terapi cairan.doc

7/24/2019 terapi cairan.doc

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TUGAS BEDAH

JALUR ADMINISTRASI

Terapi Cairan

PENDIDIKAN PROFESI DOKTER HEWAN

Ole!

T"n# D$i Ar%iana'SKH ()*+,,(,

M"a-a% G./r"n F.%"la 'SKH ()*+,,(*

FAKULTAS KEDOKTERAN HEWAN

UNI0ERSITAS WIJA1A KUSUMA SURABA1A

SURABA1A

2,(3


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JALUR ADMINISTRASI

Terapi Cairan &.45.6an

K.7in8 %en8an pen#a5i6 rin8an a6a. -ere5a #an8 -e-4.6.5an 6erapi 7airan %i

r.-a a%ala 5an%i%a6 .n6.5 pe-4erian 7airan &.45.6an9 Terapi 7airan &.45.6an 6i%a5 6epa6

.n6.5 5.7in8 %en8an %ei%ra&i 4era6' ip":"le-ia' ip"6en&i' a6a. pen#a5i6 5ri6i&9 I&"6"ni5

6in88i na6ri.- 7airan 5ri&6al"i% ;-i&aln#a' LRS< #an8 palin8 &erin8 %i8.na5an9 0"l.-e #an8

%apa6 %i&a-pai5an pa%a &a6. &i6.& 6er4a6a& "le %i&6en&i4ili6# %ari =arin8an &.45.6an' #an8

.-.-n#a -en8.n6.n85an %i $ila#a in6er&5ap.la %ari 6.4. 4a8ian a6a&9 Dala- 5e4an#a5an

5.7in8 %e$a&a' 5an6"n8 7airan 3, &a-pai (3, -L %apa6 %i6a-p.n8 6anpa 5e6i%a5n#a-anan

pa&ien9 Pe-ili5 ar.& %i4eri6a. 4a$a 7airan a5an -en#ele&ai5an 4a8ian per.6 %en8an

8ra:i6a&i %an ar.& -e-4.4ar5an %ala- 4e4erapa =a-9 Han#a 4erapa 4an#a5 #an8 6erlal.

4an#a5 %i6en6.5an "le pen8e-4an8an' &a5. 7airan per.&aaan #an8 -en#a5i65an #an8

4"7"r 7airan %ari l.4an8 #an8 %i4.a6 "le =ar.-9

Me&5ip.n i&"6"ni5' 7airan 6in88i na6ri.- le4i %i&.5ai' pe%"-an #an8 le4i l.a&

4eri5.6 -.n85in 4erla5. .n6.5 &.45.6an 7airan9 O&-"lali6a& 7airan #an8 &e%an8 %i4eri5an

6i%a5 4"le -ele4ii )3, -O&- > 58 %an 7airan ar.& -en8an%.n8 &e6i%a5n#a ), -E? > L

na6ri.-9 Te K"n&en6ra&i -a5&i-.- K @ 6i%a5 -ele4ii ), -E? > L' -e&5ip.n re&p"n n#eri

6ela %ilap"r5an Cairan %i %"&e&9 4a5an le4i ren%a -en8an%.n8 -a8ne&i.- -e-ili5i =.8a

6ela %ia-a6i .n6.5 -en#e4a45an 5e6i%a5n#a-anan9

Terapi Cairan in6ra:ena

A5&e& :ena

A5&e& :a&5.lar %iin%i5a&i5an .n6.5 5lini& 4eri5.6 &5enari"!

Pa&ien -e-4.6.5an 4"l.& 7airan a6a. 5"l"i% .n6.5 -en8el"la ip"6en&i9

Pa&ien perl. 6erapi .n6.5 rei%ra&i' n.6ri&i' a6a. ele56r"li6 5e6i%a5&ei-4an8an #an8 6i%a5

%apa6 %ipen.i -elal.i en6eral a6a. &.45.6an 4erar6i9

Pa&ien perl. pe-an6a.an e-"%ina-i5 ;C0P


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Pa&ien -e-4.6.5an in6ra:ena lainn#a "4a6 a6a. 6ran&/.&i pr"%.5 %ara9

Pa&ien perl. pen8a-4ilan &a-pel %ara &erin8 ;-i&aln#a' -ere5a %en8an DKA

L 58' #an8 -er.pa5an &erin8 %i&e4.6

&e4a8ai 4ai5 5e4.6.an 7airan arian ;#ai6.' pe-eliaraan 7airan< %an %"&i& 5e=.6an 7airan9

0"l.-e %an 6in85a6 7airan %i4eri5an .n6.5 -en8"4a6i ip":"le-ia %an %ei%ra&i pa%a 5.7in8

ar.& =a. le4i ren%a %ari #an8 %i8.na5an pa%a an=in8 5arena re&i5" 5ele4ian 7airan9

Un6.5 -e-per4ai5i ip":"le-ia' %"&i& ren%a pen88an6i 5ri&6al"i% a$aln#a %i4eri5an'

&eper6i 23 %ari &"75 %"&i&' a6a. 5ira5ira (, &a-pai (3 -L > 589 Se4.a &"r67.6 4er8.na

.n6.5 -en8i6.n8 23 %ari %"&i& &"75 5ri&6al"i% .n6.5 5.7in8 a%ala -ena-4a5an ,

.n6.5 4era6 4a%an 5.7in8 %i 589 Ja%i 23 %ari %"&i& 5e=.6an .n6.5 3 58 7a6 a5an -en=a%i 3,

-L9 Kar%i":a&5.lar %an para-e6er pe-eri5&aan /i&i5 5e-.%ian %inilai .lan8' %an ali?."6

6a-4aan 7airan %i4eri5an &a-pai &6a6.& 5ar%i":a&5.lar 6ela -e-4ai5 a6a. pen. "5

%"&i& 7airan 6ela %i4eri5an9 Karena ri&i5" ":er%"&i& 7airan pa%a 5.7in8' 7airan 6erlal. a8re&i/

Terapi .n6.5 &e7ara 7epa6 -en7apai para-e6er 5ar%i":a&5.lar #an8 n"r-al 6i%a5 %apa6

%ire5"-en%a&i5an9 T.=.ann#a a%ala .n6.5 -e-a&6i5an re&.&i6a&i #an8 7.5.p 4a$a &6a6.&

pa&ien 6i%a5 -e-4.r.5 &e4a8ai a5i4a6 ip":"le-ia' &er6a -en7e8a 7e%era "r8an #an8

%i&e4a45an "le per/.&i -i&5in9 1an8 6er&i&a De/i&i6 %i&e4a45an "le %ei%ra&i %apa6

%iper4ai5i &ela-a 4eri5.6n#a &a-pai 2) =a- &e4a8ai 4a8ian %ari 6erapi 7airan rei%ra&i9

Se4.a 5ri&6al"i% 6a-4aan #an8 %apa6 %i8.na5an .n6.5 -en8"4a6i =eni& 6er6en6. %ari

ip":"le-ia a%ala iper6"ni5 ;4ia&an#a < &aline9 Salin iper6"ni5 -e-4eri5an :"l.-e

%ara #an8 le4i 4e&ar a.8-en6a6i"n per :"l.-e %i4eri5an %ari i&"6"ni5 5ri&6al"i% pen88an6i

%an -e-ili5i e/e5 p"&i6i/ pa%a 7.ra =an6.n89 Ini -e-ili5i e/e5 #an8 &a-a &e-en6ara .n6.5

i&"6"ni5 7airan 5ri&6al"i%9 Hal ini palin8 e/e56i/ pa%a pa&ien %en8an 7e%era 5epala %an "ran8

"ran8 #an8 -en8ala-i penan85apan 5arena 5e7en%er.n8an .n6.5 -en.r.n e%e-a &ere4ral9


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Ka&ia6 &alin iper6"ni5 6er4a6a& 5arena %"&i& %i.lan8 a5an -en#e4a45an iperna6re-ia #an8

&i8ni/i5an' %an ele56r"li6 ar.& %ipan6a. 5e6a6 &ela-a pen88.naann#a9 Selain i6.' 7airan

5ri&6al"i% ar.& 4er&a-aan %i4eri5an .n6.5 -en8i-4an8i per8e&eran 7airan #an8 4erlan8&.n8

%ari in6er&6i6ial #an8 r.an8 5e r.an8 in6ra:a&5.lar9 Hiper6"ni5 &aline 4i&a %i8.na5an %ala-

ip":"le-ia re&.&i6a&i %en8an %"&i& 2 ) -L > 58' %i4eri5an &ela-a (, &a-pai (3 -eni69 Ini

5"n6rain%i5a&i %en8an iperna6re-ia #an8 a%a a6a. 4era6 %ei%ra&i9

K"l"i% =.8a %apa6 %i8.na5an .n6.5 -en8"4a6i ip":"le-ia' %en8an -e-perin8a65an

&a-a 6en6an8 5ele4ian 7airan %i 5.7in8 #an8 pa&ien &eper6i %en8an 7airan 5ri&6al"i%9 K"l"i%

-e-ili5i 5e.n6.n8an %ari -e-"4ili&a&i 7airan in6er&6i6ial 5e in6ra:a&5.lar r.an8 %an 4enar

4enar a5an -enin85a65an e/e56i/ :"l.-e &ir5.la&i %en8an =.-la #an8 le4i 4e&ar %ari i6.

%ire&api9 Selain i6.' 5"l"i% a5an 6e6ap %i in6ra:a&5.lar r.an8 le4i la-a %aripa%a 5ri&6al"i%

5arena -ere5a ar.& eni-a6i& 6er%e8ra%a&i &e4el.- eli-ina&i9 Un6.5 ini ala&an -ere5a

e/e56i/ .n6.5 6erapi ip":"le-ia' 6e5anan "n5"6i5 ren%a' %an &"759 T"6al %"&i& arian

;4ia&an#a %i8.na5an .n6.5 %.5.n8an "n5"6i5 %i ip"al4.-ine-ia pa&ien a6a. -ere5a %en8an

:a&5.li6i&< &er6a %"&i& &en8a6an 4era%a %i 5i&aran (, &a-pai 2, -L > 589 Un6.5 &"75' &eper6i

.n6.5 Terapi 5ri&6al"i%' 23 &a-pai ++ %ari %"&i& 7airan ;3 &a-pai -L > 58< %i4eri5an

%en8an 7epa6 &ela-a 3 &a-pai (, per6a-a -eni6' %an pe-eri5&aan /i&i5 pa&ien %an para-e6er

e-"%ina-i5 #an8 %inilai .lan89

Pe-an6a.an Re&p"n .n6.5 Terapi Pa&ien %en8an Hip":"le-ia

Pe-an6a.an -er.pa5an 5"-p"nen pen6in8 %ari 6erapi 7airan %an -e-.n85in5an

.n6.5 pen#e&.aian #an8 &e%an8 4erlan8&.n8 %i re&ep 7airan .n6.5 -e-en.i 5e4.6.an

pa&ien9 Terapi 7airan a%ala pr"&e& %ina-i& #an8 -e-4.6.5an pe-an6a.an a56i/ %an

$a&pa%a .n6.5 -e-a&6i5an e/e56i:i6a&' -en7e8a 5"-pli5a&i' %an -e-en.i 6.=.an

pen8"4a6an9 En%p"in6 .n6.5 re&.&i6a&i a%ala %i4eri5an %ala- K"6a5 3)9

STATUS PARAMETER 0OLUME DARAH

Hip":"le-ia ar.& %i6an8ani pa%a pa&ien &e4el.- Terapi .n6.5 %ei%ra&i9 S6a6.&

:"l.-e a%ala 5la&i5 %i4a8i -en=a%i prel"a% %an aliran -a=. para-e6er9 Te H.5.- Fran5

S6arlin8 =an6.n8 -enen6.5an =an6.n8 #an8 ".6p.6 6er5ai6 .n6.5 -en8a5iri %ia&6"li5 :"l.-e'

5"-p"nen prel"a% =an6.n8 .n6.5 ala&an ini :ena #an8 -e-a%ai 5e-4ali a%ala pen6in8.n6.5 -e-a&6i5an per/.&i #an8 6epa69 Prel"a% para-e6er in%i5a6"r 5e7.5.pan :ena 5e-4ali


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5e =an6.n8 %an 6er-a&.5 :"l.-e #an8 :ena %an %ia-e6er r.an8 =an6.n89 0"l.-e :ena 6i%a5

%apa6 lan8&.n8 %i.5.r in :i:" %an ar.& %iper5ira5an %en8an -enilai 5e-.%aan %i&6en&i

:ena' :ena &en6ral 6e5anan' %an %ia-e6er ra%i"8ra/i %ari :ena e5"r 7a:a9

Pa%a pa&ien %en8an :"l.-e %ara #an8 n"r-al' 4ai5 =.8.lari& %an :ena peri/er ar.&

4.n7i6 %en8an -.%a 5e6i5a 6er&.-4a69 K.ran8n#a %i&6en&i :ena %ala- pe-4.l. a6a&

6in85a6 =an6.n8 %apa6 -en.n=.55an ip":"le-ia9 Jela&' ini a%ala penilaian &.4=e56i/' 6e6api

%apa6 -e-4eri5an 4e4erapa i%e %ari &6a6.& :"l.-e rela6i/9

0"l.-e :ena =.8a %apa6 &e7ara 6i%a5 lan8&.n8 %inilai "le -en8.5.r C0P9 C0P

a%ala 6e5anan i%r"&6a6i5 %ari %ara -e-a&.5i =an6.n8' #an8 %i.5.r %en8an 5a6e6er %en8an

.=.n8n#a %i 5anan a6ri.- a6a. :ena 7a:a9 C0P &e4an%in8 %en8an :"l.-e %ara %i :ena 7a:a

an6eri"r %an na%a :ena9 Te5anan ini -en.r.n ip":"le-ia a6a. :a&"%ila6a&i %an -enin85a6

%en8an 6erapi 7airan a6a. :a&"5"n&6ri5&i9 Be4erapa /a56"r lain %apa6 4er5"n6ri4.&i %en8an

a5.ra&i pen8.5.ran C0P' &eper6i =an6.n8 a6a. pa6"l"8i pernapa&an' -e-4.a6n#a -en=a%i

a8a5 6i%a5 4i&a %ian%al5an ;6api 4er8.na< :aria4el /i&i"l"8i&9

C0P %apa6 %i.5.r %en8an -an"-e6er 5"l"- ;#an8 palin8 -e6"%e .-.-< a6a.

6ran&%.&er 6e5anan lan8&.n89 Ki&aran n"r-al a%ala ,(, 7- H2O9 Na-.n' 5arena :aria&i

%ala- na%a :ena %an /a56"r 6e5ni& lainn#a' nilai C0P 6.n88al &erin85ali &.li6 .n6.5-ena/&ir5an 6anpa 4an6.an pe-an6a.an lainn#a9 N"r-al %an a4n"r-al nilainilai %apa6

6.-pan8 6in%i -i&aln#a' C0P %apa6 4er5i&ar %ari 3 .n6.5 3 7- H2O pa%a e$an

ip":"le-i5 %an %ari 3 &a-pai (3 7- H2O pa%a e$an %en8an :"l.-e #an8 4erle4ian9

Ole 5arena i6. pen8.5.ran ar.& %iper6i-4an85an 4er-a5na %en8an re&ep 6erapi 7airan

an#a =i5a -ere5a 4era%a %i 4a$a , a6a. %i a6a& (, 7- air %an' #an8 le4i pen6in8' =i5a

5e&el.r.an 6ren %i C0P %ian88ap9 Den8an -e-per6i-4an85an &e-.a 6er&e%ia para-e6er'

=i5a C0P pa&ien &e7ara 5"n&i&6en %i 4a$a , 7- H2O' per6i-4an8an ar.& %i4eri5an 5e &ala

&a6. 4"l.& 7airan a6a. penin85a6an la=. pe-4erian 7airan9 Ji5a nilai C0P pa&ien &e7ara

5"n&i&6en %i a6a& (, 7- H2O' pe-4erian 7airan ar.& %iperla-4a6 a6a. %ien6i5an' %an

a%-ini&6ra&i %i.re6i5 ar.& %iper6i-4an85an9

Pen8.5.ran C0P 6er.6a-a %i6.n=.55an &ela-a re&6"ra&i :"l.-e .n6.5 &"75 %an pa%a

pa&ien .n6.5 &iapa 0"l.-e #an8 4erle4ian a%ala 5e5a$a6iran' &eper6i pa&ien a5.6 %i 8a8al

8in=al a6a. -ere5a %en8an pen#a5i6 =an6.n8 4er&a-aan9


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Pen8a-a6an 6e5ni5 #an8 4enar .n6.5 pen8.5.ran C0P &an8a6 pen6in8' &e=a. a%a

7.5.p :aria4ili6a& "pera6"r an6ar9 Un6.5 #an8 palin8 a5.ra6 %an 5lini& a&il #an8 4er-an/aa6'

p"&i&i pa&ien ar.& %i7a6a6 %ala- re5a- -e%i& %an &6a/ #an8 &a-a ar.& -ela5.5an

pe-4a7aan 4ila -e-.n85in5an9

Un6.5 -en8.5.r C0P ;lia6 Ga-4ar 3)


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5"n6ra56ili6a&' 6a5i5ar%ia' pen#a5i6 =an6.n8 re&6ri56i/' a"r6a &6en"&i&' %an :en6ila&i 6e5anan

p"&i6i/' 6i%a5 a%a #an8 4enar4enar -e-4.6.5an 6erapi 7airan9 Ji5a pen#e4a4 5.ali6a& p.l&a

-i&5in 4er6e5a% .n6.5 -en=a%i ip":"le-ia "le -en8.a65an &e=ara' 6an%a6an%a 5lini&' %an

pen8.5.ran lain' -a5a pe-4erian 7airan %apa6 %iin%i5a&i5an9

Te5anan %ara ar6eri ra6ara6a a%ala 6e5anan ra6a %ari 8el"-4an8 6e5anan na%i9 Dara

ar6eri &i&6"li5 6e5anan a%ala 6e5anan 6er6in88i 8el"-4an8 %an 6er.6a-a %i6en6.5an "le

&6r"5e :"l.-e %an 5epa6.an %in%in8 ar6eri9 Te5anan %ara ar6eri %ia&6"li5 a%ala 6e5anan

6eren%a &e4el.- &6r"5e :"l.-e 4eri5.6n#a %an 6er.6a-a %i6en6.5an "le re&i&6en&i :a&5.ler

&i&6e-i5 %an %en#.6 =an6.n89 Te5anan %ara ar6eri %apa6 %i.5.r &e7ara 6i%a5 lan8&.n8 ;%en8an

6ran&%.&er D"ppler' "5l.&i -an&e6' %an &p#8-"-an"-e6er< a6a. lan8&.n8 ;%en8an ar6eri

5a6e6er %en8an 7ara 6ran&%.&er 6e5anan


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a5an -en8a5i4a65an ip"6en&i &e4a8ai %en#.6 =an6.n8 %apa6 %i-a5&i-al5an a6a. pe-4.l.

%ara &i&6e-i5 -.n85in -a5&i-al 6er4a6a&9

Hip"6en&i %apa6 %i&e4a45an "le ip":"le-ia' -i&5in 7ar%ia7 ".6p.6' a6a. :a&"%ila6a&i

#an8 4erle4ian' &e4a8ai il.&6ra&i %en8an r.-.& &e4el.-n#a9 Ji5a pen#e4a4 ip"6en&i a%ala

ip":"le-ia' 6erapi 7airan lan=.6 %iin%i5a&i5an9 Hip"6en&i %ia&il5an %ari :a&"%ila6a&i' &eper6i

#an8 6erlia6 %en8an ip"6er-ia pa%a 5.7in8' ar.& %i6an8ani %en8an a6ia6i 7airan Terapi

4er&a-aan %en8an re$ar-in8 e5&6ernal9 Kapan :a&"%ila6a&i #an8 6i%a5 pan6a& 5arena

:a&"ple8ia' &eper6i %en8an &ep&i& a6a. "5 %i&6ri4.6i/' pen8"4a6an ar.& 6er%iri %ari 6erapi

7airan %i6a-4a %en8an a6 :a&"a56i/ ;pre&&"r& a6a. 5a6e5"la-in< &eper6i /enile/rin a6a.

%"pa-in9 Hal ini pen6in8 .n6.5 %iin8a6 4a$a 5a6e5"la-in &e4ai5n#a 6i%a5 %i4eri5an &a-pai

%"56er e$an a%ala 7.5.p #a5in 4a$a :"l.-e &ir5.la&i #an8 -e-a%ai 6ela %ip.li5an'

5arena pen88.naann#a &e-en6ara pa&ien ip":"le-i5 an#a a5an -e-per4.r.5 i&5e-ia'

6i%a5 -e-per4ai5in#a9 Kapan ip":"le-ia 5arena 8a8al =an6.n8' 6erapi 7airan lan=.6 6i%a5

%iin%i5a&i5an %an 6erapi pen#a5i6&pe&i/i5 %iperl.5an9

Ka6e8"ri lain %ari para-e6er aliran -a=. a%ala 6er%iri %ari :aria4el #an8

-en7er-in5an pre5apiler na%a :a&"-"6"r ar6eri"l9 Penin85a6an 6"n.& :a&"-"6"r' a6a.

:a&"5"n&6ri5&i' .-.-n#a 6er=a%i pa%a 5"n%i&i &eper6i 6ra&i :a&"5"n&6ri56"r9 Pen.r.nan 6"n.&

:a&"-"6"r' a6a. :a&"%ila6a&i' .-.-n#a 6er=a%i pa%a 5"n%i&i &eper6i "5 &ep6i5' ip"6er-ia

a6a. iper6er-ia' %an a%-ini&6ra&i :a&"%ila6"r %an 4e4erapa ane&6e&i9 Ar6eri"l na%a %apa6

%inilai %en8an -e-an6a. -e-4ran -.5"&a $arna %an CRT9

1an8 n"r-al $arna &elap.6 len%ir -era -.%a9 0a&"5"n&6ri5&i -en.r.n 5apiler

per/.&i' -en#e4a45an $arna %ari &elap.6 len%ir 4er.4a %ari -era -.%a' p.7a6 -era

-.%a' %an 5e-.%ian -en=a%i p.6i &eper6i :a&"5"n&6ri5&i 4erlan8&.n8 6in85a6 5eparaan9

0a&"%ila6a&i -enin85a65an 5apiler per/.&i' -en#e4a45an $arna &elap.6 len%ir 4er.4a %ari

-era -.%a -en=a%i -era &e4a8ai :a&"%ila6a&i 4erlan8&.n8 %ala- 6in85a6 5eparaan9

Pen7aa#aan &e5i6arn#a' 5e6a=a-an :i&.al' %an pi8-en6a&i pa&ien %apa6 -e-4.a6 penilaian

-.6la5 -e-4ran -.5"&a $arna 4er-a&ala' %an ar.& %ie:al.a&i %ala- 5"n&er %en8an

:aria4el lain %an para-e6er /i&i"l"8i&9 Te-pa6 #an8 palin8 .-.- .n6.5 -en8a-a6i -e-4ran

-.5"&a $arna 8in8i:a 6i%a5 4erpi8-en' li%a' %an 5"n=.n86i:a9

He-"8l"4in 6er%e"5&i8ena&i -en#e4a45an per.4aan $arna 5e4ir.an %ari 6e-pa6

6i%.r 5apiler &e4a8ai &ian"&i& 4erlan8&.n8 %i 5eparaan9 Sian"&i& 4ia&an#a %i&e4a45an "le

ip"5&e-ia' #an8 ar.& &e8era e:al.a&i par. 4er/.n8&i' 6e6api 5a%an85a%an8 %apa6


19/29

%i&e4a45an "le la-4an aliran %ara 5apiler a6a. 7ar%ia7 ".6p.6 4er5.ran8' #an8 -e-erl.5an

e:al.a&i le4i lan=.6 %ari 5ar%i":a&5.lar /.n8&i9

Pen#e4a4 ane-ia p.7a6 $arna &elap.6 len%ir %an -.n85in -e-erl.5an in/.&

e-"8l"4in9 Selap.6 len%ir $arna %i6en6.5an "le =.-la e-"8l"4in 4er"5&i8en %i 6e-pa6

6i%.r 5apiler 6erlia69 Ar6eri"l :a&"-"6"r na%a -enen6.5an =.-la %ara %ala- %ia-a6i

6e-pa6 6i%.r 5apiler9

CRT 6er.6a-a %i6en6.5an "le ar6eri"l :a&"-"6"r na%a9 CRT %inilai %en8an

-en88.na5an 6e5anan %i8i6al pa%a -e-4ran -.5"&a &a-pai -ere5a -en=a%i p.6i %an

5e-.%ian -en7a6a6 4erapa la-a $a56. #an8 %i4.6.5an .n6.5 $arna #an8 n"r-al 5e-4ali9

CRT n"r-al a%ala ( &a-pai 2 %e6i59 Si6.& #an8 palin8 .-.- .n6.5 -en8e:al.a&i CRT

a%ala pa%a 8in8i:a n"n 4erpi8-en9 0a&"5"n&6ri5&i' #an8 -e-perpan=an8 CRT' -.n85in

%i&e4a45an "le ip":"le-ia' 8a8al =an6.n8' ip"6er-ia' %an a%-ini&6ra&i :a&"5"n&6ri5&i9

Ji5a &e=ara pa&ien %an 5ar%i":a&5.lar lainn#a para-e6er -en.n=.55an ip":"le-ia' 7airan

Terapi %iin%i5a&i5an9 0a&"%ila6a&i le4i pen%e5 CRT9 0a&"%ila6a&i -.n85in %i&e4a45an "le

"5 &ep6i5' iper6er-ia' %an a%-ini&6ra&i :a&"%ila6"r %an 4e4erapa ane&6e&i9 0a&"%ila6a&i

%apa6 -en#e4a45an ip"6en&i' %an 6e5anan %ara ar.& %inilai pa%a pa&ien ini9

Ka6e8"ri lain aliran 5e %epan' per/.&i =arin8an' 6er-a&.5 &.. e5&6re-i6a&' .rin'a&i%"&i& la56a6' %an 6e5anan par&ial :ena &en6ral "5&i8en9 Urin %apa6 %i8.na5an pa%a 5.7in8

%en8an /.n8&i 8in=al &e4a8ai .5.ran 6i%a5 lan8&.n8 %ari per/.&i 8in=al %an per/.&i "r8an :i6al9

Hip":"le-ia %an %ei%ra&i -en8.ran8i per/.&i 8in=al %an GFR9 Dala- 5e%.a &i6.a&i %i &ana

a5an a:i% 6.4.lar rea4&"rp&i Na @ %an 8l"-er.l.& /il6ra6' &ein88a -en8.ran8i :"l.-e .rin9

Pen.r.nan 0"l.-e .rin &ein88a %iarap5an %en8an ip":"le-ia a6a. %ei%ra&i =i5a /.n8&i

8in=al %an .rin 4er5"n&en6ra&i 5e-a-p.an n"r-al9

S.. e-4el a%ala penilaian &.4=e56i/ %i4.a6 %en8an -era4a e5&6re-i6a&9 Hal ini =.8a

%apa6 %inilai %en8an pen8.5.ran &i-.l6an in6i %an 5a5i &.. $e49 Sela-a :a&"5"n&6ri5&i

e5&6re-i6a& 6i%a5 &er6a per/.&i &e4a8ai "r8an :i6al 5arena &.n6in8 %ara =a. %ari pin88iran9

A5i4a6n#a' pelen85ap %in8in 6era%ap &.. lin85.n8an9 In6i &.. e-4el 8ra%ien n"r-al 2

.n6.5 )" Nilai C9 le4i %ari 5i&aran ini -en.n=.55an per/.&i -i&5in' palin8 &erin8 %i&e4a45an

"le :a&"5"n&6ri5&i a6a. ip":"le-ia9

A&i%"&i& -e6a4"li5 -e-ili5i 4e4erapa pen#e4a4' &ala &a6.n#a a%ala per/.&i -i&5in9

Hal ini 6er=a%i 5e6i5a a&a- la56a6 #an8 %ia&il5an %ala- =arin8an "5&i8en 4.r.5 5arena 6i%a5


20/29

-e-a%ai per/.&i %an -e6a4"li&-e anaer"4i59 A&i%"&i& #an8 6er4ai5 %inilai %en8an 7ara 8a&

%ara :ena %an -.n85in %ii%en6i/i5a&i "le 5"n&en6ra&i la56a6 %ara 6i%a5 %i&e4a45an "le

pe-4erian 7airan la56a6' pen.r.nan 4i5ar4"na6 %i.5.r a6a. 5"n&en6ra&i CO2 6"6al' a6a. le4i

4e&ar %ari %e/i&i6 4a&a n"r-al9 La56a6 %ara n"r-al 5"n&en6ra&i 4er5i&ar an6ara ,'3 %an 2

-M > L9 Se4.a p"in6"/ pera$a6an la56a6 -"ni6"r 6er&e%ia .n6.5 pa&ien e$an ;A77.6ren%'

R"7e Dia8n"&6i7&


21/29

Ji5a pen#e4a4 pen8iri-an "5&i8en -i&5in 4er6e5a% .n6.5 -en=a%i ane-ia' in/.&

e-"8l"4in %apa6 %iin%i5a&i5an9 Ji5a pen#e4a4n#a %i6en6.5an .n6.5 -en=a%i ip"5&e-ia'

e:al.a&i le4i lan=.6 /.n8&i par. %iin%i5a&i5an9 Ji5a pen#e4a4n#a a%ala 4er6e5a% .n6.5

-en=a%i ip":"le-ia' :"l.-e %ara le4i lan=.6 a.8-en6a6i"n %apa6 %i4enar5an9 Ji5a

pen#e4a4n#a a%ala 4er6e5a% .n6.5 -en=a%i 8a8al =an6.n8 a6a. :a&"5"n&6ri5&i' #an8

pen#e4a4 ar.& %i&eli%i5i %an %i"4a6i 6epa69 Cen6ral nilai PO2 :ena %i a6a& n"r-al %apa6

-e$a5ili #perper/.&i"n %ari =arin8an 6e6api le4i &erin8 %ia-4il .n6.5 -e$a5ili

pen8a-4ilan "5&i8en -i&5in "le =arin8an=arin8an &e5.n%er .n6.5 -e6a4"li&-e "5&i8en

6er8an88.' &eper6i &eper6i #an8 6er=a%i pa%a &ep&i&9 Ti%a5 a%a pen#e&.aian %ala- 6erapi 7airan

a%ala -.n85in %iperl.5an9

Te e-"%ina-i5 &6a4il Pa&ien

Pen8e-4an8an Ren7ana Terapi Cairan

Ri$a#a6 pa&ien' pe-eri5&aan /i&i5' la4"ra6"ri.- a&il' %an %ia8n"&i& #an8 %i8.na5an

.n6.5 -en8e-4an85an 6erapi 7airan 4eren7ana %en8an -en#ele&ai5an lan85alan85a

4eri5.6!

(9 Ten6.5an 5e4.6.an 6erapi 7airan pa&ien' -en8in8a6 5"-p"nen 5e4.6.an ini #an8 a5an

%ipen.i -elal.i pen#e%iaan pa&ien 5e4.6.an 8ii9 Ini %apa6 6er=a%i =i5a pa&ien -a5an %an

-in.- .n6.5 -e-en.i &e4a8ian %ari n#a 5e4.6.an &en%iri a6a. 5e6i5a paren6eral a6a.

en6eral n.6ri&i %.5.n8an %i4eri5an9

29 I%en6i/i5a&i 5ri&6al"i% i%eal ;&< %an > a6a. 7airan 5"l"i% .n6.5 -en8el"la9

+9 Ten6.5an :"l.-e %an 6in85a6 7airan a%-ini&6ra&i .n6.5 &e6iap 7airan #an8 %i4eri5an9

)9 Pili =eni& 5a6e6er #an8 6epa6' .5.ran' %an &i6.& pen#i&ipan9

39 Men8e-4an85an pr"6"5"l pe-an6a.an' %an -e-4.a6 pen#e&.aian 6era%ap ren7ana 6erapi

7airan &e&.ai %en8an re&p"n pa&ien 6era%ap pen8"4a6an9

HIDRASI STATUS 0ERSUS ip":"le-ia

Hal ini pen6in8 .n6.5 %iin8a6 4a$a &6a6.& i%ra&i a%ala air 6.4. 6"6al %ari 5.7in89

Hal ini 6er7er-in %ala- ECF :"l.-e ;#ai6.' &6a6.& :"l.-e 5ri&6al"i% %ari ECF< %an

%i6en6.5an "le ECF Na @ i&i 5arena 5e&e6araan ICF %an ECF "&-"lali6a&9 Cairan :a&5.lar5"-par6e-en -er.pa5an 5"-p"nen in6e8ral %ari 5"-par6e-en CES' 6e6api .4.n8an an6ara


22/29

:"l.-e ECF ;%an %en8an %e-i5ian air 6.4. 6"6al< %an ip":"le-ia %apa6 4er:aria&i9 S6a6.&

:"l.-e %ara %an &6a6.& i%ra&i ar.& %ie:al.a&i &e7ara in%epen%en 5arena per.4aan &6a6.&

:"l.-e in6ra:a&5.lar %apa6 6er=a%i &e7ara in%epen%en %ari i%ra&i9 Pa&ien %apa6 ip":"le-i5

6anpa %ei%ra&i9 Pa&ien pa%a 6erapi %apa6 %i4.a6 iper:"le-i 6anpa -en8"re5&i %e/i&i6 air 6"6al

6.4.9 Pa&ien %en8an e%e-a -.n85in iper:"le-i &e4a8ai a5i4a6 %ari 5ele4ian 7airan a6a.

ip":"le-i5 a5i4a6 :a&5.li6i& a6a. #p"pr"6eine-ia9

MENCIPTAKAN RENCANA FLUID

Ren7ana 7airan .-.-n#a %i4a8i -en=a%i 6i8a 5a6e8"ri' %ie:al.a&i .n6.5 &e6iap

pa&ien! %e/i&i6' pe-eliaraan' %an 5er.8ian 4er5elan=.6an9 Dala- &e6iap 5a6e8"ri 5lini&i ar.&

-enen6.5an =.-la %an =eni& 7airan .n6.5 -en8el"la %an =.8a -enen6.5an :"l.-e 7airan

%an 6in85a6 .n6.5 &e6iap =eni& 7airan #an8 %i4eri5an9 Se4.a $"r5&ee6 &eper6i #an8

%i6.n=.55an pa%a Ta4el 3+ %apa6 -en=a%i ala6 #an8 4er8.na .n6.5 -e-4an8.n ren7ana

7airan9 Me&5ip.n &erin8 le4i 4ai5 .n6.5 -en88.na5an 7airan 6.n88al 5arena per6i-4an8an

4ia#a' 6i%a5 &elal. 6epa6 .n6.5 -ela5.5an al ini .n6.5 5a&.&5a&.& #an8 5"-ple5& a6a.

&eri.& 5.7in8 &a5i69

KOREKSI 7airan e5&6ra&el.ler 0OLUME DEPLESI

Ele-en per6a-a %ari ren7ana 7airan ar.& -e-4aa& #an8 &.%a a%a &e4el.-n#a

%ei%ra&i9 Un6.5 -enen6.5an 6in85a6 6"6al %eple&i 7airan 6.4. ;%ei%ra&i


23/29

a$al9 Per.4aan 4era6 4a%an' 6er.6a-a %i =an85a pen%e5' a%ala 7ara 6er4ai5 .n6.5

-e-per5ira5an per&en6a&e %ei%ra&i' 6er&e%ia 4ar.4ar. ini %an &an8a6 a5.ra6 4era6 4a%an

6ela %ire5a-9 Ke6i5a pa&ien -e-ili5i &e=ara #an8 5"n&i&6en %en8an per5e-4an8an

%ei%ra&i' &eper6i -.n6a' %iare' a6a. p"li.ria %i6a-4a %en8an a&.pan -i&5in' ) %ari 6.4.

0"l.-e ECF 4era6 %eple&i ar.& %ia&.-&i5an 4a5an 5e6i5a 6.r8"r 5.li6 6a-pa5 n"r-al9

De/i&i6 :"l.-e %ii6.n8 %en8an -en8ali5an per&en6a&e %ei%ra&i 4era6 6.4. pa&ien

;58


24/29

Me&5ip.n =aran8' 4e4erapa pa&ien -.n85in -e-ili5i iper6"ni5 %ei%ra&i9 Ini 6er=a%i

5e6i5a air a6 6erlar.6 4e4a& ilan8 le4i %ari 5eilan8an 7airan i&"6"ni59 Hal ini le4i .-.-

%ia-a6i pa%a an=in8 5arena -ere5a -en%eri6a pana& S6r"5e le4i &erin8 %aripa%a 5.7in8

5arena &an8a6 6in88i pernapa&an 5eilan8an pana& -en8.ap5an %iperl.5an .n6.5

6er-"re8.la&i9 Na-.n' 5.7in8 4i&a -en%eri6a &6r"5e pana& &e4a8ai 4ai5' 5eilan8an air

-elal.i pernapa&an %an &ali:a 5er.8ian9 K.7in8 6er=e4a5 %i r.an8 4a$a 6ana %an le-ari

-.n85in -en8ala-i %ei%ra&i iper6"ni5 5arena -ere5a 6ela 5eilan8an &.-4er air li&an

.n6.5 -en88an6i5an 5er.8ian9 Dei%ra&i iper6"ni5 6er%e6e5&i "le 5ea%iran iperna6re-ia9

0"l.-e %e/i&i6 air a6 6erlar.6 4e4a& %apa6 %iper5ira5an %ari pla&-a Na @ 5"n&en6ra&i

&e4a8ai 4eri5.6!

De/i&i6 air 8ra6i& li6er 58 4era6 4a%an

pla&-a Na

;< ; =a-9 Karena %ei%ra&i %i5e-4an85an

perlaanlaan %ari &e-in88. 6era5ir' ren7anan#a a%ala .n6.5 -en8e-4ali5ann#a le4i

%ari 2) =a-9

Sa-pai nilai ele56r"li6 %i.5.r 6er&e%ia %ari la4"ra6"ri.-' %"56er a5an -en8an88ap

7airan 5"n&en6ra&i 2, -E? > L K @ %an -en88.na5an 7airan #an8 =.8a -en8an%.n8 M8 @@

&e5i6ar + -E? > L9 Ja%i $a=ar Pilian a5an N"r-"&"l %en8an (3 -E? > L 6a-4aan KCl

-ena-4a5an9

Lan85a 4eri5.6n#a a%ala .n6.5 -enen6.5an :"l.-e #an8 %i4.6.5an .n6.5

5er.8ian 4er5elan=.6an n"r-al .n6.5 5.7in8 %an #an8 palin8 6epa6 7airan %i8.na5an .n6.5

6.=.an ini9 0"l.-e ini %i-a5&.%5an .n6.5 -en88an6i5an 4er5elan=.6an -a&.5 a5al n"r-al

%an pin8&an 5eilan8an 7airan' 6i%a5 6er-a&.5 %e/i&i6 a6a. a4n"r-al #an8 &e%an8 4erlan8&.n8

5er.8ian -.n6a 6er.&-ener.&9

Men88.na5an r.-.& ;+, 4era6 4a%an %ala- 58< @ , .n6.5 -e-per5ira5an 6"6al

:"l.-e 7airan %i -L per 2) =a- %iperl.5an "le pa&ien' %"56er -enen6.5an 4a$a 358

5.7in8 -e-4.6.5an 22, -L > ari' a6a. -L > =a-9 Un6.5 pe-eliaraan a Na @ 7airan

ren%a &eper6i Pla&-aL#6e 3 @ 3 %e5&6r"&a &e&.ai9 Ini 4eri&i 4.//er' Na @ %an M8 @@' %an

air 6erlar.6 4e4a& .n6.5 pe-eliaraan9 Pa&ien a5an %iali5an 5e n.6ri&i paren6eral par&ial

.n6.5 -en#e%ia5an 5e4.6.an 8ii &e6ela 5ira5ira 2) =a- per6a-a ra$a6 inap' #an8

5e-.%ian a5an -e-4eri5an 7airan pe-eliaraan 5e4.6.an9

Beri5.6n#a' %"56er -e-ili =eni& =eni& %an 6in85a6 7airan .n6.5 -en8el"la .n6.5

-en88an6i 5er.8ian #an8 &e%an8 4erlan8&.n8 n"r-al9 Dala- 4er4i7ara %en8an 5lien' %"56er

-e-per5ira5an 4a$a 5.7in8 -.n6a &e5i6ar ), -L %ala- 2) =a-9 Te %"56er a5an

-en#e&.ai5an ren7ana 7airan =i5a %i.5.r 0"l.-e 4er4e%a %ari per5iraan ini &e-en6ara 5.7in8

%ia-a6i &ela-a (2 =a- 5e %epan9 K.7in8 6i%a5 -e-ili5i 5ele4ian 5e-i a6a. pernapa&an

5er.8ian' %iare' %e-a-' a6a. &pa&i 5e6i8a #an8 %i5enal9 Sein88a &aa6 ini &a6.&a6.n#a #an8

a4n"r-al 5er.8ian 4er5elan=.6an -.n6a9 Dala- -en8an6i&ipa&i &er.pa =.-la -.n6a


28/29

&ela-a 2) =a- 4eri5.6n#a' 6a-4aan ), -L ;&e5i6ar ('3 -L > =a-< %i6a-4a5an 5e ren7ana

7airan9 Ini a5an %i4eri5an &e4a8ai 7airan i&"6"ni5' &eper6i N"r-"&"l %en8an 6a-4aan 5ali.-'

&eper6i %i6.n=.55an &e4el.-n#a .n6.5 6erapi pen88an6ian9

Den8an -.n6a %."%en.-' a&i%"&i& -e6a4"li5 %apa6 %iarap5an9 Na-.n' 5arena

5.7in8 -.n85in a5an %apa6 -e-per4ai5i ini &en%iri 5e6i5a &epen.n#a 6eri%ra&i' %"56er

a5an 4ia&an#a -en.n88. a&il 5i-ia &er.- &e4el.- -e-per6i-4an85an 6erapi &pe&i/i5

.n6.5 8an88.an a&a-4a&a9

Tera5ir' .n6.5 -en8i6.n8 6e6e& per -eni6' %"56er -en8a-4il 6in85a6 7airan #an8

%iin8in5an ;%ala- -L > =a- =a-9

W"r5&ee6 -en#ele&ai5an -e$a5ili re&ep 7airan .n6.5 5.7in89 Beri5.6n#a' re&ep

ar.& %i6er=e-a5an 5e %ala- ren7ana a%-ini&6ra&i9 Jeni& 7airan %apa6 %i4eri5an 4er&a-aan

-en88.na5an Tp"r69

Re5"-en%a&i pa&ienM"ni6"rin8

Pen8.5.ran 4er.lan8 %ari 4era6 4a%an a%ala #an8 6er4ai5 7ara .n6.5 -enilai

penin85a6an &6a6.& i%ra&i9 Karena per.4aan 6.4. ra-pin8 %an -a&&a le-a5 6i%a5 6er=a%i%en8an 7epa6' per.4aan =an85a pen%e5 %ala- 4era6 4a%an -en7er-in5an per.4aan %ala-

7airan 6.4.9 Pen8.5.ran 4era6 4a%an ar.& %ila5.5an &e6iap ) &a-pai (2 =a- 6er8an6.n8

pa%a 5eparaan 5"n%i&i %an 6in85a6 7airan 5.7in8 #an8 %i4eri5an9 Ini pen6in8 .n6.5

-en88.na5an &5ala #an8 &a-a &e6iap 5ali' %an -an.&ia &5ala pe%ia6ri5 -.n85in -en=a%i

#an8 palin8 a5.ra69

T.r8"r 5.li6 %apa6 %i8.na5an .n6.5 -enilai penin85a6an &erial %ala- &6a6.& i%ra&i9

Te 6en6in8 5.li6 5e7en%er.n8an 4i&a =.8a %apa6 %i8.na5an .n6.5 -enen6.5an a%an#a

&.45.6an e%e-a9 Ke6i5a 5.li6 pa&ien 4ia&an#a 6eri%ra&i a%ala %irili&' ia -en8e-4ali5an

7epa6 .n6.5 p"&i&i i&6iraa6 n#a9 Den8an e%e-a &.45.6an 4era6' 6e5anan %i8i6al .n6.5 5.li6

per-.5aan 4enar4enar a5an -en#e4a45an l.4an8 &e-en6ara a6a. le&.n8 pipi6 %i per-.5aan

5.li6 5e6i5a =ari %iap.&9 E%e-a pa&ien &.%a 5ele4ian 4e4an %en8an 5ri&6al"i%' %an Terapi

5ri&6al"i% lan=.6 6i%a5 %i4enar5an9


29/29

Urin =.8a %apa6 %ipan6a. .n6.5 -en8e:al.a&i &6a6.& i%ra&i pa&ien9 O.6p.6 .rine #an8

n"r-al 4er:aria&i an6ara ,'3 %an 2 -L > 58 > =a-9 Oli8.ria ;".6p.6 .rin ,'3 -L > 58 per =a-

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