Mrs. Minah, 63 years old female, complains of two episodes of urinary incontinence.

On both occasions she was unable to reach a bathroom in time to prevent loss of urine. The firts episode occured when she was in her car and the second while she was in a shopping mall. She is reluctant to go out because of this problem urge incontinence. She has no menstrual periode since she was 50. Whitin the last month, her husband died and ever since she stayed with a housemaid. Physival examination found the body weight is 75 kg, height is 156 cm, the blood pressure is 150/80 mmHg, there is apical-radial pulse defisit, body temperature is 36,50C, there is no exertional dyspnea, fatigue, and headache. Laboratory finding is within normal limit. Lumbal densitometry is -3,0 and femoral densitometry is -2,7. Geriatric Depression Scale (GDS) 6 . MMSE score is 26. Mrs. Minah so far was in treatment of captopril 12,5 mg, two times daily.

Tutor : dr Msy Rulan Adindya Klarifikasi Istilah 1. Inkontinensia urin 2. Inkontinensia urge 3. 4. 5. 6. 7. 8. 9. : ketidakmampuan pengendalian pembuangan urine : pengeluaran urine secara involunter akibat peregangan orivisium vesika urinaria misal saat Siklus menstruasi : daur menstruasi yang dialami wanita ketika usia produktif Dispnea : pernapasan yang sukar atau sesak Lumbal densitometri : penentuan berbagai variasi ketebalan melalui perbndingan dengan bahan lain atau standar tertentu Kaptopril : obat anti hipertensi golongan ACE inhibitor Apikal-radial pulse defisit : perbedaan jumlah denyut jantung di apeks dengan arteri radialis GDS : skala yang digunakan untuk mengukur tingkat depresi pada geriatri MMSE : pemeriksaan untuk mengukur fungsi kognitif

Identifikasi Masalah 1. Mrs. Minah, 63 years old female, complains of two episodes of urinary incontinence. On both occasions she was unable to reach a bathroom in time to prevent loss of urine. The firts episode occured when she was in her car and the second while she was in a shopping mall. She is reluctant to go out because of this problem urge incontinence 2. She has no menstrual periode since she was 50. 3. Whitin the last month, her husband died and ever since she stayed with a housemaid. 4. Physival examination found the body weight is 75 kg, height is 156 cm, the blood pressure is 150/80 mmHg, there is apical-radial pulse defisit, body temperature is 36,50C, there is no exertional dyspnea, fatigue, and headache. 5. Laboratory finding is within normal limit. Lumbal densitometry is -3,0 and femoral densitometry is -2,7. Geriatric Depression Scale (GDS) 6 . MMSE score is 26. 6. Mrs. Minah so far was in treatment of captopril 12,5 mg, two times daily. Analisis Masalah

1.

Mrs. Minah, 63 years old female, complains of two episodes of urinary incontinence. On both occasions she was unable to reach a bathroom in time to prevent loss of urine. The firts episode occured when she was in her car and the second while she was in a shopping mall. She is reluctant to go out because of this problem urge incontinence a) Bagaimana fisiologi berkemih ?juber, hendy b) Bagaimana etiologi inkontinensia urine ? cimey, kardiyus c) Bagaimana hubungan usia dan jenis kelamin dengan keluhan? Ramadan, ayu d) Bagaimana klasifikasi dari inkontinensia urine ?abang, anggun 2. She has no menstrual periode since she was 50. a) Bagaimana hubungan periode menstruasi atau menopause dengan inkontinensia urine? Indah , ridho b) Apa dampak dari menopause? Catri, feddy 3. Whitin the last month, her husband died and ever since she stayed with a housemaid. a) Apapengaruh meninggalnya suami dan tinggal bersama pembantu terhadap Ny. Minah ? kadek , pacong b) Bagaimana cara menentukan status psikologis Ny.Minah ? juber, kardiyus c) Bagaimana hubungan status psikologi dengan inkontinensia urine ? (2arah ) cimey, hendy 4. Physival examination found the body weight is 75 kg, height is 156 cm, the blood pressure is 150/80 mmHg, there is apical-radial pulse defisit, body temperature is 36,50C, there is no exertional dyspnea, fatigue, and headache. Bagaimana interpretasi dan mekanisme abnormal dari pemeriksaan fisik? Catri , ridho 1. P hubungan h y s i 5. Laboratory finding is within normal limit. v a Lumbal densitometry is -3,0 and femoral densitometry is -2,7. l Geriatric Depression Scale (GDS) 6 . MMSE score is 26. e a) Bagaimana interpretasi dan mekanisme abnormal dari pemeriksaan penunjang? Ramadan, x anggun a b) Pemeriksaan Laboratorium apa saja yang dibutuhkan ? ayu, abang m i 6. Mrs. Minah so far was in treatment of captopril 12,5 mg, two times daily. n a) Bagaimana farmakokinetik dari kaptopril? Indah , feddy a b) Bagaimana farmakodinamik dari kaptopril ? kadek , pacong t c) Bagaimana indikasi dan kontraindikasi dari kaptopril ? dan obat yang paling tepat untuk i diberikan ke Ny. Minah ? juber, abang o d) Bagaimana efek samping dari kaptopril ? anggun, cimey n 7. Pertanyaan tambahan f a) Bagaimana penegakkan diagnosis dan pemeriksaaan penunjang hendy kardiyus o b) DD indah ramadan u c) WD ayu ridho n d) Epidemiologi feddy pacong d t h e Obesitas Hipertensilihat jnc 7 Pulse defisit

e) f) g) h) i) j) k) l) m)

Etiologi catri kadek Faktor resiko juber, pacong Patofisiologi hendy, ramadan Manifestasi klinis ayu kardiyus Tatalaksana cimey, abang Pencegahan anggun, indah Komplikasi feddy , ridho Prognosis catri, kadek SKDI juber

Hipotesis Ny Minah 63 tahun mengalami inkontinensia urin dengn obes hiperte AF osteoporosis

LI minimal 2 1. 2. 3. 4. 5. Juber, feddy, ridho 1 dan 2 Ayu catri abang kardiyus 2 dan 3 Kadek pacong cimey 3 dan 4 Ramadan, hendy, anggun indah 4 dan 5 Inkon urin (anat +fisiologi berkemih) Obesitas Hipertensi AF Osteoporosis

Tugas print yang li aja dak usah cover dak usah jilid