MAPPING BTKV (Jumat, 12 OKTOBER 2018)

KMR Nama, JK, HR Alamat Diagnosis Lab Planning

Umur
AQSHA 1
Kelas 7 Zulfiat Sri, AD 7 Banda Post Av shunt ar Lab (4/10/18) Rswat luka
lk, 61 th Aceh fossa mediana Hb/L/Tr Evaluasi Thrill
cubiti dextra 8,6/12/207
Na/k/Cl
141/4,2/107
Iso 2 Sukarni, lk, AD 2 Stenosis Lab (25/9/18) Joint operasi Senin
65 th esophagus distal Hb/Ht/E/L/T :
10,6/31/3x6/5,4/184
AQSHA 2
K3B2 Zulfahri POD Efusi pleura Lab 9/10/2018 Evaluasi produksi WSD
Syahrul 2 bilateral + post Hb/Ht/E/L/T :
Zen, lk, 40 chest tube 10 27 3.9 12 472
thn,1186281 dextra + obs Tgl 7 10
. joundice ec Albumin 2.46
cholelithiasis+ Kgds 95
cholesistisis
ARAFAH 1
K4B1 Mhd Raja AD 2 Aceh Efusi pleura Lab tgl 5/10/2018 Saran joint converence
Ijlal Lk, Barat sinistra dd Hb/Ht/E/L/T
13th, massa paru 10.3 /31 /3.9/ 6.9/ Hasil TTNA
1184744 sinistra 407 Suatu proses radang
Lab (27/09/18) kronik(dr istanul badri)
Hb/Ht/E/L/T
10.5/31/3.9/8.2/554
Alb: 3.42
GDS: 98
Ur/Cr: 19/0.62
Na/K/Cl:
142/4.9/103
RAUDHAH 3
K3B1 Salbiah,Pr, POD Aceh Post Lab (02/10/18) rawat luka dengan madu
58th, 7 Tamiang Debridement ai Hb/ht/L/T setiap pagi dan sore
1186485 sellulitis ar 12,1/35/15,7/265 Nacl3%(dgn 3:1)
cruris dextra Gds 129 Persiapan redebridement
Ur/cr 36/0,79 + necrotomy Senin
Na/K/Cl K. kardio (+)
145/3,7/103
K4B3 Maulianatul POD Pidie Efusi pleura Lab (01/10/18) Evaluasi produksi WSD
Hikmah, pr, 6 sinistra post Hb/Ht/E/L/Tr: Tunggu Hasil PA
20 thn, chest tube 10.8/33/4.4/7.0/162 (16/10/18)
1186105 sinistra + Alb: 2.56 Rencana Pleurodesis
Partial Saran aff chest tube
Obstruksi ec Lab (28/9/18) produksi WSD <100
tumor caecum Alb: 1.49
post laparotomy GDS: 112
Eksplorasi

K5B2 Kadri, Pr, POD Efusi Pleura Lab (8/10/18) Observasi Produksi WSD
37th, 3 Dextra Post Hb/Ht/L/T Rencana pleurodesisis
1144085 Chest Tube 10,4/32/6,7/320 jika produksi <100
Dextra GDS 99 Hasil PA invasive ductal
Ur/Cr carcinoma mamae grade 3
23/0,75 metastase ke KGB
Na/K/Cl
146/3,6/100
RAUDHAH 4
K2B2 Muhammad AD 5 Pidie Efusi Pleura Lab 9/10/18 Evaluasi produksi WSD
Nasir, lk, bilateral Post Hb/Ht/L/T
49thn, Chest Tube 9,6/29/13,6/434
1186081 Dextra Protein
total/Alb/Glo
7,10/2,69/4,41
 Gds/Gd2pp
92/144
Ur/Cr 51/0,98
Na/K/Cl
137/6,0/114

Lab 5/10/2018
Hb/Ht/E/L/T :
7,7/24/2,8/16,2/523
K6B1 Abdurrahma POD Pidie Sellulitis ar cruris Lab (6/10/18) Rawat luka dengan madu
n, Lk,77 thn, 4 sinistra post HB/Ht/L Pagi dan Sore
1000570 debridement + 13,2/39/19,0
necrotomy GDS 290
Ur/cr
107/1,60
Na/K/Cl
143/4,3/104
RAUDHAH 5
K6B2 Mulyadi POD Aceh Post Eksplorasi Lab 8/10/2018 Observasi tanda-tanda
rajali, lk, 40 3 (Bireun) vaskular + repair Hb/Ht/E/L perdarahan
thn, pseudoaneurisma 8/24/2,9/14/208
1178152 + debridement +
secunder hecting
ai rupture
pseudoaneurisma
ec infected wound
post AV shunt ar
fossa mediana
cubiti sinistra
HCU
SURGICAL
Bed 1 Darmi, lk, AD 3 Aceh Fr. costae 8, Lab 10/10/2018 Observasi, saran hari ini
51 thn, Barat 9,10,11 Hb/Ht/E/L/T : lepas rawat
Aceh Barat hemithoraks 10,3/30/3,6/89/11,0
sinistra + fr Ur/Cr : 62/1,15
ramus pubis dex
+ fr illiaca
dextra + fr
metatarsal 1
dextra post k-
wire+ anterior
dislokasi at
shoulder joint
dextra post
close reduction