BAB II

DISCUSSION

2.1 PART OF THE BODY

 MUSCLE& SKELETON

MUSCLE system has a function to move the body. The muscle system in humans consists of 600
muscles. The true back muscles are two very complicated jurai layers, located on the right and
left back of the spine, filling the space between the thorns and the taju latitude.

SKELETAL The function of the skeletal system, among others, is to keep all parts of the body
from collapsing, to protect the delicate instruments such as the brain, heart, and lungs, as a place
of attachment of muscles, to the movement of the body by the mediation of the muscles, making
blood cells especially red blood cells, giving shape to the body building of the fruit

 CARDIOVASKULAR

Circulatory system or circulation serves to pump blood throughout the body. The human
circulatory system is the heart. The inside of the heart consists of 4 chambers: the left foyer, the
left chamber, the right foyer and the right chamber. The left porch and the left chamber are
connected to each other, as do the right awning and the right chamber. The left side of the heart is
separated from the right by the cavity of the heart cavity.

 RESPIRATORY

The respiratory system is the anatomy of the human body that serves to breathe. organs used in
the lungs. The lungs consist of two parts, namely the right and left. The right lung is divided into
three lungs (lobes). and the left lung consists of two halves namely the top and bottom. In the
respiratory system, oxygen is a very important requirement, because humans inhale oxygen and
remove carbon dioxide and water vapor.

 SENSORY

The sensory system in humans serves as a recipient of stimuli from the surrounding environment.
Man has five sense systems called the five senses. The five senses are the sense of sight by the
eye, the sense of hearing by the ear, the sense of smell oelh the nose, the onde of touch by the
skin, and the sense of taste by the tongue. And from every part of the five senses have different
functions.

 DIGESTIVE

The digestive system in the human body functions to receive food, digest food, process food
digestion, then absorb the nutrients contained in the food into the bloodstream, and remove the
dregs or residual food remaining or can not be digested by the body. Digestive system from the
mouth to the anus that is from the mouth, throat, esophagus, stomach, small intestine, colon,
rectum and ends in the anus
  REPRODUCTIVE

The reproductive system is a series and interactions of internal organs that function to breed. The
reproductive system in women is centered in the ovaries whose function is to produce ova and
hormones. Female reproductive organs consist of uterus, ovary, and copulation. The ovaries are
the sex glands that produce egg cells. While the reproductive apparatus in men that testis that
serves as a producer of sperm and hormone testosterone.

 IMMUNE

The immune system or immune system serves to defend the body from the attack of objects that
cause diseases such as bacteria, viruses, parasites that can cause disease. The immune system is
present throughout the body especially in the spleen.

 NERVOUS

The nervous system serves to collect, transmit, and process information in the brain and nerves.
The human nervous system is composed of the central and peripheral nervous system. The central
nervous system consists of the brain & spinal cord. While in the peripheral nervous system
consists of autonomic and somatic nervous system. The nervous system is responsible for
delivering stimuli from the receptors to be responded by the human body.

 EXCRETORY

The excretory system is the kidneys and structures connected in the production and excretion of
urine. The excretory organs in the human body consist of the kidneys, liver, skin and lungs. The
kidneys function in removing the urine, the liver functioning to remove bile dyes or ure, the skin
works to sweat, while the lungs function in removing water vapor & carbon dioxide.

 LYMPHATIC

The lymphatic system is the structure involved in lymph transfer of tissues and blood flow.
Lymphatics works in the human body to drain laimfa in the human body. The lymphatic system
consists of lymph vessels and lymphoid organs.

 ENDOCRINE

Endorking system is a system that controls the gland without any channels that produce hormones
or communication in the body with hormones. Hormones are messenger chemicals that are
synthesized and secreted by the endocrine glands. The endocrine gland is composed of the
thyroid gland, the herofise gland, hypothalamus, parathyroid, pineal, adrenal.
2.2 MEDICAL EQQUIPMENTS

Medical device or medical equipment are non drug containing instruments, apparatus, machines and / or
implants used to prevent,diagnose, cure and alleviate illness, care for the sick, restore health to humans,
and / or structure and improve body function. Basd on the function of health equipment can be classified
into several classification such as function, usage properties, usability, age equipment, kinds and shape,
practicality of strorage. Here is some kinds for basic health hedical equipment like a tension, stethoscope,
intravenous drops ,spuit and anymore. This example of medical equipment, there are :

1. Bak Instrument / Instrument Tray

2. Spuit / syringe or injection

3. Sphygmomanometer

4. Bengkok / Nierbeken
5. Anatomy Pincet

6. ChirurgisPincet

7. Tongue Depressor

8. Infusion Set

9. CathetherFunction
 10. Urine Bag

2.3 NURSES DUTY IN WARD

Nursing Organizational Structure

Job Assignment Personnel in the Care Unit

- Coord. Nursing / UPP Head

- Head of Room / Deputy

- Observer

- Inventory

- PP / PA

- Administration / Billing

- Cleaning Service

JOB DESCRIPTION

KA UPP (HEAD OF NURSING IMPLEMENTATION UNIT)

• Coordinate nursing services in one installation
• Prepare a proposal for planning the needs of personnel, tools / facilities, building maintenance, training
and guidance on human resources in the inst
• Identify labor competency levels
• Calculate the power category ratio
• Lead meetings to rooms and staff
• Maintain ethical standards and application of communication Responsible for all applications of hospital
and nursing policies: infection control, staff performance, application of assignment methods, Jamkesmas,
etc.
• Prepare installation reports
• Monitor the use of all sources so that it is carried out efficiently
• Maintain up-to-date knowledge and innovation and inform staff
• Participating in committees in hospitals
• Ensure that all facilities function properly
• Solve conflicts in the installation
• Ensure the cleanliness of the room and bathroom is installed
• Evaluate staff personal books every year

• HEAD OF ROOM

o Managing the yan and care of the ward / living room

o Managing the nursing administration

o Preparing the proposed power planning, equipment / facilities, building maintenance, training and
guidance in the room

o Facilitating the identification of opportunities to move forward

o Ensuring complete documentation • Maintaining ethical standards in clinical practice

o Maintaining up-to-date knowledge and innovation

o Responsible staff to comply with RS and bid policy: inos, k3, jamkesmas, assignment methods

o Filling in the personal book of each staff

o Ensuring all equipment and buildings are functioning properly

o Eliminating anxiety and anger from patients, visitors and staff

o Solving conflicts at work

o Leading room meetings

o Making monthly room reports

o Arranging roster

o Signing attendance list

o Maintaining registers and notes

o Identifying non-performing legal aspects

o Ensuring clean room and bathroom every day

o Ensure all patients are visited especially patients need observation

o Following the operand and big round

o Ensuring billing data input is done correctly

• OBSERVATION

o Carry out the duties of the head of nursing outside the work day

o Monitor the implementation of the service in the hospital

o Monitor the attendance and discipline of staff

o Ensure the patient gets the appropriate service

o Ensure availability and availability of medical facilities and equipment, tools and buildings

o Coordinate the service process

o Facilitate the process needs services

o Address and coordinate emerging issues

o Ensure documentation

• PRIMARY NURSERY

o Lead and responsible for the implementation of care and yankep and documentation and
administration on a group of patients who are responsible

o Participate in visite

o Addressing the problems / conflicts of patients, guards and officers in the area

o Coordinate the process yan to ka room

o Set and memkahu all kepkepuah process in the area

o Ensure completeness of documentation and administration of the ps- entry to go home

o Ensure cleanliness of the room and bathroom in the area

o Implement computer data input for billing system afternoon / evening

• ASSOCIATED ASSISTANT / ASSISTANT

o Responsible and carry out the askep on the patient who is responsible

o Implement nursing documentation

o Visitevisite

o Caring for the patient from mrs to go home

o Ensuring the cleanliness of the patient's treatment room and bathroom

o Coordinate with PP for implementation of askep

o Implement data input biling afternoon / evening

• INVENTORY

o Propose the need of equipment / facilities and maintenance of building to karu

o Ensure the availability of equipment / materials in the room

o Responsible for the implementation of cleanliness and beauty of rooms and bathrooms
throughout the room

o Setting placement tools / materials

o Creating logistics reports

o Implement the process procurement

o Responsible for availability / preparedness of clothing all facilities / materials / equipment and
building in the room

o Coordination to ka room for its fulfillment and implementation of hygiene monitoring

• ADMINISTRATIVE ROOM ADMINISTRATION

o Implementing the administration of the room from the incoming home and the execution of the
process

o Conducting billing data inputs of all patients

o Cleaning the counter area and facilities

o Sending medical record files to CM

• CLEANSHIPS OF HYGIENE

o Cleaning the room and bathroom

o Cleaning the patient's bed

o Sending clothes dirty and take clean clothes

o Empty the trash

o Washing the trash

o Washing the shower wasom

o Responsible for cleanliness spoelhok

o Helping inventory for the amprah goods

o Helping nurses deliver laboratory materials.

2.4 NURSING DIAGNOSIS

The diagnosing phase involves a nurse making an educated judgement about a potential or actual health
problem with a patient. Multiple diagnoses are sometimes made for a single patient. These assesments not
only include a description of the problem or illness (e.g. sleep deprivation) but also whether or not a
patient is at risk of developing further problems. The diagnoses phase is a critical step as it is used to
determine the course of treatment.

1. Assesment

An RN uses a systematic, dynamic way to collet and analyze data about a client, the first
step in delivering nursing care. Assesment includes not only physiological data, but also
physiological, sociacultural, spiritual, economic, and life- style factors as well, for example, a
nurse’s assesment of a hospitalized patient in pain includes not only the physical causes and
manifestations of pain, but the patient’s response-an inabilityto get out of bed, refusal to eat,
withdrawal from family members, anger directed at hospital staff, fear, or request for more pain
mediation.

2. Diagnosis

The nursing diagnosis is the nurse’s clinical judgment about the client’s response to
actual or potential health conditions or needs. The diagnosis reflects not only that the patient is in
pain, but that the pain has caused other problems such as anxiety, poor nutrition, and conflict
within the family, or has the potential to cause complications for example, respiratory infection is
a pontential hazard to an immobilized patient. The diagnosis is the basisfor the nurs’s care plan.

3. Outcomes/Planning

Based on the assessment and diagnosis. the nurse sets measurable and achievabe short-
and long range goals for his patient that might include moving from bed to chair at least three
times per day: maintaining adequate nutrition by eating smaller, more frequent meals resolving
conflict throughcounseling, or managing pain through adequate medication. Assessment data,
diagncsis, and goals are written in the patient's care plan so that nurses as well as other healtn
professionals caring for the have access to it.

4. Implemerntation

Nursing care is implemented according tothe care plan, so continuity of care for patient
during hospitalization and in preparation fer discharge needs to be assured Care is documented in
the patient s record.
 5. Evaluation

Both the patient's status and the effectiveness of the nursing care must be continuously
evcluated, ond the care plan modifed as needed

2.5 NURSING ASSESMENT

The systematic colletion of all data and information relevant to the care of patients, their
problems, ond needs. The Initial step of the assessment consists of obtaining u careful and complete
history from the patient. If this cannot be done because the mental or physical condition of the patient
makes communication impossible, the nursing history is abtained from those who have information about
the patient and the reason(s) for his or her need of medical and nursing care. Obtaining an accurate and
comprehensive history requires skill in communicating with individuals who are ill, including those who
are reluctant or unable to share important life experiences and medical data. The skilled nurse will be able
to obtain the essential infomotion despite resistance. Next in the assessment is the physical exam ination
of the patient in order to dotermine how thc disease has altered physical and mental status. To do this
requires that the nurse be capable of pefoming visual and tactile inspection,pulption,percussiu and
auscultation and have knowledge of what represents deviation from the norm and how disease and trauma
alter the physical and mental condition of a patient. After these two steps have been completed, the nurse
will be able to establish a nursing diagnosis.

2.6 WALKING AIDS

Mobility aids is a tool designed to help and improve mobility for people with motion sensitivity.With this
tool, people with disabilities, elderly, stroke patients, and wheelchair users will be greatly helped..What
are the benefits of mobility aids?

Mobility aids briefly has the benefit of helping users with mobility limitations to be able to perform
activities / mobilization more easily.It turns out that mobility aids are diverse and diverse, let's see and
learn the benefits of each of those walkers.

a) WALKER / FOOTWEAR 4
Walker also known as the 4 foot stick, is the most stable motion aids.This tool is placed in front
of the user that serves as a support to run in stages.A good walker will have the same power at
the same time so easy to use.
b) CRUTHCES / KRUK

Crutches or better known as crutches is a walker used to support the movement of the dotted
pivot on the upper arm (armpits) used on the left and right.

b) CANE / WALKING STICK / STICK ELBOW

Cane / walking sticks, or better known as sticks, are the simplest walkers, they are used as a
support for the hand to move slowly

c) MOBILITY SCOOTER

Mobility scooter like combine scooter with electric wheelchair.But what distinguishes this
scooter will be more robust because it has 3 wheels, or 4 wheels, sousers do not need to deal with
balance adjustment.Relatively more practical for people who want to mobilize
independently.However, such mobility aids are rarely encountered in Indonesia, as the
Indonesian mobility aids industry is still in the development stage.
2.7 INTERNAL ORGAN

An organ is a collection of tissues that has a special role to play in the human body. Every body
organ has an important function to play. Organs also work together to make organ systems, such
as the digestive system or blood system.

a. Brain
Brain is one of the most important organs in the human body and is responsible for the main
actions carried out by the body. This brain is protected by a skull and is covered in a cranium
that keeps it very safe, because it is the center of the nervous system.
The human brain performs executive functions too, such as self-control, planning, reasoning,
and abstract thinking, which makes humans the smartest species on earth
b. Pineal
The pineal gland is an important colored endocrine glandreddish gray that is present in the
brain. The pineal gland is about the size of a rice and consists mainly of special cells called
pinealocytes. One of the most important hormones secreted by the pineal gland is melatonin,
which is responsible for influencing generative development and the sleep-wake cycle
associated with the body.
c. Hypothalamus
The hypothalamus is a part of the human brain that controls the release of the main hormones
by the pituitary gland. The hypothalamus is also responsible for maintaining body
temperature and controlling generative and reproductive behavior. The hypothalamus also
 provides a link to the central nervous system through the pituitary gland. The hypothalamus
also functions in controlling hunger, sleep and fatigue.
d. pituitary
The pituitary gland is one of the most important glands in the human body and is called the
master gland of the endocrine system. The pituitary gland is located at the base of the brain
but is not considered part of the brain. The pituitary gland secretes a hormone that helps a lot
in regulating homeostasis, which is the active balance of metabolism managed by several
complex biological mechanisms.
e. salivary gland
Exocrine glands (glands with channels) are found near the mouth and throat. The main
function of this gland is to expel saliva into the mouth to wet the food. The salivary gland
also starts digestion and helps in protecting teeth from decaying. The salivary gland can be
subdivided into the parotid gland (located around the ramus of the mandible), the
submandibular gland (located below the lower jaw) and the sublingual gland (located under
the tongue). Next is the thyroid gland
f. thyroid gland
The thyroid gland is located at the base of the neck and the largest endocrine gland in the
body. The thyroid gland secretes two important hormones - thyroxine (T4) and
triiodothyronine (T3). This hormone is responsible for the growth and metabolism of the
body. Excessive secretion of thyroid hormones causes hyperthyroidism when insufficient
secretion of thyroid hormone causes hypothyroidism, which are two of the most common
problems faced by humans.
g. Parathyroid
The parathyroid gland is four small endocrine glands located in the neck. Each of them is
about the size of a rice. The main function of the parathyroid gland is to produce parathyroid
hormone which controls the amount of calcium in the blood and bones. People who have
overactive parathyroid glands suffer from hyperparathyroidism and people with less active
glands suffer from hypoparathyroidism.
h. Pharynx
Pharynx is part of both the respiratory and digestive systems. The pharynx is located under
the mouth and nasal cavity, and above the esophagus and larynx. The main function of the
 pharynx is to filter the air. Pharynx makes the air warm, moistens and passes through this
moisturizes air into the lungs. The pharynx can be divided into three parts: nasopharynx,
oropharynx, laryngopharynx
i. Larynx
Larynx is a cartilage structure that is above the trachea and contains vocal cords. The main
function of the larynx is to give a tone of voice when we speak. Larynx is better known as a
voice box. Larynx also protects the trachea from food aspiration. Any interference in this
organ can cause pain in the throat, loss of voice, or breathing problems.
j. Thymus
The thymus is a pyramidal gland located just below the neck. Thymus is one of the most
specialized organs of the immune system. The main function of the thymus gland is to
produce lymphocytes or T-cells that help in developing immunity to disease. Thymus is
atrophy with age, ie organ size decreases with age.

2.8 PART OF THE BODY AND HEALTH PROBLEM

1. The endocrine system consists of eight major glands that secrete hormones into
the blood. These hormones, in turn, travel to different tissues and regulate
various bodily functions, such as metabolism, growth and sexual function.
2. The immune system is the body's defense against bacteria, viruses and other
pathogens that may be harmful. It includes lymph nodes, the spleen, bone
marrow, lymphocytes (including B-cells and T-cells), the thymus and
leukocytes, which are white blood cells.
3. The lymphatic system includes lymph nodes, lymph ducts and lymph vessels,
and also plays a role in the body's defenses. Its main job is to make is to make
and move lymph, a clear fluid that contains white blood cells, which help the
body fight infection. The lymphatic system also removes excess lymph fluid
from bodily tissues, and returns it to the blood.
4. The nervous system controls both voluntary action (like conscious movement)
and involuntary actions (like breathing), and sends signals to different parts of
the body. The central nervous system includes the brain and spinal cord. The
 peripheral nervous system consists of nerves that connect every other part of
the body to the central nervous system.
5. The body's muscular system consists of about 650 muscles that aid in
movement, blood flow and other bodily functions. There are three types of
muscle: skeletal muscle which is connected to bone and helps with voluntary
movement, smooth muscle which is found inside organs and helps to move
substances through organs, and cardiac muscle which is found in the heart and
helps pump blood.