Scribd Logo
Upload

Welcome to Scribd!

  • Minor 8

    Uploaded by

    emailshidqi
    3 views2 pages
    A 52-year-old man came to the emergency department after being pricked by a nail in his right foot that morning. He had washed the wound and applied betadine. He was complaining of pain in the wound, especially when walking. His vital signs were normal. On examination, there were two puncture wounds on the sole of his right foot without active bleeding. He was diagnosed with a puncture wound to his right foot and treated with antibiotics, analgesics, and wound cleaning.

    Original Description:

    minor

    Original Title

    minor8

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    A 52-year-old man came to the emergency department after being pricked by a nail in his right foot that morning. He had washed the wound and applied betadine. He was complaining of pain in the wound, especially when walking. His vital signs were normal. On examination, there were two puncture wounds on the sole of his right foot without active bleeding. He was diagnosed with a puncture wound to his right foot and treated with antibiotics, analgesics, and wound cleaning.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    3 views2 pages

    Minor 8

    Uploaded by

    emailshidqi
    A 52-year-old man came to the emergency department after being pricked by a nail in his right foot that morning. He had washed the wound and applied betadine. He was complaining of pain in the wound, especially when walking. His vital signs were normal. On examination, there were two puncture wounds on the sole of his right foot without active bleeding. He was diagnosed with a puncture wound to his right foot and treated with antibiotics, analgesics, and wound cleaning.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    PEMERINTAH KABUPATEN KULON PROGO

    DINAS KESEHATAN
    RSUD NYI AGENG SERANG
    Jl. Sentolo - Muntilan KM 0,3, Banguncipto, Sentolo, Kulon Progo 55664
    Telp. (Hunting) 0274-2890651, IGD 0274-1890181, Fax. 0274-2890180
    Website : rsnas.kulonprogokab.go.id Email : rsnas@kulonprogokab.go.id, rsudnas@gmail.com

    RESUME MEDIS IGD


    No . 392659/392659

    No RM : 009671 Klinik : IGD


    Nama : SENEN, BP (L) Tgl Periksa : 30-08-2022
    Sendiri RSUD Nyi Ageng
    Tgl Lahir : 02-03-1970 Cara Masuk :
    Serang
    Cara Bayar : PRIBADI

    Alergi Obat
    Alergi Makanan
    Riwayat Obat
    Riwayat Penyakit
    Pasien datang setelah tertusuk paku di kaki kanan. pasien tertusuk paku tadi
    pagi jam 08.00 kemudian pasien mencuci lukanya dan memberi betadin. saat ini
    pasien mengeluhkan nyeri pada luka terutama jika kaki digunakan untuk
    menapak. demam (-), kaki terasa kaku (-). menurut pasien paku tidak berkarat.
    S Keluhan Pasien pernah disuntik ATS namun sudah >5 tahun yang lalu.
    Keluhan batuk (-), pilek (-), nyeri telan (-), sesak nafas (-).
    Riw perjalanan luar kota (-). Riwayat dikunjungi orang dari luar kota (-). Riwayat
    kontak dengan kasus konfirm COVID (-)
    R/ alergi obat (-), R/ HT DM disangkal.
    KU: CM E4V5M6
    TD 133/91 mmHg
    HR 100 x/m
    RR 20 x/m
    t 36.6 C
    SpO2 98%
    Pemeriksaan Fisik Mata CA -/-, SI-/-
    Pulmo: SDV (+/+), Wh (-/-), RBH (-/-), RBK (-/-)
    O Cor: BJ I-II int N, reguler, bising (-)
    Abdomen: BU (+) N, timpani, supel, NT (-)
    Ekstremitas : akral hangat, CRT <2 dtk
    status lokalis: terdapat 2 luka tusukan pada telapak kaki kanan, perdarahan
    aktif (-)
    BB TB TD Heart Rate RR Temp
    Vital Sign
    133/91 100 Kali 20 Kali 36.6oC

    Vulnus punctum pedis dextra ec tertusuk paku


    A Diagnosa

    cross incission 2
    Tindakan Inj. ATS 1 amp (skintest terlebih dulu)

    P BLPL
    Rencana cefixime 2x200 mg
    Asam Mefenamat 500mg 3x1
    Kelanjutan : Pulang

    30-08-2022 18:09
    PEMERINTAH KABUPATEN KULON PROGO
    DINAS KESEHATAN
    RSUD NYI AGENG SERANG
    Jl. Sentolo - Muntilan KM 0,3, Banguncipto, Sentolo, Kulon Progo 55664
    Telp. (Hunting) 0274-2890651, IGD 0274-1890181, Fax. 0274-2890180
    Website : rsnas.kulonprogokab.go.id Email : rsnas@kulonprogokab.go.id, rsudnas@gmail.com

    Kulon Progo, 30 Agustus 2022

    Laras Alfienty, dr. MMR

    30-08-2022 18:09

    You might also like