Question and Answer

GROUP 3 (ELIMINATION)

1. Refi rizki s 181141030

So I want to ask how do we know if our elimination is balanced, meaning that the income and expenditure
are balanced?

answer

Restu Baitumah Eka 181141031

I will answer question from refi, Elimination will be balanced if the expenditure and fluid intake are
balanced

Liquid Balance Formula

Inteake / fluid intake = Output / fluid out + IWL (Insensible Water Loss)

Intake / Intake: starting from intravenous fluids, drinking, the fluid content in the patient's food, the volume
of drugs, including injectable drugs, dripping drugs, albumin etc.

Output / Fluid out: urine within 24 hours, if the patient has a catheter in place then calculate the size in the
urobag, if it is not attached then the patient must collect his own urine, usually in a 1.5 liter mineral water
bottle, then feces.

IWL (insensible water loss (IWL): the amount of discharge is unconscious and difficult to calculate, namely
the amount of sweat, breath vapor.

IWL FORMULATION

IWL = (15 x BW) / 24 hours

2. Dela Fika 181141006

why socio-cultural, developmental and diagnostic tests result in changes in urine elimination. as well as
what diagnostic tests affect urine elimination.

answer

Lailatun Ni'mah 181141019

I will answer questions from Dela

(Growth and development)

The rate of growth and development can affect voiding patterns. This can be found in children, who have
more difficulty controlling urination. However, the ability to control urination increases with age.

(Sociocultural)
Culture can affect the fulfillment of urine elimination needs, such as the existence of culture in certain
communities that prohibits urination in certain places and also positions when urinating such as squatting or
standing. Defecate at times or in the toilet.

(Diagnostic check)

This diagnostic test can also affect the need for urine elimination, particularly procedures associated with
urinary tract examination such as an intra venus pyelogram (IVP). This examination can limit the amount of
intake thus reducing urine production. In addition, cystoscopy can cause local edema in the urethra so that
urine output is not disturbed.

So the diagnostic tests that affect urine elimination are intra venus pyelogram (IVP) and cystoscopy

3. Dwi Olinda E 181141008

I want to ask to explain how the process of diarrhea and constipation occurs.

answer

siti nurannisa 18114103, atika rahmani 181141003

I will answer questions from olinda

The diarrhea mechanism begins with some of the most common factors is food, since inappropriate food
leads to hyperperistaltic activity or a rapid peristaltic movement that results in lowered chance of the
intestines absorbing the food and the resulting diarrhea.

namely from the etiological factors causing damage to the digestive tract resulting in neuro mucus damage
and resulting in decreased intestinal peristalsis, so that the transit time of feces is long and results in a high
fluid reabsorption process, resulting in hardened stool, difficult to remove and occurs constipation. That's it
and Thank you

4. Thoyibatun Nafia181141040

how to deal with mothers who after giving birth experience frequent urination and also cannot pee for days

answer

Wahyu Pratama 181141044

I will answer the question from Fifi.

Frequent urination after childbirth is caused by pelvic floor muscles weakening after childbirth.

The fix is

1. Do Kegel exercises

Kegel exercises can strengthen the muscles around the urinary tract so that they are effective in preventing
incontinence.

2. Electrical stimulation therapy

This therapy is performed by delivering low-power electricity to the pelvic floor muscles. Muscles contract
like when doing Kegel exercises

3. Lose your weight

Weight gain during pregnancy can weaken the pelvic floor muscles. Therefore, do a healthy diet and do
regular exercise so that your weight returns to normal.

how to deal with difficulty urinating

1. Drink plenty of fluids to get the urge to urinate. It is also useful for dealing with constipation that may be
experienced after childbirth.

2. If you are able to walk, take the opportunity to walk lightly. Gravity and light movements will help the
body's systems return to normal, including the system in the bladder.

3. Don't hesitate to ask for privacy when trying to pee. Ask the nurse to wait outside the bathroom.

4. Drink warm water to reduce pain when urinating and a burning sensation in the perineum.

5. Ainun Jr 18114101

how can people who like spicy to avoid diarrhea and constipation?

answer

Ainina Shalsa Ifada 181141051

I will answer questions from sister ainun

How can people like spicy get diarrhea and constipation?

So spicy food or excessive consumption of spicy food also affects intestinal peristalsis, or more clearly
increases intestinal peristalsis, when rapid intestinal peristalsis can result in a decreased chance of the
intestine absorbing food. It also causes someone to experience constipation.

And constipation in medical terms is referred to as indigestion or constipation. Constipation is a disorder in

passing stool or defecating with an unusual frequency.

Constipation conditions in certain circumstances can cause complications in the stomach to the rectal area.
This can cause pain in the rectal area until hemorrhoids develop.

To fix this, drink lots of water at least 2 liters per day. Then, add staple foods combined with the intake of
green vegetables and fruits. Can also consume jelly regularly.
GROUP 4 (PERSONAL CARE)

1. Name: Elisabeth de Rosa

Nim: 181141009

Group:5

I want to ask, How do we as nurses deal with patients who refuse to perform self-care?

I will answer a question from sister Elisabet @⁨Elisabeth S.Kep⁩

So to treat patients like that, the first thing we do as nurses is to build a trusting relationship so that the patient
begins to believe in the words or suggestions that we will do later, of course, continue to use therapeutic methods so
that patients can easily understand them. what we explain, like giving an explanation. the importance of bathing that
can prevent the patient from bacteria and then an explanation of how to dress and apply makeup so that the patient
is more confident.

If the patient has mental disorders do not forget to do bhsp therapy and tell him the benefits of personal hygiene
then train the patient how to bathe, dress up and wear clothes and if the patient begins to understand give praise or
gifts. So that patients are excited the next day to do personal hygiene well.

2. Name: Ainina Shalsa I

Nim: 181141051

Group: 3

Please ask permission to ask, why is the high risk of violent behavior included in nursing problems in personal care?
what is the case like? and what nursing interventions as a nurse met the case?

I will answer the question sist Shalsa

Violence can lead to self-care problems because limited self-care is usually the result of severe stressors and difficult
to handle by clients (client cases may experience low self-esteem) so he does not want to take care of or care for
himself either in bathing, dress, decorate, eat, or defecate and BAK.

If the nurse does not intervene, the client may experience a high risk of social isolation (Nasution, 2013). According
to Thomas (2012) self-care deficit is one of the symptoms that is often found in patients with mental disorders,
where hallucinations are often identified with schizophrenia. Of all schizophrenia, 70% of them have deficits in self-
care, other mental disorders that are often accompanied by hallucinatory symptoms are Manic Depressive Disorder
and Delirium (Hardiyah, 2010).

Because usually schizophrenia can also experience violence because in some cases patients who experience
schizophrenia are considered very disturbing or some even think of being possessed and this is where physical and
verbal abuse occurs which will cause the patient to experience very heavy stress and cause interference with self-
care. Patients with mental disorders in addition to experiencing self-care deficits will experience a high risk of violent
behavior. For example, patients with mental disorders who experience self-care disorders will have a high risk of
violent behavior such as shackling, forced to bathe, forced to eat, of course, not only verbally, this coercion is often
interrupted by verbal and physical violence such as hitting, kicking, etc. Patients with mental disorders are willing to
give treatment.
I wiil answer question from Shalsa about the nursing intervension from the case,

According to philanthropist (2013), self-care deficit management

can be done with an implementation strategy approach (SP). Strategy

the implementation is:

SP 1 patient:

1) Identification of personal care problems: personal hygiene, dressing, eat / drink, defecate / defecate.

2) Explain the importance of personal hygiene.

3) Explain personal hygiene methods and tools.

4) Practice how to maintain personal hygiene: shower and change clothes, brush teeth, wash hair, cut nails

5) Put on the daily activity schedule for bath exercises, toothbrushes times per day), wash hair (2 times per week),
cut nails (once per Sunday).

SP 2 patient:

1) Evaluate personal hygiene activities. Give compliments.

2) Describe the methods and tools for dressing up.

3) Practice how to dress up after personal hygiene: combs, make up for women; comb, shave for men.

4) Include on an activity schedule for personal hygiene and grooming.

SP 3 patient:

1) Evaluate personal hygiene and dress up activities. Give compliments.

2) Explain how to eat and drink. Practice eating and drinking tools and utensils.

3) Practice proper eating and drinking.

4) Enter on the activity schedule for personal hygiene exercises, dress up, eat and drink well.

SP 4 patient:

1) Evaluate personal hygiene activities, make up, eat and drink. Give it praise

2) Explain how to defecate and urinate properly.

3) Practice good bowel and urination.

4) Enter on the activity schedule for personal hygiene exercises, dress up, eating and drinking and defecating and
urinating.

3. Name : Faizatul Dwi Mufidah

Nim : 181141011

Group 6
I want to ask, in the classification of personal hygiene, there is skin care, so how do you care for skin on personal
hygiene?

I will answer a question from faiza

In the medical world, especially caring for skin care patients is an important thing to pay attention to because the
goal is that the patient is free from body odor, has intact skin, comfort and understands the skin care method itself
after some patients wear binders, casts, dressings and so on. - other. Generally, the skin is cleaned by bathing. When
taking a shower, we should use many types of soap contains vegetable fat because it can prevent loss moisture and
smooths the skin. Detergent soap is rare used for bathing because of its irritating nature. In choosing and using soap,
make up, deodorant, and shampoo should choose products that do not cause stinging or irritation.

Skin care methods are as follows:

1) Get used to showering at least 2 times a day or after activity.

2) Use soap that is not negative.

3) Wash the whole body, especially the skin folds such as between - between the fingers, armpits, behind the ears,
etc.

4) Do not use soap for the face.

5) Immediately dry the body with a soft towel face, hands, body, to feet

4. name : Oktaviyanti I

Nim : 181141029

group 1

what if the medical personnel make a procedure mistake such as bathing the patient is there a risk to the patient?

I Will answer a question from Octa

What if the health worker makes a mistake during the procedure for bathing the patient? According to the group, in
terms of bathing procedures, they must follow the SOP as usual or the one that applies in the hospital, but if the
error causes injury, it may be problematic, but if the error of the bathing procedure does not cause the patient to
harm, it can be continued. Or maybe from mam ifah you can add🙏🏻

Emmm,

Basically the answer is correct already..

Just want to add a lil bit for the term of mistakes..

Sometimes,for some cases,you will not be alone to do that action,so perhaps before you make a mistake, your
partner will try to remind you first..

But if there's a crusial mistake you have done,something that we can do is fixing the problem first..

For example related to the cateter or infusion set or another machine on the body, so we have to deal with those
things first.. While also we can ask for a help from anothe partner.. (If necessary)..

However,I think as it is usually done for routine,the mistake will be minor to happen..😁
Term or problem about 'privacy' will always ve there..

We can't even avoid it..

But somewthing we can do is just how to make the problem fixed well..

As long as you follow the step and the respect and good service are always appears on your performance,everything
will be fine😊

Sometimes when we are very skillful with our practice,whatever it is,we have to learn for our words..

Emmm,actually there will be some cases for different place and time when we turn to serve our patients..

For this case,it would be kind of reflection on how you make your best service through the words and actions..

Remember also that we are not alone for facing the problems😅

(Even it is your own patient)

We are a social human being so we have another ones to help us..When we ask or need..

So,make a good collaboration not only with your parteners even more with the family and thus to the patient to
make a deal with cooperation..

I think everything could be solved

Something important for personal care is more to realize that each person (could be) different.

So please pay attention for this..

Fon't directly judge or ask all patients to be the same..As even a skin response could be different..

Based on the SOP and all the modified approaches and therapheutic communications that probably we can do for
them

5. M3 (181141025)

Kel 2

How to intervene in a patient who has a problem with personal hygiene problems in the hair (curses and fouls and
other problems), while he doesn't like anyone touching his hair, if someone touches his hair he will threaten or risk
hurting others and himself

I Will answer a question from sist @⁨Uul S.Kep⁩

For patients who have problems with personal care and hair hygiene, but the patient does not want to be touched
by us as nurses, first explain what the purpose of this action is and the nurse will certainly try to build a trusting
relationship, we cannot immediately clean the patient's hair but of course have to communicate first approach the
patient first, but if the patient still doesn't want to be touched, then as a nurse we can communicate to the patient
to clean it himself while still watching and we build or give an example (come on sir / ma'am like this, follow me,
please follow me, sir Like this, sir, I rinse the shampoo. Yes, that's right, keep rinsing, sir like this. Yes, good sir) we
don't need to force the patient, but we have to give understanding to the patient and we still provide facilities such
as soap, shampoo, etc. to patients so that patients are happy and sem really do it.
GROUP 4 (SLEEPING)

1. Name : M. Lukman Sasongko

Nim : 181141021

Group 6.

Ask permission to ask on the sleep control slide, there are STEP P1, P2, P3 and P4.

STEP 1: Create a sleep routine, examples of what kind of sleep routine and which one can most effectively control
our sleep?

STEP 2: create a comfortable bedroom environment, what is a comfortable bedroom environment like, so that our
sleep can be coordinated properly, right? Usually everyone has a different concept of sleeping?

STEP 3: taking medication and therapy, what if this drug can become addictive? Then how do we as nurses handle
this?

STEP 4: Stop thinking about negative things, why does this affect sleep control?

Answer :

1. For this sleep routine, it can be like a scheduled sleep schedule, for example at 21.00 you have to sleep, so this
routine will familiarize us with being able to control sleep. Or it could be that the routine before bed can be in the
form of praying or calming the mind (meditation), drinking water, avoiding electronic use I think when someone
feels calm it will be easy to sleep

2. A comfortable environment can be like modifying a room that is more comfortable for us, such as a cleaner room,
organized, and not noisy, so an environment like this can help control sleep to make it more comfortable and there
is therapeutic oils (essential oils) that are placed in the room so that fresh air and can be soothing. Yes, everyone is
different, therefore modifying this environment according to individual comfort. However, if what is meant by the
hospital environment, it is certainly clean enough and not noisy enough for individuals. If the patient is a child, the
room is modified in general, such as the children's favorite, there are pictures of numbers, animals, and others.

3. Sleeping pills will make a person dependent, but of course, before giving medication, the nurse collaborates with
the doctor, of course, regarding the dosage. Doctors will not give drugs arbitrarily and the dosage is according to the
patient's needs.

4. Stop thinking about negative things, of course you have to. Because many people are going to sleep but suddenly
become overthinking and make that person even experience insomnia due to confusion in her negative thoughts.
That way it will affect someone's sleep, so stopping thinking about negative things can certainly affect sleep control
because the person will be more comfortable and calm when they want to sleep.

2. Name: dela Fika

181141006

Group 1

In management there is reverse therapy. What kind of therapy and what can be done by the patient himself because
sometimes people who have sleep disorders are not all in the hospital. Then the purpose of drugs has the effect of
that limitation
Answer :

there are several therapies that can be done alone to reduce anxiety including

1) Relaxation

According to Goldfried and Davidson relaxation is one of the techniques in behavior therapy developed by Jacobson
and Wolpe to reduce tension and anxiety. Walker added that this technique can be used by patients without the
help of a therapist and they can use it to reduce tension and anxiety experienced daily at home (in Ramadhani and
Aulia, 2011). So individuals can do their own relaxation techniques such as listening to music, reading novels, or even
calming down or meditating.

2) Control of breathing

Breathing control is a technique for controlling the breath which is fast and focuses on breathing. People who are
experiencing anxiety tends to breathe quickly and shallowly due to feelings of panic or worry. Though this can
increase anxiety. According to Wayne (2003) slower and deeper breathing almost always has a calming effect. This is
one of the quickest ways to stop panic attacks. Individuals can breathe more calmly or train breathing to be more
relaxed.

3) Music therapy

Music is a chorus of sound stimuli that form vibrations that can stimulate the senses, organs and emotions. This
means that individuals who listen to music will respond, both physically and psychologically, which will arouse the
body's systems, including the activity of the glands in them (Nilsson, 2009: 8-10). Music has three important
components, namely beat, rhythm, and harmony. Beat or beats affect the body, rhythm affects the soul, while
harmony affects the spirit (Yuanitasari, 2008: 17). Ferawati (2015: 3) states that music functions to increase physical
vitality, relieve fatigue, relieve anxiety and tension, increase concentration, deepen relationships, enrich friendships,
stimulate creativity, sensitivity, and strengthen character and positive behavior. Hoffman (1997: 52-54) states that
music can help achieve a state of relaxation, relieve insomnia, lower blood pressure, and normalize heart
arrhythmias. Esther (2003: 42) says that music allows the body to synchronize the rhythm of the music, for example,
if a person is anxious so that the heartbeat is louder and faster, by listening to music with a slow rhythm, his heart
rate will also slow down and synchronize with the rhythm of the music. Music aims to help express feelings, reduce
muscle tension, and reduce anxiety. Listening to music with good harmony will stimulate the brain to analyze the
song.
and through the cochlear nerve the music is captured and transmitted to the brain nerves later music will affect the
pituitary to release the hormone beta-endorphins (happiness hormones) (Yuanitasari, 2008: 41). Someone who
listens to music can be calmer, feel comfortable and greatly affect a person's level of anxiety face something. Music
therapy is designed to solve different problems and their meaning will also be different for each person, so music
therapy
used more comprehensively, including to deal with pain, stress management and anxiety (Djohan, 2006: 37). Based
on the expert opinion above, it can be concluded that music therapy is an effective method to reduce anxiety and
can manage stress.

Drug limitation is a restriction on drug use. So it's better to do all the other therapies first than just directly consume
the drug to solve the problem. But then if the case is kind of getting worse,having drug for the solution could be
done but ofcourse with the determined dossage of consulted treatment.

3. Name: Lailatun Ni'mah

Nim: 181141019
Group 3

Please ask permission to ask, why are the signs and symptoms of sleep disturbances tired when you wake up? The
rest is calm, relaxed, without any pressure which should make you feel fresher when you wake up. Please explain

Answer :

I will answer the question of sister Laila Sleep is supposed to make the body more relaxed, but when someone
experiences sleep disturbances, when they wake up they will experience fatigue due to sleep that is not optimal,
sleeping in a relaxed state will also make the body feel tired when they wake up.

There are several reasons when we wake up that we should feel refreshed, but instead feel tired, this can be due to
irregular sleep patterns and too much physical activity throughout the day.

other causes, namely:

1. Too much sleep or lack of sleep

2. Stress

stress can affect sleep quality and is one of the causes of fatigue when waking up. In addition, a person will usually
wake up frequently at night when experiencing stress, or even difficulty falling asleep. This reduces the quantity of
sleep, so it is easy for you to feel tired and hopeless.

3. Sleep disturbances

If you have slept with the ideal duration, but still feel tired when you wake up, you could experience sleep
disturbances. There are various types of sleep disorders, such as insomnia, sleep apnea, and narcolepsy.

So fatigue when waking up is due to excessive physical activity all day long and stress can affect the quality of sleep
so that sleep does not relax and experiences fatigue when waking up.

4. Name: Syafiqah Tsabitah Sari

NIM: 181141038

Group 2

Permission to ask for management in what way to reduce anxiety?

Answer :

I will answer tge question of sister safika

for management as mentioned in the ppt there are non-pharmacological and pharmacological, for non-
pharmacological, it can be by means of relaxation therapy such as (reading a book), massage therapy can be
massaging the head to make it more relaxed, setting the position before bed as comfortable as the patient so that
sleep is more comfortable, management environment (such as making the room quieter by giving essential oils to be
more relaxed, music therapy (such as listening to music to make it more relaxed), and pharmacological therapy
where collaborating with doctors about administering drugs according to patient needs.
GROUP 5 (WORKING AND PLAYING)

QUESTION WORK

1. Nama : Elistya Widhiya (181141010 )

Group 4

Suppose a child has been traumatized by an accident, domestic violence, or natural disaster. What kind of play
therapy will be given?

Answer :

Name: Elisabeth de rosa (181141009)

Here I will answer questions from Elistya.

In general, there are 2 (two) therapeutic approaches that can be done for PTSD sufferers, namely by using
pharmacotherapy and psychotherapy. Treatment by means of pharmacotherapy, in the form of therapy using drugs
and drugs that are medically underestimated for consumption by sufferers. Meanwhile, the therapeutic approach
that uses a psychological model or what is known as psychotherapy, aims to improve the patient's social function.
The treatment model for victims who experience PTSD in children is certainly different from adults. For children, the
approach model that can be used is play, or what is known as play therapy. Play therapy is useful in providing
therapy to children who have PTSD. Therapists usually use games to initiate topics that cannot be started
immediately. This can help children feel more comfortable in processing their traumatic experiences. In general,
children who experience a traumatic condition show symptoms such as fear, anxiety, sadness, avoidance and less
responsive to various emotions.

For example, for play therapy, you can use any kind of play therapy, such as playing with dolls and playing musical
instruments, the main goal is to eliminate / forget the trauma of the child, even if it is only for a short time and
balanced with other pharmacological and psychological therapies.

2. Nama : Wahyu Pratama (181141044)

Group : 3

Please permission to ask In ppt explained that there is play therapy. If there are children who do not want to be
invited to play, how do the nurses handle the problem ?

Thank you 🙏

Answer : Name: Siti Aisyah (181141036)

I will answer questions from wahyu.

So ,,, We have to wait until the child wants to play. Because playing cannot be forced. The purpose of play is to make
children feel happy and ultimately make it easier to contribute to the treatment process.

The approach taken is to entertain children with communication that certainly makes children comfortable, for
example by giving understanding so that children without playing can also feel comfortable and finally want to
undergo treatment.

3. Name : Faizatul Dwi Mufidah (181141011)

Group : 6

I want to ask, Explain what are the play therapy techniques?

Answer :

Name : Irene Da Cruz (181141018)

I will answer the question from Sis Faiza

play therapy techniques include :

•Creative visualization

•Storytelling

•Role playing

•Phone toys

•Masks or animal toys

•Doll or action figure

•Arts and crafts

•Games of water and sand

•Blocks and construction toys

•Dances and creative movements

•Music game

These various types of games not only make children feel happy, but can also make it easier for the therapist to
observe and deal with problems experienced by children.

4. Name : oktaviyanti i (181141029)

group 1

I want to ask, what play therapy is given to children with special needs and what needs to be considered in play
therapy for children with special needs.

Answer : mahmudi (181141022)

I Will answer the question Ms Octa

children with special needs are free to choose the games they like, choose games that make them comfortable and
free in creativity and also we have to classify their fellow children with special needs. for example, drawing, coloring
and playing a musical instrument. This therapy is usually carried out for 30-45 sessions each with a total of 20
sessions. While the child is playing, parents or caregivers and psychologists can observe the child and dig deep
information about the child's character, likes and behavior. we can also give rewards for what he did so that he was
more motivated and more enthusiastic.

5. Syafiqah Tsabitah Sari (181141038)

Group 2
I want to ask what is the relationship between work and play therapy? Are these two activities an element of
interrelation?

Answer :

Ainun Jr (181141001 )

I answer question from fiqa,

depending on the purpose. for example, in the case of providing nursing care to children, play therapy is needed. In
addition to making it easier for nurses to take action, play can also be a reference for how the child responds to the
situation around him with the help of a play tool, the nurse can assess the child's condition seen from the child's
activeness and response in playing. What about work ?

In terms of work, from a nurse's perspective, it is easier to provide care for mom, so it makes it easier for nurses to
work because their child patients are willing to cooperate and become less afraid, for example. If from psychology
work, we can see the character and the way children interact, it can also be seen from the expressions of their
children. There are children who are psychologically disturbed, maybe because they are too sad even though they
are playing, but their expressions are still sad.for jobs that do not involve health, play is also needed so as not to get
bored and stress mom which is certainly by playing your own way, maybe with games on your cellphone.
GROUP 5 (AXIETY)

1.Name : Ardila tsenawatme (2011415088)

I would like to ask on the slide there is a level of anxiety, what does it mean by: 1. Mild, moderate, severe anxiety,
and give an example like what, explain? Thank you.

2. Name: Ainina Shalsa I (181141051)

Group: 3

Ask permission to ask how and what are the categories of anxiety level indicators?

Answer :

Name: Mahmudi (181141022)

ok i will answer questions from sisters shalsa and ardila. I made one answer because the question is the same.
namely about the level of anxiety indicators

There are four indicators to determine the patient's level of anxiety. the first mild, the second moderate, the third
weight, the fourth panic. we have to be able to know the categories or changes that occur in patients, to be able to
assess with the four indicators. for example the patient has a change in verbalization. On the first indicator, namely
mild, the patient asks more often. on the second indicator, namely moderate the patient is experiencing tremors and
changes in tone of voice. on the third indicator, namely weight. communication is difficult to understand. In the
fourth indicator, panic, patient communication cannot be understood.here I only take one example, namely in the
first category. so for more details we have to really know what kind of patient.

3. Refi RIzki s

ask permission to ask For example, there are ordinary people who often experience anxiety, then what steps should
be taken to get rid of that anxiety? Then if the person is often experiencing anxiety and even anxious about things
not to worry about. Does the person need treatment for their anxiety?

Answer :

Name: Ainun Jariyah

I will answer question from revi

Previously, what was the meaning of the word "often" like? And what was the cause / trigger for anxiety, and how
did the individual respond?

Because if you are only anxious at a mild level, you can inhale so that the body relaxes again. If the response shows
severe anxiety and it continues, it is highly recommended to be examined, which will be given pharmacological
treatment assistance.So treatment in people who exprience anxiety depends on the response and changes
exprienced by the individual. Only then can determine what kind of trietment Will be given.In essence, if anxiety
disorders have caused difficulty in carrying out activities, insomnia, fatigue, difficulty concentrating, to depressive
symptoms in the form of suicidal thoughts or thoughts, it is recommended to immediately consult a doctor.

4.Name : Maulidatul (181141025)

groub 2

How to treat a patient who has severe anxiety due to rape? He is worried about his future
Answer :

Name: Annisa Oktavianis (171141005)

I will answer question from sister

Maulidatul .M.M.

The first treatment for victims of abuse and rape is to ensure their safety, including emotional safety. In
psychological treatment, a psychological examination will be carried out at an early stage to determine the condition
of the victim.

Based on the results of the examination, the psychologist will determine the right handler according to the needs
and conditions of the victim. Some of the common psychotherapy approaches for rape victims are Eye Movement
Desensitisation and Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), and support group therapy.

Overcome the trauma problem first, because if the trauma is resolved, anxiety will decrease because it has restored
the patient's confidence level.

Could you please add for more info of EMDR? What is it like?

Because I think for CBT and support group are familiar enough😁

Ok mom I wiil explain EMDR, EMDR is a psychotherapy that can be aimed at overcoming a trauma (especially PTSD)
in adults, but is now being introduced to treat forms of trauma that occur in children.

In summary, the work form of EMDR is to strengthen the positive system within the sufferer to deal with trauma to
the sufferer so that mentally, emotionally, they are much stronger in dealing with past trauma so that they can
reduce the symptoms that arise when the sufferer faces the same form of trauma.

EMDR has 8 phases of treatment consisting of:

Phase 1, where the patient and psychiatrist look for the source of trauma through the history of the disease.

Phase 2, where the psychiatrist will look for ways within the patient that can be used as a source of dealing with
forms of trauma. Sometimes in this phase the psychiatrist will also provide information, suggestions and input so
that the patient has a positive picture of himself and the patient's emotional strength and the positive values that
exist in the sufferer.

phase 3-6, here begins the EMDR phase. Where the patient is invited to recall the source of the trauma while the
psychiatrist provides input through eye movements, sounds, tones, etc. to change the image about the trauma into a
positive image. Example. Where a rape sufferer feels inferior, dirty and despicable then starts changing his image so
that I can go through the trauma safely and I am strong.

Phase 7, where the patient begins to keep a journal about his daily life for a few weeks after therapy is finished. Are
there any symptoms, are there any new triggers, other complaints, etc.

Phase 8, where sufferers and psychiatrists see the results of the EMDR process. Here will be assessed whether EMDR
is successful, whether other methods are needed to improve or help sufferers.

5. Name: Dwi Olinda E. (181141008)

Group 6

How is nursing care and therapy for anxious patients so as not to experience excessive anxiety?
Answer :

Name: Elisabeth de rosa (181141009 )

I will answer questions from sister dwi olinda.

Nursing care is given to patients who experience excessive anxiety, namely the first to communicate with the
patient, what is experienced by the patient, for example the patient has difficulty sleeping because of thinking about
the problem, so We, as nurses, think that we have to give advice so that patients avoid feeling anxious ... for
example, encourage the patient to do relaxation techniques every time he feels anxious, or advise the patient to
focus on activities, for example if there is a schedule for cleaning the house or other activities, instruct the patient to
do so. In order to avoid feeling anxious.

Therapy given to anxious patients so as not to experience excessive anxiety, namely pharmacological therapy and
psychotherapy:

-Pharmacological therapy

Pharmacological therapy is the treatment for anxiety by using drugs that can restore the function of neuro-
transmitter disorders (nerve-conducting signals) in the central nervous system of the brain (limbic system), anti-
anxiety drugs (anxiolytic), such as diazepam, clobazam, bromazepam. , lorazepam, buspirone HCl, meprobamate
and alprazolam.

-Psychotherapy

Psychotherapy is given depending on individual needs, including:

Psychotherapy is to provide motivation, enthusiasm and encouragement so that the patient does not feel hopeless
and is given confidence and self-confidence.
GROUP 6 (DEMENTIA)

1.Name: dela

Nim : 181141006

Group 1

I want to ask when someone with dementia doesn't have family support. what management is right for the
patient

Nama : miya

And I will try to answer the question dela

What if the patient with dementia does not have family support? how is it managed?

The answer is ...

because the role of family is very important for patient ssuffering from dementia, why is it important
because the role of the family is the first role that accompanies daily activities such as religious spiritual
activities, to always provide support and provide comfort to patients so that they always interact and even
recover more finea gain but if the role of the family is not supportive What does the nurse do?

we as nurses can only provide the best, such as a psychological and supportive approach accompanied by
disease management that underlies the dimension, namely it self, therefore it is important to find out the
cause of dementia so that the management is given appropriately.

2. Siti Nurannisa

181141037

Group 3

I want to ask,Why can hypertension be said to be the etiology of dementia?

Nama : Faizatul

I willanswerthequestion, Ms. Anisa

So, because hypertension is the cause of vascular dementia, hypertension also plays an important role in the
occurrence of disease. Alzheimer's. Dementia is divided into several subtypes, including Alzheimer's
disease (AD), Vascular Dementia (VaD) and Mixed dementia(VaD) is caused by a stroke affectingthe area
memory processes, in the elderly, subcortical vascular disease related toVaD. Exposure to small blood
vessels in the brain with high blood pressure causing interference microvascular, white matter, silent lacunar
damage and disconnection cortical. Disorders of the brain caused by prolonged hypertension associated
with cognitive impairment, blood pressure control adequate during sleep is neuroprotective of the brain and
ultimately will reduce the incidence of dementia.

3. Name: ainunjariyah

From grup 5

talking about dementia, according to the group how about the statement stating "long-term
drugconsumptionispronetotriggerdementia". howdidthegrouprespond? becausethere are
stillprosandconsregardingthatstatement?

Nama : olinda

I willanswer a questionfrom Ms. Ainun

To treatdementiasothatitis not progressive, dostimulationforthebrain, such as reading, tellingstories, sewing,

knitting, andothers, "said dr. Nitish.

Apartfromtheaboveefforts, dr.
Nitishalsorecommendsthatyouconsultyourdoctorifyoususpectthatyouhavedementia. In addition,
todifferentiatebetweendementiacausedbytheagingprocessorAlzheimer'sdisease,
itisnecessarytoundergoanexaminationby a doctordirectly.

Consultationwith a doctorincludes a
detailedmedicalinterviewandphysicalexaminationtodeterminethecauseandthemostappropriatetreatment.

Long-term consumptionofdrugs, especiallyanticholinergics, ispronetotriggeringdementia. However,

theimpactis not toosignificantcomparedto a bad lifestyle, such as smoking, alcohol, anddoes not
optimizetheworkofthebrainproperly. thereforehealthylivinggreatlyaffectsthehealthofourbodies,
alwaysadopting a healthylifestyleisimportant.

4. Name : Thoyyibatun Nafiah

Nim : 181141039

Group : 2

Thisisifthereissomeonewhooftenforgetssomething, such as forgettingtoputthingsdown, itdoesn'thappen once,

but over and over, andeven he alsolosestheabilitytospeak, andforgetsdifficultorrarelyusedvocabulary. Can
that say dementia? If so, how are thingsdonetoresolvethesesymptoms?

Nama : iqbal
I'llanswersisterFifi'squestions

Yes, he issaidtohavedementiabecause he oftenforgetsbecause he forgetsrepeatedlyis a decrease in

memoryandthinkingpatterns, thiscondition has animpactonlifestyle, socialskills,
tothesufferer'sdailyactivities.

To reducethesesymptomssuch as

1. Stop smoking

2. Exerciseregularly

3. Getenoughsleep

4. Maintainnutritionalintakeandadopt a healthy diet, forexamplebyeatingfoodslow in fatandhigh in fiber.

Consumptionofvitaminsforthebrainisalsothoughttobegoodforpreventingdementia.

5. Reducealcoholintake

6. Maintain ideal bodyweight

7. Controlbloodpressure, blood sugar levels, andcholesterol. Etc

5. Vrizca Dwi Aprilina

Nim: 181141043

Group: 4

In theetiologyofconfusion (delirium), oneofwhichistherainfallfactor,

maybethegroupcanexplainwhyrainfallcanaffectthisconfusedconditionandhowthemanagementofthisconfusion
(delirium) itself

Nama : lukman

I willanswerquestionsfromsister Vrisca fromgroup 4.

Delirium isanacuteandtransient global organic disorder

ofcentralnervoussystemfunctionthatcausesimpairedconsciousnessandattention (Allison etal., 2004). in
Septian, 2015).

The term delirium issynonymouswithacuteconfusedstate, strictlyspeaking, itdescribes a

varietyofseparateacuteconfusedstatescharacterizedbyperiodsofrestlessness, increased mental activity,
easyawakening, clearunpreparedness in responsetocertainstimuli (such as suddensounds). , interferewith
visual hallucinations, motor hyperactivity, andautonomicstimulation. Distractionofattention, essential in
acuteconfusion, occursdespitetheapparentconfusion. Delirium
agitationisusuallyfluctuatingandcanchangeordevelopinto a dim confusedstate. The
clinicalpictureisshownbyjoyfulhallucinationsof delirium tremensthataccompanydrinkingcessation. However,
delirium canappear in acuteconfusionduetoanycause (Isselbacheretal. In Aggraini, 2014).

Rainfallfactor

The rainfallfactorisoneofthefactorscausingsomatic delirium. Theseincludeenvironmentalchanges

(roomdisplacement), pneumonia, infection, dehydration, hypoglycemia, immobilization, malnutrition,
anduseof a bladdercatheter. The useofanesthesiaalsoincreasestheriskof delirium, especially in
prolongedsurgery. Similarly, elderlypatientswho are admittedtothe ICU have a higherriskAggraini, (2014).
GROUP 6 (PAIN)

1. Nama: Maulanang Anang

Kel: 4

How do we as nurses provide education about pain relaxation measures to patients both pharmacologically
and non-pharmacologically?

Nama: Ummul Azmiyatul.U

NIM : 181141041

I will answer questions from anang

is, our way as nurses To provide education about pain relaxation measures to patients both
pharmacologically and non-pharmacologically?namely withassist clients in increasing the level of
knowledge of health, symptoms of disease and even measures given.

For action

-pharmocology, namely (using drugs) or to relieve pain is often associated with the emergence of unwanted
side effects.

- non-pharmacological, namely (without drugs)

Or to slow (or prevent) the use of drugs and the total dose of medication that must be received.

2. Name: Dela fika

Group 1

what action is appropriate for children who experience chronic pain and acute pain

what action is appropriate for children who experience chronic pain and acute pain?

Nama: Uswatun Hasanah

NIM : 1811141042

I will answer questions from dela

its action is to use pharmacological and non pharmacological actions

-Pharmacology, namely with

using narcotic analgesic drugs either intravenously

or intramuscularly. such as the drug ibuprofen

-Non pharmacology aims to reduce fear, pain and suffering and increase pain in children (Ekwueme, 2009).

And non pharmacology can be done with

physical therapy methods (including skin stimulation, massage, warm compresses and

cold, TENS, acupuncture and acupressure) as well as cognitive and biobehavioral therapy (including deep
breathing exercises, progressive relaxation,

rhythmic breathing, music therapy, imaginary guidance, biofeedback,

distraction, therapeutic touch, meditation, hypnosis, humor and magnets)

(Blacks and Hawks, 2009). Pain control non pharmacology

to be cheaper, easier, effective and without harmful effects

(Potter & Perry, 2005).

3. Name : Thoyyibatun Nafiah

Nim :181141039

Group 2

Usually when the pain management uses a warm or cold water compress, I will ask when it is better if the
two compresses are given. If wrongly using the compress method will make the pain worse?

Nama: Roynaldi Iqbal R

I will answer questions from sister Fifi

- Warm water compress

To relieve severe pain, you can soak in warm air for 30 minutes to a maximum of 2 hours. Use warm
compresses for up to 1-2 weeks

- Cold water compress

In the treatment of injuries, cold packs should only be used for 48 hours.

The recommended time for applying cold compresses is 10-15 minutes to a maximum of 20 minutes.
Applying cold compresses for too long can hamper blood circulation and interfere with the injury.

Does the wrong time to use the compress method will make the pain worse?

No, because the compress that is given is only to relieve pain, so it will not worsen the pain, it's just that the
right time to compress it can effectively relieve the pain
4. Name: Wahyu Pratama

Nim: 181141044

Group 3

Please ask permission to ask other than using warm water to relieve pain, is there any other way to treat
pain?

Nama: Serly Rosa Agustin

I answer questions from wahyu

Besides compressing with warm water, you can take pain relievers, such as mefenamic acid, mefinal, get
enough rest, lie down so that the pain subsides, compress with cold water.

5. Name: Irene Da Cruz

Group 5

In the pain theory there is such a thing as the gate control theory, what kind of theory is it, please explain?

Nama: M. Lukman Sasongko

I will answer a question from sister irene da cruz from group 5.

Melzack & Wall (1965) first proposed the theory of pain mechanisms, namely their "Gate Control" theory,
which explains the pain control gate theory, which states that there is a kind of "gateway" that can facilitate
or slow down the transmission of pain signals (Tamsuri, 2006).

According to this theory, pain depends on the action of large and small nerve fibers, both of which are
located in the root of the dorsal ganglion. Stimulation of large nerve fibers will increase the activity of the
gelatinose substance which results in the closing of the mechanism so that T cell activity is inhibited and
causes stimulation to be inhibited as well. Large fiber stimulation can directly stimulate the cerebral cortex.
The results of this perception will be returned to the spinal cord via efferent fibers and the reaction affects
the activity of T cells. Stimulation of small fibers will inhibit the activity of the gelatinous substance and
open the door to the mechanism, thereby stimulating T cell activity which in turn will deliver pain stimuli
(Long, 1989).