1, CHf

Assessement

Functional: NYHA IV

Etiology : CAD, VHD

Risk Factor:

- Diabetes Mellitus

IP Dx

BNP (≥ 35 pg/mL)

Pro-BNP (≥ 125 pg/mL)

IP Tx

Pharmacology

• PO Ramipril tab 5 mg 1x1 

• Spironolactone tab 25 mg 1x1

• Furosemid inj 2 x 1 A

Non-pharmacology :

• Low fat intake

• Reduce activity

• Low salt intake

• Low potassium intake 

IP Mx

Vital sign

ECG

IP Ex

Bed Rest/Restriction of physical activity

Reducing Emotional stress

Routine drugs consumption

Sit position or a half sleep position

Restriction fluid (max 1L/day)

2. ckd

Assesment

Complication :

 Metabolic Ascydosis

 Edema pulmo

Ip Dx

 BGA

 X-foto thorax

Assesment

Complication :

 Metabolic Ascydosis

 Edema pulmo

Ip Dx

 BGA

 X-foto thorax

Ip Tx

- Pharmacotherapy:

Specific therapy for underlying disease

Slows down the deterioration of kidney function;

Prevention of cardiovascular disease

- Non-pharmacotherapy:
Low protein diet 0.6 – 0.8 g/kgBW/day

Control water and salt balance

Control of electrolyte and acid balance disorders

Ip Mx

 Vital Sign

 GFR

 Albuminuria

 ureum & kreatinin

Ip Ex

 explain about CKD

 Routin to control the Blood preassure

 explain about diet intake (Kind of food)

3. Efusi pleura

Assesment

Etiologi :

1. Efusi pelura transudat

2. Efusi Pelura eksudat

Ip Dx

Parasintesi diagnostic and therapeuatic

Ip Tx

Parasintesis

Terapi underlying disease

Ip Mx

- Vital sign ( RR )
Ip Ex

• Rest / reduce activity

3. Ulkus Diabetikum
Assessment : 
Etiologi:
1. Neuropati
2. Vascular
3. infeksi
komplikasi : sepsis

IP DX : 
Neuropathy :
Microfilament test
Vascular :
TBI
Doppler vascular
Arteriography
Pengecsatan gram
Kultur bakteri

IP Tx:
Inj. Ampicillin sulbactam 1,5 gr 3x1
Konsul bedah
IP Mx :
GDS
TTV
IP Ed:
- Diabetic foot care
- Consumption of a low-glucose diet
- Regularly check blood sugar
- Complications of diabetic ulcers
4. DM type 2
● ASSESMENT
❑ Complication:
✔ ACUTE : Hypoglicemia,hyperglicemia
✔ CHRONIC :
Microangiopathy
❖ Diabetic Neuropathy
❖ Diabetic Retinopathy
❖ Diabetic Nephropathy
Macroangopathy
❖ Coronary Heart disease
❖ Peripheral Arterial disease
❖ Cerebrovaskuler disease
❑ Status Glikemik
IP Dx :
• EMG
• Funduskopi
• Mikroalbuminuria
• Angiografi
• ABPI
• CT scan cranium
• HbA1C
IP Tx
Non Pharmacological Treatment :
● Balanced nutrition therapy
● Low sugar diet
● Exercise 30 minutes a day
Pharmacological Treatment :
● Humalog 3 x 4 unit
IP Ex :
- Follow a healthy diet (type, total, and schedule of food)
- Increase physical activity
- Taking diabetic medications (insulin )safely and regularly
- Do SMBG (Self Monitoring of Blood Glucose)
- Explain about the symptoms of hypoglychemia and how to handle it
5. Hipoalbumin
ASSESSMENT
low intake protein, malabsorpbsi protein
IPDx
-
IPTx
reatment on underlying disease
inbumin 250 mg 3x2tab PO
IPMx
Monitoring Albumin count
IPEx
Diet high albumin (eggs, meats, fish, nut)