MANAJEMEN GAGAL NAPAS ET CAUSA KETOASIDOSIS DIABETIKUM DI ICU: SUATU STUDI KASUS

Essy Gusning Ranti, Hilman Syarif, Irfanita Nurhidayah

Abstract


Ketoasidosis diabetikum (KAD) merupakan komplikasi akut hiperglikemia yang dapat mengakibatkan gangguan elektrolit dan penurunan tekanan osmotik koloid sehingga pasien dapat mengalami gagal napas, yang merupakan indikasi pasien harus dipasang ventilator mekanik di ruang ICU. Studi kasus ini bertujuan untuk mengetahui manajemen keperawatan pada pasien yang mengalami mengalami gagal napas karena KAD dengan metode deskriptif melalui pendekatan asuhan keperawatan kritis. Masalah keperawatan yang muncul pada kasus ini adalah adalah risiko ketidakseimbangan cairan dengan intervensi manajemen cairan, pemantauan cairan,dan manajemen elektrolit. Ketidakseimbangan kadar glukosa darah dengan intervensi manajemen hiperglikemia. Gangguan penyapihan ventilator mekanik dengan intervensi manajemn penyapihan ventilasi mekanik dan manajemen asam – basa: asidosis metabolik. Risiko aspirasi dengan intervensi pencegahan aspirasi dan manajemen jalan napas. Hasil evaluasi terdapat perbaikan pada kondisi pasien namun belum signifikan ditandai dengan masih terdapat mukus di jalan napas, ronchi (+), pH = 7,412 (Normal), PCO2 = 26,4 mmHg (rendah), PO2 = 33 mmHg (rendah), HCO3= 16,3 mmHg (rendah), d-dimer= 1370 mg/mL, ureum= 138 mg/dL, kreatinin = 3,70 mg/dL, pasien direncanakan hemodialisa, pasien terpasang ventilator mode (S) CMV, masih terdapat kemerahan diseluruh tubuh, dan terdapat dekubitus derajat 1, sehingga intervensi dilanjutkan oleh perawat ruangan.

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