,TTV,pembe
r
ian hepa
r
in /
o
bat-
o
bat
s
e
s
uai kebutuhan,tempat pung
s
i / penu
s
ukan@
P
emantauan me
s
in : k
o
ndukti
v
ita
s
,
s
i
r
kula
s
i da
r
ah3.
Pos
t Haem
o
diali
s
a
P
enekanan tempat pung
s
i K/U, TTV, timbang BB
III.
 
I
n
d
ikasi
 
1
.
 
Ke
s
ada
r
an menu
r
un2.
 
Gejala u
r
emia,mual,muntah3.
 
U
r
eum >200mg%4.
 
Hype
r
laemia .7 MEQ 5.
 
A
s
id
os
i
s
 
P
H da
r
ah >7 mg6.
 
Azetemia K
r
eatinin >8 mg%7.
 
An nu
r
ia > 5 ha
r
i8.
 
CCT <5%
 
IV.
 
Pe
natalaksanaan
H
a
emod
ialisa
 
@ Skema pemantauan pemba
r
ian hepa
r
inHepa
r
in 500 I V / jamFilte
r
baik Filte
r
cl
o
th/beku
P
e
r
da
r
ahan (-) pe
r
da
r
ahan (+) Ganti filte
r
 (D
os
i
s
diubah)CT <
1
20 CT >
1
20Maintenance D
os
i
s
hepa
r
in
P
e
r
da
r
ah
s
t
o
p Filte
r
cl
o
th@ Sa
r
ana hubungan
s
i
r
kula
s
i / ak
s
e
s
 
s
i
r
kula
s
ia)
 
Dengan inte
r
nal A - V
s
hunt / fi
s
tula amin
o
 b)
 
Dengan exte
r
nal A V
s
hunt ( Schibne
r
)c)
 
Tanpa
1
dan 2 ( Fem
or
a dll )@ Fung
s
i Amin
o
 
y
 
P
a
s
ien
s
ebelumnya dianju
r
kan cuci lengan dan tangan
y
 
Tehnik a
s
eptic + anti
s
eptic ( betadin + alk
o
h
o
l )
y
 
Ane
s
te
s
i l
o
kal ( lid
o
cain inj, p
ro
cain inj )
y
 
P
ung
s
i
v
ena (
o
utlet ) dengan AV fi
s
tula n
o
G
1
4
s
/d G
1
6 / ab
o
cath kemudian fik
s
a
s
i
s
e
r
tatutup dengan ka
ss
a
s
te
r
il
y
 
Be
r
ikan b
o
lu
s
hepa
r
in inj ( d
os
i
s
awal )
y
 
Fung
s
i inlet ( fi
s
tula ) kemudian fik
s
a
s
i lalu tutup dengan ka
ss
a
s
te
r
il@ Sc
r
ibne
r
 
1
)
 
De
s
infektan2)
 
Klem kanula a
r
te
r
i dan
v
ena3)
 
B
o
lu
s
hepa
r
in inj ( d
os
i
s
awal )@ Fem
or
al
1
)
 
De
s
infektan2)
 
Anae
s
te
s
i l
o
kal3)
 
Fung
s
i
o
utlet/
v
ena (
s
alah
s
atu
v
ena yang be
s
a
r
bia
s
anya dilengan)4)
 
B
o
lu
s
hepa
r
in injek
s
i (d
os
i
s
awal)

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