tag:blogger.com,1999:blog-42121047899742268972024-02-06T19:59:21.619-08:00SurgicalNURSSurgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-4212104789974226897.post-23093075670257080902011-09-11T23:13:00.000-07:002011-09-11T23:49:11.509-07:00KETIDAKSEIMBANGAN ELEKTROLIT<div style="text-align: center;"><strong><em><span style="color: red; font-family: Arial, Helvetica, sans-serif;">HIPONATREMIA</span></em></strong></div><br />
<span style="font-family: Arial;"><strong>>Paras sereum natrium kurang dari 135 mmol/L</strong></span><br />
<strong><span style="font-family: Arial;">>Etiologi :</span></strong><br />
<strong><span style="font-family: Arial;"> a. Pengambilan makanan mengandungi garam terhad</span></strong><br />
<strong><span style="font-family: Arial;"> b. Kekurangan Natrium berlebih:</span></strong><br />
<strong><span style="font-family: Arial;"> -diaphoresis</span></strong><br />
<strong><span style="font-family: Arial;"> -muntah,cirit birit</span></strong><br />
<strong><span style="font-family: Arial;"> </span></strong> -<strong>gangguan sekresi hormon aldosteron</strong><br />
<strong> *aldosteron diperlukan untuk penyerapan semula Na+ di ginjal</strong><br />
<strong>>Manifestasi klinikal :</strong><br />
<strong> 1. Gangguan fungsi gastrousus</strong><br />
<strong> -anoreksia</strong><br />
<strong> -nausea dan muntah</strong><br />
<strong> -abdominal cramping</strong><br />
<strong> -diare(pengerakan peristalsis bertambah)</strong><br />
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<strong> 2. Gangguan pada otak dan sistem saraf kerana peningkatan IC dan kandungan air di sel otak meningkat</strong><br />
<strong> -pening kepala - irritability - coma</strong><br />
<strong> -keliru -tremors</strong><br />
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<strong> 3. Sistem Urinary</strong><br />
<strong> -output kurang</strong><br />
<strong> -spesifik gravity kurang</strong><br />
<strong> -sodium kurang ( 135 mmol/L )</strong><br />
<strong> -osmolality kurang</strong><br />
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<strong>4. Sistem cardiovascular</strong><br />
<strong> -nadi cepat</strong><br />
<strong> -lemah</strong><br />
<strong> -irregular</strong><br />
<strong> -hppotensi</strong><br />
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<strong>> Ujian diagnostik :</strong><br />
<br />
<strong>1.Serum Sodium Osmoality</strong><br />
<strong> -Serum sodium < 135 mmol/L</strong><br />
<strong> -Serum osmoality < 280 m Osm/Kg</strong><br />
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<strong>2. 24 hours urine specimen</strong><br />
<strong> -Paras sodium dalam urine</strong><br />
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<strong>> Diagnosis Kejururawatan</strong><br />
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<strong>1. kurang pengetahuan berkaitan dengan permakanan</strong><br />
<strong>2. Gangguan nutrisi : kurang dari keperluan badan berkaitan proses penyakit / kurang pengambilan sodium</strong><br />
<strong>3. Dehidrasi berkaitan dengan kehilangan cecair dan sodium</strong><br />
<strong>4. Risiko kecederaan berkaitan dengan keliru</strong><br />
<strong> </strong><br />
<strong><span style="font-family: Arial;">< Pengurusan kejururawatan</span></strong><br />
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<strong><span style="font-family: Arial;">-Pemberian sodium :</span></strong><br />
<strong><span style="font-family: Arial;"> *oral : makanan (magerine,oyster sauce)</span></strong><br />
<strong><span style="font-family: Arial;"> *intravena : infusi isotonik (NaCI 0.9%)</span></strong><br />
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</span></strong><br />
<strong><span style="font-family: Arial;"> = penambahan sodium ekstrasel dengan cepat boleh meransang pergerakan air yang berlebihan dari dalam sel ke luar kompartmen interstisial.</span></strong><br />
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<strong><span style="font-family: Arial;">- Pemerhatian</span></strong><br />
<strong><span style="font-family: Arial;"> *tanda vital</span></strong><br />
<strong><span style="font-family: Arial;"> *tanda hypervolemia</span></strong><br />
<strong><span style="font-family: Arial;"> *monitor serum Na+ dan chloride</span></strong><br />
<strong><span style="font-family: Arial;">- Rehat untuk elek keletihan</span></strong><br />
<strong><span style="font-family: Arial;">- Nilai intergriti kulit } dehidrasi</span></strong><br />
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<div style="text-align: center;"><strong><span style="color: lime; font-family: Arial;">HIPERNATREMIA</span></strong></div><div style="text-align: center;"><strong><span style="font-family: Arial;"><br />
</span></strong></div><strong><span style="font-family: Arial;">> Natrium/sodium berlebihan dalam cecair ekstrasel ( lebih dari 145 mmol / L )</span></strong><br />
<strong><span style="font-family: Arial;">> Pengambilan cecair yang berkurangan</span></strong><br />
<strong><span style="font-family: Arial;"> * eg : puasa berkepanjangan, gangguan dalam mekanisme kehausan</span></strong><br />
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</span></strong><br />
<strong><span style="font-family: Arial;">>Manifestasi klinikal</span></strong><br />
<strong><span style="font-family: Arial;"> *membrane mukosa kering dan lidah kering, kasar</span></strong><br />
<strong><span style="font-family: Arial;"> *dahaga</span></strong><br />
<strong><span style="font-family: Arial;"> *urin pekat</span></strong><br />
<strong><span style="font-family: Arial;"> *urin berwarna pekat</span></strong><br />
<strong><span style="font-family: Arial;"> *fatigue</span></strong><br />
<strong><span style="font-family: Arial;"> *lethargy</span></strong><br />
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<strong><span style="font-family: Arial;">>Diagnosa kejururawatan</span></strong><br />
<strong><span style="font-family: Arial;"> *Ketidak seimbangan elektrolit : hipernatremia kerana pengambilan berlebih</span></strong><br />
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<strong><span style="font-family: Arial;">> Pengurusan kejururawatan</span></strong><br />
<strong><span style="font-family: Arial;"> * Ases keadaan klien : mukosa kering, dahaga, letih</span></strong><br />
<span class="Apple-style-span" style="font-family: Arial;"><b> *Bantu pesakit minum air sekurang - kurangnya 2 - 3 liter / hari</b></span><br />
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<span class="Apple-style-span" style="font-family: Arial;"><b><span style="background-color: magenta; color: lime;">Done By : Wan Jofarnorsheila Megat Johari ( 001461 )</span></b></span><br />
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</b></span></div>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com0tag:blogger.com,1999:blog-4212104789974226897.post-31394672204667693772011-09-09T10:00:00.000-07:002011-09-10T10:33:24.866-07:00<div class="separator" style="clear: both; text-align: center;"></div><div style="text-align: center;"><span style="font-size: large;"><b style="color: purple;">KETIDAKSEIMBANGAN CECAIR DAN ELEKTROLITK</b></span></div><div style="text-align: center;"><br />
</div><div style="text-align: left;"><span style="font-size: large;"><b style="color: purple;"><u><span style="color: black;"><span style="font-size: small;">Ketidakseimbangan cecair</span></span></u></b></span><span style="font-size: large;"><b style="color: purple;"> </b></span></div><div style="text-align: left;"><span style="font-size: large;"><span style="color: purple;"><span style="color: black; font-size: small;">A.Edema</span></span></span></div><div style="text-align: left;"><span style="font-size: large;"><span style="color: purple;"><span style="color: black; font-size: small;">B.Dehidrasi</span></span></span></div><div style="text-align: center;"><span style="font-size: large;"><span style="color: purple;"><span style="color: black; font-size: small;"></span></span><b style="color: red;"><br />
</b></span></div><div style="color: red; text-align: center;"><span style="font-size: large;"><b><span style="font-size: small;">A.Edema</span></b></span></div><div style="color: magenta; text-align: left;"><span style="font-size: large;"><span style="font-size: small;">DEFINISI</span></span></div><ul><li><span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;">pengumplan cecair abnormal di ruang interstitial atau di dalam kavtit badan.</span></span></span></span></li>
</ul><ul><li><span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;">dikenali juga sebagai<b><i> fluid volume excess .</i></b></span></span></span></span></li>
</ul><div style="color: magenta;"><span style="font-size: large;"><span style="font-size: small;">JENIS EDEMA</span></span></div><br />
<span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;">A. Local/tempatan</span></span></span></span><br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3uljvi4XOo_iM4rcmJFeKtYx8x-ixyNkJlf-5LRxMfrKQY2sSEjSM_Uzw697AQ4IkEo8uA-rCrxNnteSsnwA29PX1b0shhUXOBEoDRZUqkJpQk2zR7uhGjwfnmG9ZS2MvnlQw_c4OOas/s1600/myx.jpeg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3uljvi4XOo_iM4rcmJFeKtYx8x-ixyNkJlf-5LRxMfrKQY2sSEjSM_Uzw697AQ4IkEo8uA-rCrxNnteSsnwA29PX1b0shhUXOBEoDRZUqkJpQk2zR7uhGjwfnmG9ZS2MvnlQw_c4OOas/s1600/myx.jpeg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><b>myxedema</b></td></tr>
</tbody></table><ul><li><span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;">periorbital edema/eye puffiness</span></span></span></span></li>
<li><span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;">pulmonary edema</span></span></span></span></li>
<li><span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;">serebral edema</span></span></span></span></li>
<li><span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;">myxedema</span></span></span></span></li>
<li><span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;">lymphedema</span></span></span></span></li>
<li><span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;">ascites</span></span></span></span></li>
</ul><span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;"> </span></span></span></span><br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLn8IVbKNZIhMUmTpqouI60olJt8MP08XBCsyHBTVoNaGJBnBNyfBnfLWawM13dAtN69lETlTTtHS2dsO9CiWEckyJE4-PVuAGvmzhAeguskzBUdtCvaX0Yjpn_qG_UqJMAA7cn6xpjYc/s1600/mata.jpeg" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLn8IVbKNZIhMUmTpqouI60olJt8MP08XBCsyHBTVoNaGJBnBNyfBnfLWawM13dAtN69lETlTTtHS2dsO9CiWEckyJE4-PVuAGvmzhAeguskzBUdtCvaX0Yjpn_qG_UqJMAA7cn6xpjYc/s200/mata.jpeg" width="156" /></a></td></tr>
<tr><td class="tr-caption" style="color: black; text-align: center;"><b>periorbital edema</b></td><td class="tr-caption" style="text-align: center;"><br />
</td></tr>
</tbody></table><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcUpMM1dms7ICqmlTO1Q-qsYq6a1fNxdHhpFuEi3QqqIg6OcejJ9z1NV_HrPtBpSj6coBL1s3EaY0xOopaQwtkPPzFIZrpSJ0YteQ0XSBrWCPV5bThxd39rWHauGiUcjfGJnX5CXTfvXk/s1600/lymph.jpeg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcUpMM1dms7ICqmlTO1Q-qsYq6a1fNxdHhpFuEi3QqqIg6OcejJ9z1NV_HrPtBpSj6coBL1s3EaY0xOopaQwtkPPzFIZrpSJ0YteQ0XSBrWCPV5bThxd39rWHauGiUcjfGJnX5CXTfvXk/s1600/lymph.jpeg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><b>lymphedema</b></td><td class="tr-caption" style="text-align: center;"><br />
</td></tr>
</tbody></table><span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;"></span></span></span></span><br />
<span style="font-size: large;"><span style="color: red;"><span style="color: black;"><span style="font-size: small;"></span></span></span></span><br />
<div class="separator" style="clear: both; text-align: center;"></div><br />
B.Generalized (keseluruhan badan)<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLA7m-6n1RHBQL4krLSpHHhP01z7vnZBI3PI9jYK9t7JViYlezxPqAeCilrVUnBLFNT16yDOGPZ_RrW9alx515OjU4J1D5dzcevZWr1WZoxXCwRHPm6PAhBwAVA6EG8C1ike0p4SvjQS0/s1600/body.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLA7m-6n1RHBQL4krLSpHHhP01z7vnZBI3PI9jYK9t7JViYlezxPqAeCilrVUnBLFNT16yDOGPZ_RrW9alx515OjU4J1D5dzcevZWr1WZoxXCwRHPm6PAhBwAVA6EG8C1ike0p4SvjQS0/s1600/body.jpeg" /></a></div><br />
<ul><li>Dependent Edema ---> terdapat di anggota badan yang paling rendah disebabkan tarikan graviti.</li>
</ul><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmur0crRsWtm6rL9r7uDY-fv3PwxeBkmAqnuzHRB-CpNcG0HkXf4INoIkbUp58KM8NnfF_AmmV-ggbI_zdN4Zm6z5_QtvuXBdx7xa7uSSOB8g7_x7EVB7rMD7mw4gflFndgTkfLmf_fDY/s1600/pitt.jpeg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="176" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmur0crRsWtm6rL9r7uDY-fv3PwxeBkmAqnuzHRB-CpNcG0HkXf4INoIkbUp58KM8NnfF_AmmV-ggbI_zdN4Zm6z5_QtvuXBdx7xa7uSSOB8g7_x7EVB7rMD7mw4gflFndgTkfLmf_fDY/s200/pitt.jpeg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><b>Pitting Edema</b></td></tr>
</tbody></table><ul><li>Pitting Edema --->berlekuk apabila ditekan.</li>
</ul><ul><li><span style="color: black; font-size: small;">Non pitting edema</span> ---> eg. lymphedema</li>
</ul><br />
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<span style="color: magenta;">ETIOLOGI</span><br />
a. ketelapan (permeability)membran kapilari bertambah, akibat :<br />
<ul><li>kecederaan</li>
<li>kebakaran </li>
<li>inflamasi</li>
<li>jangkitan</li>
<li>alahan</li>
</ul>b .tekanan hidrostatik meningkat ---> tinggi pergerakan cecair intravaskular (kapilari ke dalam ruang interstitial) <br />
c. sekatan di sistem limfatik : kanser<br />
d. sekatan pada vena<br />
e. kekurangan protein ---> tekanan koloid dalam darah rendah <br />
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<span style="color: magenta;">TANDA DAN GEJALA</span><br />
<ul><li>berat badan meningkat cepat</li>
<li>pengeluaran urin turun</li>
<li>vena di leher (jugular vein) menjadi bengkak</li>
<li>lemah, tindak balas lambat atau tiada respon </li>
<li>aneroksia (kurang selera makan)</li>
<li>takhikardia</li>
<li>takipnea</li>
<li>dispnea</li>
<li>orthopnea</li>
</ul>- Pesakit yang berisiko edema<br />
<ul><li>penyakit renal</li>
<li>penyakit jantung</li>
<li>kebuluran</li>
<li>pesakit dengan terapi IV terkawal </li>
<li>pesakit tua</li>
</ul>- Pengenalan diagnostik :<br />
<ul><li>BUSE (Blood Urea Serum Elektrolit)</li>
<li>Heamodilution : pencairan darah</li>
</ul><span style="color: magenta;">RAWATAN</span><br />
<ul><li><span style="color: magenta;"><span style="color: black;"> Ubatan</span></span></li>
</ul><span style="color: magenta;"><span style="color: black;">- Diuretics eg. Furosemide</span></span><br />
<span style="color: magenta;"><span style="color: black;">- ACE inhibitors eg. Captopril, Enalapril</span></span><br />
<span style="color: magenta;"><span style="color: black;">- Angiotensin receptor blocker eg.Losarton</span></span><br />
<ul><li><span style="color: magenta;"><span style="color: black;">Heamodialysis (pada penyakit kegagalan ginjal)</span></span></li>
</ul><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;">DIAGNOSA DAN INTERVENSI KEJURURAWATAN</span></span></span><br />
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<ol><li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">Potensi isipadu ceceair badan lebih keperluan badan dari keperluan badan</span></span></span></span></li>
</ol><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">Tindakan :</span></span></span></span><br />
<ul><li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">cegah dan kenalpasti pesakit yang berisiko</span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">kawal kadar infusi intravenasepeti arahan </span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">hadkan cecair bagi pesakit yang berisiko </span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">rekod I/O dengan tepat</span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">beri makanan rendah sodium</span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">gunakan larutan 0.9% saline untuk infusi intravena</span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">ases kefahaman pesakit tentang diet yang dihadkan dan rutin ubat-ubatan</span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">berikan nasihat kesihatan tentang tanda gejala isipadu cecair yang berlebih</span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">monitor berat badan pesakit dan timbang berat badan setiap hari</span></span></span></span></li>
</ul><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;"> 2. Risiko/potensi kudis tekanan</span></span></span></span><br />
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<span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">Tindakan:</span></span></span></span><br />
<ul><li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">tukar baringan pesakit kerap kali</span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">periksa bahagian-bahagian yang berisiko</span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">ampu bahagian sendi dan tulang yang prominen dengan belon air</span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">elak geseran apabila mengangkat atau memusingkan pesakit</span></span></span></span></li>
<li><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;">lakukan rawatan massage dengan lotion</span></span></span></span></li>
</ul><div style="text-align: center;"><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;"> </span></span></span></span></div><div style="text-align: center;"><span style="color: magenta;"><span style="color: black;"><span style="color: magenta;"><span style="color: black;"> </span></span></span></span><span style="color: red; font-size: large;"><b><span style="font-size: small;">B. Dehidrasi</span></b></span></div><span style="color: magenta; font-size: large;"><span style="font-size: small;">DEFINISI</span></span><br />
<ul><li><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;">dikenali sebagai <b><i>Fluid Volume Deficit/Negative Fluid Balance</i></b> </span></span></span></li>
<li><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;">imbangan cecair yang negatif --->kehilangan cecair yang berlebihan</span></span></span></li>
<li><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;">kekurangan jumlah isipadu cecair badan yang diperlukan oleh badan untuk berfungsi nornal</span></span></span></li>
</ul><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;"> </span></span></span><span style="color: magenta; font-size: large;"><span style="font-size: small;">ETIOLOGI</span></span><br />
<ol><li><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;">kehilangan cecair yang jelas (muntah, diarhea, kebakaran)</span></span></span></li>
<li><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;">ubat-ubatan : diuretic, laxative</span></span></span></li>
<li><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;">kekurangan pengambilan makan atau minum kerana tidak upaya ,sakit tekak</span></span></span><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;">, sakit tekak, ketumbuhan mulut, malnutrition, kurang pngetahuan jumlah isipadu cecair yang diperlukan </span></span></span></li>
<li><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;">kegagalan mekanisme kawalan air</span></span></span></li>
<li><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;">keperluan yang berlebihan</span></span></span></li>
<li><span style="color: magenta; font-size: large;"><span style="font-size: small;"><span style="color: black;">terdedah lama pada udara kering </span></span></span></li>
</ol><ul></ul>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com0tag:blogger.com,1999:blog-4212104789974226897.post-69403722203246682792011-09-07T00:52:00.000-07:002011-09-11T23:43:41.291-07:00CECAIR BADAN<div class="separator" style="clear: both; text-align: center;"></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin-left: 1em; margin-right: 1em;"><br />
</div><br />
<br />
<div style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><img class="rg_hi" data-height="247" data-width="204" height="247" id="rg_hi" src="http://t2.gstatic.com/images?q=tbn:ANd9GcRQbhmFCSrPljw9RU32hvzj3Wg0hzL3jKqb07j_CjRSpFQDQnHb" style="height: 247px; width: 204px;" width="204" /></div></div><br />
<span style="color: lime;">HOMEOSTASIS </span><br />
<br />
<span style="color: black;">Keadaan <em><span style="color: blue;"><strong>equilibrium environment</strong></span></em> dalaman badan yang dikekalkan secara semulajadi oleh respon penyesuaian untuk terus hidup dengan sihat.</span><br />
<br />
<span style="color: lime;">CECAIR DALAM BADAN</span><br />
<div></div><div></div><ul><li>Sebahagian tubuh manusia terdiri daripada cecair. </li>
<li>kandungan cecair : 45 % hingga 80% berat badan.</li>
<li>jumlah air dalam badan bergantung kepada :</li>
</ul><div></div> <span style="font-family: inherit;">1. Umur :</span><br />
- dewasa : 60% <br />
- dewasa tua : 45% - 55%<br />
- kanak- kanak<strong> </strong>: 70% - 80%<br />
2. Jantina : lelaki lebih banyak dari perempuan<br />
3. Amaun lemak : tisu lemak banyak<strong> </strong><span style="color: red;"><strong>--></strong> <span style="color: black;">kandungan cecair sedikit</span></span><br />
<br />
<span style="color: lime;">FUNGSI CECAIR BADAN</span><span style="color: red;"><span style="color: black;"></span> </span><br />
<ul><li><span style="color: red;"><span id="goog_1340085355"></span><span id="goog_1340085356"><span style="color: black;">Media untuk penghadaman makanan ( <em>food digestion</em> )<em> </em>dan reaksi metabolik dalam sel</span></span></span></li>
<li><span style="color: red;"><span style="color: black;">Pengangkutan (<em> transportation</em> ) nutrient ke sel-sel dan membuang bahan kumuh di dalam badan</span></span></li>
<li>Bahan pelincir badan ( <em>lubricant</em> ) </li>
<li>Membantu mengawal suhu badan melalui evaporasi dan perpeluhan</li>
<li>Penahan / penghalang atau pemulihan renjatan ( <em>shock</em> ) </li>
</ul><span style="color: lime;">Komposisi Cecair Badan</span><br />
<ul><li><span style="color: black;">Gas oksigen</span></li>
<li>Nutrient</li>
<li>Bahan kumuh : CO2, urea</li>
<li>Mineral : sodium, potassium, kalsium</li>
<li>Charged particles iaitu ions, e.g Na+, Cl-</li>
</ul><span style="color: lime;">Pengagihan Cecair Badan ( <em>body fluid distribution )</em></span><br />
<ol><li><span style="color: black;">Cecair Intraselular ( <em>Intracelullar fluid / ICF )</em></span></li>
</ol><ul><li>Cecair yang ada dalam sel badan</li>
<li>30 - 40% berat badan atau 2/3 dari total cecair badan</li>
<li>Penting untuk fungsi sel</li>
<li>Mengandungi bahan boleh larut ( solute ) seperti : CO2, glukos dan elektrolit</li>
<li>Media metabolisme sel</li>
<li>Elektrolit yang banyak di ICF : potassium, magnesium, phosphorus</li>
</ul> 2. Cecair ekstraselular ( extracellular fluid / ECF )<br />
<ul><li>Cecair luar sel</li>
<li>22% berat badan atau 1/3 dari total cecair badan </li>
<li>Sebagai sistem pengangkutan nutrient ke sel dan bahan kumuhan dari sel eg : plasma <span style="color: red;">--></span><span style="color: black;"> plasma mengangkut O2 dari paru-paru</span></li>
<li>Elektrolit yang banyak terdapat di ECF : sodium, chloride, bicarbonat</li>
</ul><div align="left" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://t3.gstatic.com/images?q=tbn:ANd9GcRCNP951mdGAmrBYPSuv2krrGbPsVnSrhVNIazTN3vOBWPFpblTLw" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" class="rg_hi" data-height="188" data-width="269" height="188" id="rg_hi" src="http://t3.gstatic.com/images?q=tbn:ANd9GcRCNP951mdGAmrBYPSuv2krrGbPsVnSrhVNIazTN3vOBWPFpblTLw" style="height: 188px; width: 269px;" width="269" /></a>ECF terbahagi kepada 3 kompartmen :</div><div align="left" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">a ) Cecair intravascular</div><div align="left" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><ul><li>dalam salur darah ( cth, plasma )</li>
<li>20% ECF (1/5)</li>
<li>penting untuk fungsi sel normal</li>
<li>sebagai media untuk proses metabolik sel</li>
</ul></div>b) Cecair interstitial <br />
<ul><li>berada di sekeliling sel</li>
<li>75% ECF (4/5)</li>
<li>Mengangkut bahan kumuh dari sel ke dalam plasma darah melalui kapilari</li>
</ul>c) cecair transcelular<br />
<ul><li>di kompartmen lain ( kaviti pleural, cecair cerebrospinal, cecair gastro usus, perikardial, sinovial)</li>
<li>2% berat badan</li>
</ul><span style="color: lime;">MEKANISME PERGERAKAN CECAIR DAN ELEKTROLIT</span><br />
<div align="left" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div align="left" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Kompartmen cecair badan dipisahkan oleh suatu membran sel dan membran kapiler.Jika membran <em><span style="color: blue;"><strong>permeable</strong></span></em> (telap) secara sempurna ia disebut<em><strong> <span style="color: blue;">selective</span></strong> <span style="color: blue;"><strong>permeable</strong></span> </em>ke atas bahan yang melintasinya.</div><div align="left" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div align="left" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: lime;">Jenis-jenis Mekanisma Pergerakan Cecair Badan dan elektrolit</span></div><div align="left" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div align="left" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: black;"> 1.</span><span style="color: black;">Transport Pasif</span><br />
Mekanisma pergerakan molekul dan ion yang menggunakan tenaga kinetik ( pergerakan ) unik melalui <br />
sel-sel membran.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;">mekanisma pasif:</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"><ul><li>Osmosis</li>
<li>Diffusion/resapan</li>
<li>Filtrasi/penurasan atau penapisan</li>
</ul></div>a) Osmosis<br />
<ul><li>Pergerakan molekul air melintasi membran sel dari larutan konsentrasi rendah ke larutan konsentrasi lebih tinggi sebagai usaha untuk mencapai keseimbangan.</li>
</ul>b) Diffusion<br />
<ul><li>Pergerakan rawak molekul atau ion dalam cecair, gas atau pepejal melalui suatu membran nipis atau liang-liang halus membran kapilari.Molekul bergerak dari kawasan konsentrasi tinggi ke kawasan konsentrasi rendah.</li>
</ul>c) Filtration<br />
<ul><li>Proses cecair dan solute bergerak bersama melintasi suatu membran dari satu kompartmen ke kompartmen lain kemudian mengalami penapisan atau penurasan untuk memisahkan bahan-bahan pejal.Pergerakan tersebut berlaku dari kawasan bertekanan lebih tinggi ke tekanan lebih rendah.</li>
</ul> 2.Active Transport<br />
Pergerakan molekul dan ion melalui membran sel dari larutan berkepekatan lebih rendah ke larutan berkepekatan lebih tinggi dengan menggunakan tenaga <span style="color: red;"><em><span style="color: blue;"><strong>adenosine triphosphate</strong></span></em> </span><span style="color: black;">(ATP) dan bantuan enzim.Menggerakkan bahan samada keluar atau masuk ke sel.</span><br />
<br />
<span style="color: lime;">KESEIMBANGAN CECAIR DI DALAM BADAN</span><br />
<br />
Definisi<br />
Cecair badan berada dalam bahagian dan konsentasi yang normal dan berada di dalam ruang tertentu.Badan mengekalkan keseimbangan cecair melalui sistem pengaturan hormonal dan organ.<br />
<br />
Sumber dan purata amaun pengambilan cecair harian untuk dewasa :<br />
<ul><li>Minum <span style="color: red;">--> </span><span style="color: black;">1200 - 1500 mls</span></li>
<li><span style="color: black;">Air dalam makanan </span><span style="color: red;">--> </span><span style="color: black;">1000 mls</span></li>
<li><span style="color: black;">Proses metabolisme</span><span style="color: red;"> --> </span><span style="color: black;">200 - 400 mls</span></li>
<li><span style="color: black;">Total </span><span style="color: red;">--> </span><span style="color: black;">2400 - 2700 mls/hari</span></li>
<li><span style="color: black;">Primary regulator : thirst mechanism (mekanisma dahaga)</span></li>
</ul>Thirst Mechanism<br />
<br />
Thirst center : hypotalamus otak<br />
<ul style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://physiologyonline.physiology.org/content/19/1/1/F3.expansion.html" style="clear: right; cssfloat: right; float: right; height: 516px; margin-bottom: 1em; margin-left: 1em; width: 132px;"><img src="http://physiologyonline.physiology.org/content/19/1/1/F3.small.gif" /></a> </ul><div style="text-align: left;">1. Stimulasi : peningkatan tekanan osmotik cecair badan, penurunan vascular volume,penghasilan angiotensin.Ia akan merangsang pusat dahaga di hypotalamus dan akan timbul rasa dahaga dan keinginan untuk minum bagi menggantikan cecair yang hilang.</div>2. Rangsangan mekanisma dahaga aktif <br />
-kelebihan osmolality di luar sel<br />
-hipotensi<br />
-poliuria<br />
-kekurangan cecair badan<br />
3.Rasa dahaga berkurangan :<br />
-pesakit yang tua atau terlalu letih<br />
-pesakit oedematous<br />
-pesakit koma atau keliru<br />
<br />
Cara-cara dan purata pengaluaran cecair harian untuk dewasa<br />
<ul><li>Air kencing <span style="color: red;">--> </span><span style="color: black;">1400-1500 mls/hari (30-50 mls/jam)</span></li>
<li>Insensible losses : </li>
</ul> -Paru-paru (penghembusan udara)<span style="color: red;"> --></span><span style="color: black;"> 350-400 mls/hari</span><br />
<span style="color: black;"> -Kulit <span style="color: red;">--></span> 350-400 mls/hari</span><br />
<span style="color: black;"> -Peluh </span><span style="color: black;"><span style="color: red;">--></span> 100 mls/hari </span><br />
<span style="color: black;"> -Feses <span style="color: red;">--></span> 100-200 mls/hari </span><br />
Total : 2300 - 2600 mls/hari<br />
<br />
Keseimbangan cecair badan dikawal oleh <br />
1.Sistem endokrina (hormon)<br />
a) Anti Diuretic Hormon (ADH)<br />
<ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Dihasilkan oleh hipotalamus</div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Hipotalamus mengatur sekresi ADH <span style="color: red;">--></span><span style="color: black;"> sel osmoreseptor </span></div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">ADH akan dirembeskan pada keadaan hiperosmolality seperti kesakitan,suhu badan meningkat,stress,kekurangan cecair diluar sel dan ubat-ubatan.</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div align="left" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: center;"><a href="http://www.occc.edu/biologylabs/Images/Homeostasis%20Images/Fluid_copy.JPG" imageanchor="1" style="clear: left; cssfloat: left; float: left; height: 255px; margin-bottom: 1em; margin-right: 1em; width: 662px;"><img border="0" height="255" id="il_fi" src="http://www.occc.edu/biologylabs/Images/Homeostasis%20Images/Fluid_copy.JPG" style="padding-bottom: 8px; padding-right: 8px; padding-top: 8px;" width="288" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> b) Aldosteron</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Aldosteron dihasilkan oleh kortex adrenal dan menggalakkan penyerapan sodium dan penyingkiran potassium</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">2.Renal</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> Peranan ginjal dalam mengekalkan keseimbangan cecair badan :</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">mengekalkan isipadu dan osmolality ECF dengan mengatur ekskresi air dan elektrolit</div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">mengatur <em><span style="color: red;">reabsorption</span></em> air dari plasma filtrate dan amaun eksresi urine</div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">berperanan dalam menyeimbangkan elektrolit dan pengaturan asid dan bes dengan cara mengeluarkan ion hydrogen dan menahan ion bicarbonate</div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">mengekalkan isipadu cecair melalui sistem renin-angiotensin</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">3.Sistem limfatik</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Sistem ini berperanan penting dalam mengembalikan cecair yang berlebihan dan protein dari ruang interstitial ke dalam peredaran darah.</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">4.Sistem gastrointestinal</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Trek gastrousus membolehkan kebanyakkan intake cecair melalui oral</div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Cecair disingkirkan kebanyakkan dari renal dan sedikit oleh trek gastrousus dalam najis,makanan,air dalam makanan pejal</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Faktor-faktor yang mempengaruhi keperluan cecair badan</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">1.Umur</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Kandungan cecair badan manusia berbeza mengikut umur</div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Umur meningkat akan mengurangkan pengambilan cecair</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">2.Cuaca</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Apabila cuaca panas dan kering,peluh yang keluar jika tidak digantikan dengan pengambilan air akan menurangkan cardiac output.</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">3.Tekanan/Stress</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Stress akan merangsang kelenjar pituitari.Ia akn menggalakkan rembesan hormon ADH yang menyebabkan retensi sodium dan air dan meningkatkan tekanan darah.</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">4.Pemakanan</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Kebuluran dan kelaparan boleh menjadi punca protein dalam ruang intravaskular berkurang dan tekanan osmotik juga berkurang.</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">5.Penyakit</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Mual dan muntah</div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Cirit birit</div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Demam</div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Luka dan kebakaran</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">6.Ubatan</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Lasix-agen diuretik</div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Steroid/hormon adrenokortikal(aldosteron)-edema</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">7.Sedutan gastrik berterusan(<em>gastric suction</em>)</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Kehilangan asid hidrochloric</div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">8.Irigasi dengan cecair hipotonik</div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Penggunaan air suling <span style="color: red;">--></span><span style="color: black;"> air akan meresap ke interstitial (tisu) dan menyebabkan pencairan cecair dan elektrolit badan.</span></div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: purple;"><em><strong>BY : NORIAH BAKRI (001432)</strong></em></span></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
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</div>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com0tag:blogger.com,1999:blog-4212104789974226897.post-17907420924638967902011-09-05T01:19:00.000-07:002011-09-11T23:39:46.124-07:00<div style="text-align: left;"><strong><span style="color: magenta; font-family: "Courier New", Courier, monospace; font-size: large;"><em> <span style="font-size: x-large;">TERAPI INTRAVENA</span></em></span></strong></div><br />
<strong><em><span style="color: #cc0000; font-family: "Trebuchet MS", sans-serif;">DEFINISI</span></em></strong><br />
<ul><li><span style="color: black; font-family: Trebuchet MS;">Terapi intravena merupakan suatu cara berkesan dan sempurna untuk membekalkan cecair dan elektrolit secara langsung ke dalam ruang EC terutama melalui vena</span></li>
</ul><strong><em><span style="color: #cc0000; font-family: "Trebuchet MS", sans-serif;">TUJUAN</span></em></strong><br />
<ul><li><span style="color: black; font-family: Trebuchet MS;">kembalikan imbangan cecair dan elektrolit pada pesakit</span></li>
<li><span style="font-family: Trebuchet MS;">cegah ketidakseimbangan cecair dan elektrolit pada pesakit</span></li>
<li><span style="font-family: Trebuchet MS;">kekalkan imbangan cecair dan elektrolit bagi pesakit yg tidak boleh makan dan minum</span></li>
<li><span style="font-family: Trebuchet MS;">bekalkan glukos</span></li>
<li><span style="font-family: Trebuchet MS;">bekalkan makanan Total Parenteral Nutrition (TPN)</span></li>
<li><span style="font-family: Trebuchet MS;">bekalkan vitamin yg larut dalam air </span></li>
<li><span style="font-family: Trebuchet MS;">beri ubat IV</span></li>
</ul><strong><em><span style="color: #cc0000; font-family: Trebuchet MS;">PRINSIP PEMBERIAN TERAPI INTRAVENA</span></em></strong><br />
<ul><li><span style="color: black; font-family: Trebuchet MS;">Semasa lakukan prosedur terapi intravena,jururawat perlu mengikut teknik universal precaution</span></li>
<li><span style="font-family: Trebuchet MS;">Semua darah dan cecair badan hendaklah dianggap sbg bahan berpotensi untuk infeksi</span></li>
<li><span style="font-family: Trebuchet MS;">Gloves hendaklah dipakai apabila melakukan sebarang prosedur dlm terapi intravena</span></li>
</ul><strong><em><span style="color: #cc0000; font-family: Trebuchet MS;">LOKASI PEMASANGAN INTRAVENA INFUSION</span></em></strong><br />
<ul><ul><li><span style="color: black; font-family: Trebuchet MS;"><strong>DEWASA-</strong>Lengan:- Vena basalic dan vena medial cubital</span> </li>
<li> <span style="font-family: "Trebuchet MS", sans-serif;"><strong>-</strong>Tangan</span>:- <span style="font-family: "Trebuchet MS", sans-serif;">dorsal metacarpal,basilik dan cephalic vein</span></li>
<li><span style="font-family: Trebuchet MS;"> <strong>-</strong>Kaki:- saphenous vein,dorsal plexus,dorsal arch</span></li>
<li><span style="font-family: Trebuchet MS;"><strong>BAYI-</strong> vena scalp dan dorsal </span></li>
</ul></ul><strong><em><span style="color: #cc0000; font-family: Trebuchet MS;">CARA PEMILIHAN VENA YANG SESUAI</span></em></strong><br />
<ul><li><span style="color: black; font-family: Trebuchet MS;">mulakan dgn vena distal</span></li>
<li><span style="font-family: Trebuchet MS;">jika boleh pada tangan yang tidak dominan</span></li>
<li><span style="font-family: Trebuchet MS;">pilih vena yg senang dipalpasi dan jelas kelihatan</span></li>
<li><span style="font-family: Trebuchet MS;">vena dikaki hanya jika tiada vena di tangan sudah thrombus</span></li>
</ul><strong><em><span style="color: #cc0000; font-family: Trebuchet MS;">TANGGUNGJAWAB JURURAWAT</span></em></strong><br />
<span style="color: black; font-family: Trebuchet MS;">1.Dalam persediaan infusi intravena</span><br />
<ul><li><span style="font-family: Trebuchet MS;">kenalpasti diagnosis/penyakit</span></li>
<li><span style="font-family: Trebuchet MS;">pastikan arahan doktor</span></li>
<li><span style="font-family: Trebuchet MS;">kenalpasti tujuan infusi intravena</span></li>
<li><span style="font-family: Trebuchet MS;">pehatikan sebarang komplikasi </span></li>
<li><span style="font-family: Trebuchet MS;">pastikan laluan cecair tiada pencemaran.tidak bocor,tidak expire</span></li>
</ul><span style="font-family: Trebuchet MS;">2.Tanggugjawab semasa pemberian</span><br />
<ul><li><span style="font-family: Trebuchet MS;">pastikan jumlah dan kadar terapi intravena adalah betul</span></li>
<li><span style="font-family: Trebuchet MS;">tukar botol infusi yg baru sebelum menjadi kosong</span></li>
<li><span style="font-family: Trebuchet MS;">pastikan tubing tidak tertekan </span></li>
<li><span style="font-family: Trebuchet MS;">tukar tubing jika perlu/mengikut protokol hospital</span></li>
<li><span style="font-family: Trebuchet MS;">tubing tiada gelombang udara</span></li>
<li><span style="font-family: Trebuchet MS;">tukar dressing secara aseptik setiap 48 jam sekali/mengikut protokol hospital</span></li>
</ul><span style="font-family: Trebuchet MS;">3.Lakukan pemerhatian atas bahagian suntikan </span><br />
<ul><li><span style="font-family: Trebuchet MS;">jarum masih dalam vena</span></li>
<li><span style="font-family: Trebuchet MS;">tiada bengkak,merah,kesakitan</span></li>
<li><span style="font-family: Trebuchet MS;">tiada phlebitis</span></li>
<li><span style="font-family: Trebuchet MS;">keluar cecair pada bahagian suntikan </span></li>
</ul><strong><em><span style="color: #cc0000; font-family: Trebuchet MS;">FAKTOR YANG PENGARUHI PEMBERIAN INFUSI</span></em></strong><br />
<span style="color: black; font-family: Trebuchet MS;">1.KETINGGIAN BOTOL</span><br />
<ul><li><span style="font-family: Trebuchet MS;">3 kaki dari loikasi jarum</span></li>
<li><span style="font-family: Trebuchet MS;">jika terlalu tinggi akan bebankan jantung dan jika terlalu rendah aliran akan jadi lambat</span></li>
</ul><span style="font-family: Trebuchet MS;">2.PANJANG TIUB</span><br />
<ul><li><span style="font-family: Trebuchet MS;">saiz dan diameter tiub-saiz lumen besar cepatkan titisan</span></li>
<li><span style="font-family: Trebuchet MS;">toniciti cecair-airan isotonic lebih mudah masuk berbanding airan hipertonik</span></li>
</ul><span style="font-family: Trebuchet MS;">3.LOKASI BRANULA</span><br />
<ul><li><span style="font-family: Trebuchet MS;">jika pasang di bahagian siku,pergelangan tangan akan ganggu gan sekat infusi</span></li>
</ul><span style="font-family: Trebuchet MS;">4.GANGGUAN FLOW</span><br />
<ul><li><span style="font-family: Trebuchet MS;">jangan pasang B/P kuff di bahagian lengan kerana menggangu infusi</span></li>
</ul><span style="font-family: Trebuchet MS;">5.PATENSI BRANULA DAN TIUB</span><br />
<ul><li><span style="font-family: Trebuchet MS;">jika tiub tersumbat dgn darah beku/berpintal atau berubah posisi akan menganggu infusi atau aliran menjadi perlahan</span></li>
</ul><span style="font-family: Trebuchet MS;">6.KEPERLUAN PESAKIT</span><br />
<span style="font-family: Trebuchet MS;">a.Hadkan isipadu cecair</span><br />
<span style="font-family: Trebuchet MS;">b.pemberian segera</span><br />
<br />
<strong><em><span style="color: #cc0000; font-family: Trebuchet MS;">KOMPLIKASI TERAPI IV</span></em></strong><br />
<span style="color: black; font-family: Trebuchet MS;">1.Phlebitis:inflamasi pada vena</span><br />
<span style="font-family: Trebuchet MS;"> Thrombophlebitis:jika ada bekuan darah menyertai inflamasi</span><br />
<span style="font-family: Trebuchet MS;">2.Infiltration:cecair masuk ke dalam tisu subcutaneous</span><br />
<span style="font-family: Trebuchet MS;">3.Air embolism:udara masuk ke sistem sirkulatori</span><br />
<span style="font-family: Trebuchet MS;">4.Infeksi</span><br />
<span style="font-family: Trebuchet MS;">5.Fluid overload:kelebihan cecair kerana kadar titisan terlalu laju dan risiko pada pesakit dgn gangguan jantung atau renal</span><br />
<br />
<strong><em><span style="color: #cc0000; font-family: Trebuchet MS;">SEBAB-SEBAB KEGAGALAN IV</span></em></strong><br />
<ul><li><span style="color: black; font-family: Trebuchet MS;">jarum mugkain tersekat di tepi pembuluh dan ganggu pengaliran</span></li>
<li><span style="font-family: Trebuchet MS;">jarum tersumbat oleh beku darah</span></li>
<li><span style="font-family: Trebuchet MS;">botol dgn tubing adalah terlalu rendah</span></li>
<li><span style="font-family: Trebuchet MS;">liang jarum terlalu kecil</span></li>
</ul><strong><em><span style="color: #cc0000; font-family: Trebuchet MS;">LANGKAH PENCEGAHAN</span></em></strong><br />
<ul><li><span style="color: black; font-family: Trebuchet MS;">pastikan titisan tidak terlalu perlahan</span></li>
<li><span style="font-family: Trebuchet MS;">tukar infusi sebelum solusi kering</span></li>
<li><span style="font-family: Trebuchet MS;">posisi tangan lurus </span></li>
<li><span style="font-family: Trebuchet MS;">tubing jgn terlipat</span></li>
</ul><strong><em><span style="color: #cc0000;">PENGIRAAN TERAPI INTRAVENA</span></em></strong><br />
<ul><li> <span style="color: purple;">Kadai titisan/minit = <u>bilangan isipadu cecair diarahkan x faktor titisan</u></span></li>
<li><span style="color: purple;"> waktu dalam minit</span></li>
</ul><span style="color: purple;"> </span><br />
<span style="color: purple;"> Faktor titisan ialah bilangan titisan yang menghantar sebanyak 1 mL cecair IV </span><br />
<span style="color: purple;"> Untuk macrodrip set = 20 titisan/mL</span><br />
<span style="color: purple;"> microdrip set =60 titisan/mL</span><br />
<br />
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<em><span style="color: red;"><span style="font-family: Times, "Times New Roman", serif; font-size: large;">DONE <span style="color: red;">BY:</span><span style="color: magenta;">AZLIZA SUZANA(001420)</span></span></span></em>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com1tag:blogger.com,1999:blog-4212104789974226897.post-5745942880009341982011-08-22T08:12:00.000-07:002011-09-11T23:32:15.953-07:00<div class="Section1"><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><span lang="EN-US" style="font-family: "Segoe Script", "sans-serif";"> <b> </b></span><b><span lang="EN-US" style="color: #0070c0; font-family: "Segoe Script", "sans-serif"; font-size: 24pt;">LUKA (WOUND)</span></b><span lang="EN-US" style="color: #0070c0; font-family: "Segoe Script", "sans-serif";"></span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Definisi intergriti kulit dan luka</span></b></div><div class="Standard" style="margin-left: 35.45pt; mso-list: l24 level1 lfo1; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Intergriti kulit merujuk kepada kewujudan kulit dan lapisan kulit yang normal,tiada sebarang luka.</span></div><div class="Standard" style="margin-left: 35.45pt; mso-list: l24 level1 lfo1; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka adalah gangguan kepada intergriti / keutuhan kulit</span><span lang="EN-US" style="font-family: "Segoe Print";">.</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Keadaan luka</span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l35 level1 lfo2; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">kulit sudah pecah / hilang keutuhannya.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l35 level1 lfo2; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Blister dan koyak juga dikira luka.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l35 level1 lfo2; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Bedsore (kudis tekanan) juga adalah luka akibat kecuaian jururawat.</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Jenis-jenis luka</span></b></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><span lang="EN-US" style="font-family: "Segoe Print";">dikelaskan mengikut:</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l42 level1 lfo3; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">1.<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">cara diperolehi / punca</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l42 level1 lfo3; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">2.<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">penampilan</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l42 level1 lfo3; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">3.<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">peringkat kontaminasi luka</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l42 level1 lfo3; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">4.<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">mekanisma terjadinya luka</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l42 level1 lfo3; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">5.<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">jenis luka kedalaman dan keluasan luka</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">1. Jenis luka mengikut punca</span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l43 level1 lfo4; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Sengaja (intentional wounds)</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l43 level1 lfo4; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Tidak sengaja (unintentional wounds)</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Sengaja (intentional wounds)</span></b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l40 level1 lfo5; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Akibat terapi yang dirancang / tatacara rawatan.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l40 level1 lfo5; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Tatacara invansif seperti insisi surgikal, <i>cannulation intravena, lumbar puncture, thoractesis, paracentesis .</i></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l40 level1 lfo5; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka dilakukan guna pisau /jarum yang tajam dan steril.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l40 level1 lfo5; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka bersih, keliling luka rata dan tahap pendarahan terkawal.</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Tidak sengaja (unitentional wounds)</span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l44 level1 lfo6; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Akibat trauma seperti kemalangan, tertikam, tertembak, terbakar, terkepit.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l44 level1 lfo6; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Keliling luka tidak rata dan tidak bersih.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l44 level1 lfo6; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Trauma mungkin banyak dan pendarahan tidak terkawal.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l44 level1 lfo6; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Kontaminasi berlaku berisiko tinggi dapat infeksi.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l44 level1 lfo6; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Penyembuhan luka lambat.</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">2. Penampilan.</span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l28 level1 lfo7; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Tertutup.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l28 level1 lfo7; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Terbuka.</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; font-size: 11pt;">Luka tertutup.</span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l22 level1 lfo8; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Akibat pukulan kuat, terhentak, diserang,dengan senjata tumpul atau kecederaan jalan raya.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l22 level1 lfo8; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Tiada koyak dikulit dan tiada pendarahan keluar.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l22 level1 lfo8; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Tisu rosak didalam mungkin berlaku pendarahan dalaman kerana rupture kepada saluran darah.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l22 level1 lfo8; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Mungkin bahaya kerana rosak organ dalaman. </span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgoSDDe_zr511tkeyad0rhH5SMES8of7xDAYN1My2rqFwXKJqoG8n6i2TOjlFaN645-j2sLnjKqVonbMN0aXrokvwwBirqJ2B5qUiVGJ4jNiKMmo0ho2fWt_vJt_CT6qUc0uRmyALJtzGw/s1600/download" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgoSDDe_zr511tkeyad0rhH5SMES8of7xDAYN1My2rqFwXKJqoG8n6i2TOjlFaN645-j2sLnjKqVonbMN0aXrokvwwBirqJ2B5qUiVGJ4jNiKMmo0ho2fWt_vJt_CT6qUc0uRmyALJtzGw/s1600/download" /></a></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Luka terbuka</span><span lang="EN-US" style="color: #ffc000;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l45 level1 lfo9; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US">Ada koyak dikulit</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l45 level1 lfo9; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Terdapat <i>'portal of entry' </i>iaitu jalan masuk oleh mikribes kedalam badan.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l45 level1 lfo9; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Ada pendarahan dan kerosakan tisu samada kulit sahaja atau tisu lembut dan organ dalaman.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l45 level1 lfo9; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Berisiko mendapat infeksi.</span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3qk6ZP1ZHMcG9BE8OTC2qcn2F45zDfKmauBIISgCM7L9r-p3E58vokrV4l-J8Q2JazlItvg7GkYxTNpJahDK1I8shur6aVFnOiNUTxDXS9QtHw9aOi7TYVYPUbJiVSPlEonvuWIoPjrc/s1600/download+%25281%2529" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3qk6ZP1ZHMcG9BE8OTC2qcn2F45zDfKmauBIISgCM7L9r-p3E58vokrV4l-J8Q2JazlItvg7GkYxTNpJahDK1I8shur6aVFnOiNUTxDXS9QtHw9aOi7TYVYPUbJiVSPlEonvuWIoPjrc/s1600/download+%25281%2529" /></a></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">3. Jenis luka mengikut peringkat kontaminasi luka</span></b><b><span lang="EN-US" style="font-family: "Segoe Print";">.</span><span lang="EN-US"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l31 level1 lfo10; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka bersih.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l31 level1 lfo10; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka kotor / tercemar.</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; font-size: 11pt;">Luka bersih</span></b><b><span lang="EN-US" style="color: #ffc000; font-size: 11pt;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l2 level1 lfo11; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka yang tidak tercemar dengan mikrobes.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l2 level1 lfo11; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Punca luka steril. <b><i>e.g Pembedahan</i></b></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l2 level1 lfo11; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Warna luka merah dan minimal discaj.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l2 level1 lfo11; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Cepat sembuh jika dijaga dengan teknik asepsis.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l2 level1 lfo11; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;"><br />
</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Luka kotor / tercemar</span><span lang="EN-US" style="color: #ffc000;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l13 level1 lfo12; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka berlaku di persekitaran yang terdedah kepada kekotoran.</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l13 level1 lfo12; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka tercemar kepada mikrobes seperti di jalan raya, paku karat, longkang atau nalis binatang.</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l13 level1 lfo12; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka begini terdedah kepada mikrobes pathogenik yang telah bejaya masuk kedalam kulit yang koyak.</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">4.Jenis luka mengikut mekanisma terjadinya luka</span><span lang="EN-US" style="color: #ffc000;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l49 level1 lfo13; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="color: black; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-bidi-font-style: italic; mso-fareast-font-family: Symbol; mso-hansi-font-family: Symbol; mso-themecolor: text1;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><i><span lang="EN-US" style="color: black; font-family: "Segoe Print"; font-size: 11pt; mso-themecolor: text1;">Contusion</span></i><i><span lang="EN-US" style="color: black; font-size: 11pt; mso-themecolor: text1;"></span></i></div><div class="Standard" style="margin-left: 0cm; mso-list: l49 level1 lfo13; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><i><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Incision</span></i></div><div class="Standard" style="margin-left: 0cm; mso-list: l49 level1 lfo13; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><i><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Abrasion</span></i><i><span lang="EN-US" style="font-size: 11pt;"></span></i></div><div class="Standard" style="margin-left: 0cm; mso-list: l49 level1 lfo13; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><i><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Laceration</span></i><i><span lang="EN-US" style="font-size: 11pt;"></span></i></div><div class="Standard" style="margin-left: 0cm; mso-list: l49 level1 lfo13; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><i><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Puncture</span></i><i><span lang="EN-US" style="font-size: 11pt;"></span></i></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">a) Contusion</span></b><span lang="EN-US" style="color: #ffc000;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l48 level1 lfo14; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">dihentak / tehantuk dengan benda keras</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l48 level1 lfo14; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">menyebabkan luka tertutup</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l48 level1 lfo14; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Rosak pada tisu lembut dan salur darah</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l48 level1 lfo14; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Sebabkan bengkak dan kesakitan</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">b) Incision</span><span lang="EN-US" style="color: #ffc000;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l3 level1 lfo15; text-indent: 0cm;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka pembedahan / tatacara invansif</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l3 level1 lfo15; text-indent: 0cm;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Guna alat yang tajam dan steril</span></div><div class="Standard"><br />
</div><div class="Standard"><br />
</div><div class="Standard"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">c) Abrasion</span><span lang="EN-US" style="color: #ffc000;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l0 level1 lfo16; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka akibat terjatuh atau tergesel benda yang tak rata</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l0 level1 lfo16; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Kecederaan menyagat (<i>friction</i>) permukaan kulit</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l0 level1 lfo16; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Amat sakit kerana hujung-hujung saraf tercedera</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">d) Laceration</span></b><span lang="EN-US" style="color: #ffc000;"></span></div><div class="Textbody" style="margin-left: 0cm; mso-list: l46 level1 lfo17; text-indent: 0cm;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US">Akibat trauma / kecederaan tak sengaja</span></div><div class="Textbody" style="margin-left: 0cm; mso-list: l46 level1 lfo17; text-indent: 0cm;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print";">Boleh disebabkan oleh alat tajam tapi tak bersih</span></div><div class="Textbody" style="margin-left: 0cm; mso-list: l46 level1 lfo17; text-indent: 0cm;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print";">Kulit koyak dan uka tak rata '<i>jagged</i> ‘</span></div><div class="Textbody" style="margin-left: 0cm; mso-list: l46 level1 lfo17; text-indent: 0cm;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print";">Berisiko tinggi dapat infeksi</span></div><div class="Textbody"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">e) Puncture</span><span lang="EN-US" style="color: #ffc000;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l7 level1 lfo18; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Akibat tusukan alat tajam / peluru</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l7 level1 lfo18; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka sebabkan kulit terkoyak dan pendarahan</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l7 level1 lfo18; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Luka biasanya dalam dan berpotensi cederakan organ dalamam</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l7 level1 lfo18; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Risiko dapat infeksi</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div align="center" class="Standard" style="text-align: center;"><b><span lang="EN-US" style="color: #7030a0; font-family: "Segoe Print"; font-size: 24pt;">PENYEMBUHAN LUKA</span></b><b><span lang="EN-US" style="color: #7030a0; font-size: 24pt;"></span></b></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Definisi</span><span lang="EN-US" style="color: #ffc000;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l17 level1 lfo19; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Penyembuhan luka merujuk kepada peningkatan kualiti tisu hidup</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l17 level1 lfo19; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Dikenali pula sebagai <b>regenerasi </b>(<b><i>regeneration</i></b>)</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">- </span><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 10.5pt;">sembuh dengan pengantian sel-sel yang sama</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Jenis-jenis penyembuhan luka</span><span lang="EN-US" style="color: #ffc000;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l38 level1 lfo20; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Primary Intention healing</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l38 level1 lfo20; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Secondary Intention healing</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l38 level1 lfo20; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Tertiary Intention healing</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Primary Intention Healing</span><span lang="EN-US" style="color: #ffc000;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l1 level1 lfo21; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Terdapat pada insisi pembedahan tertutup</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><u><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Cri-cirinya</span></u><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;"> :</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l50 level1 lfo22; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Permukaan tisu telah bercantum (tertutup)</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l50 level1 lfo22; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Pinggir luka dikemaskan, dirapatkan dan dijahit atau stapled</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l50 level1 lfo22; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Tiada kehilangan tisu atau minima</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l50 level1 lfo22; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Terjadi granulasi tisu dan parut (scar) minima</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Secondary Intention Healing</span><span lang="EN-US" style="color: #ffc000;"></span></b></div><div class="Standard" style="margin-left: 0cm; mso-list: l29 level1 lfo23; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Terdapat pada luka akibat trauma, pressure ulcer, infeksi dan mempunyai banyak exudate</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><u><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Ciri-cirinya</span></u><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;"> :</span><span lang="EN-US" style="font-size: 11pt;"></span></div><div class="Standard" style="margin-left: 0cm; mso-list: l27 level1 lfo24; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Pinggir luka yang tidak kemas</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l27 level1 lfo24; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Banyak kehilangan tisu</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l27 level1 lfo24; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Tepi luka tidak boleh dirapatkan</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l27 level1 lfo24; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">Mempunyai banyak exudate dan debris. Debris perlu dibersihkan sebelum penyembuhan berlaku</span></div><div class="Standard" style="margin-left: 0cm; mso-list: l27 level1 lfo24; text-align: justify; text-indent: 0cm; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">penyembuhan lebih lama, scar lebih besar</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">letak gambar</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="margin-left: 36pt; text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Tertiary Intention Healing</span></b></div><div class="Standard" style="margin-left: 36pt; mso-list: l12 level1 lfo25; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Terdapat pada luka terbuka 3-5 hari yang lewat dijahit</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l12 level1 lfo25; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Dikenali pula sebagai delayed primary intention</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><u><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Ciri-cirinya :</span></u></div><div class="Standard" style="margin-left: 36pt; mso-list: l33 level1 lfo26; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Biasanya menyebabkan parut yang besar dan dalam jika dibandingkan dengan primary dan secondary intention</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l33 level1 lfo26; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Boleh menyebabkan edema, infeksi dan banyak exudates</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Fasa penyembuhan</span></b></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="margin-left: 18pt; mso-list: l39 level1 lfo29; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Fasa inflammatory</span></b></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="font-family: "Segoe Print";">-</span></b><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Fasa inflamasi ini berlaku serta merta dan berakhir dalam 3-6 hari</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">-2 proses utama pada fasa inflamasi :-</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l16 level1 lfo27; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Hemostasis (menghentikan pendarahan)</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l16 level1 lfo27; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image003.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Phagocytosis</span></div><div class="Standard" style="margin-left: 18pt; text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="margin-left: 18pt; mso-list: l23 level1 lfo28; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Fasa proliferative</span></b></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt;">-</span></b><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Berlaku 3 atau 4 hari hingga 21 hari selepas injury</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">-Terjadi <b>pembentukan kolagen (</b>bahan protein yang menambah kekuatan luka) oleh fibroblast.</span></div><div class="Standard" style="text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="margin-left: 18pt; mso-list: l23 level1 lfo28; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Fasa matang dan kontraksi parut</span></b></div><div class="Standard" style="margin-left: 18pt; text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="font-family: "Segoe Print";">(maturation and remodeling)</span></b></div><div class="Standard" style="margin-left: 18pt; text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="font-family: "Segoe Print";">-</span></b><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Berlaku dalam 21 hari hingga 1-2 tahun selepas injury</span></div><div class="Standard" style="margin-left: 18pt; text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="font-family: "Segoe Print";">-</span></b><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Pembentukkan kolagen bar uterus terjadi. Ini akan menambahkan kekuatan dan ketegangan kepada tisu baru</span></div><div class="Standard" style="margin-left: 18pt; text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="margin-left: 18pt; text-align: justify; text-justify: inter-ideograph;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; font-size: 14pt;">Eksudat Luka</span></b></div><div class="Standard" style="margin-left: 18pt; mso-list: l23 level1 lfo28; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Definisi eksudat :</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l26 level1 lfo30; text-align: justify; text-indent: -18pt; text-justify: inter-ideograph;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Bahan seperti cecair dan sel yang keluar dari salur darah semasa fasa inflamatori dan terkumpul dalam tisu atau permukaan tisu</span></div><div class="Standard" style="margin-left: 36pt; text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="Standard" style="margin-left: 18pt; mso-list: l23 level1 lfo28; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Jenis-jenis eksudat</span></div><div class="Standard" style="margin-left: 18pt;"><b><span lang="EN-US" style="font-family: "Segoe Print";">1.Serous exudates:</span></b></div><div class="Standard" style="margin-left: 36pt; mso-list: l26 level1 lfo30; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Mengandungi serum (bahagian cecair jernih daripada darah)</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l26 level1 lfo30; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Mengandungi sedikit protein dan sedikit sel</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l26 level1 lfo30; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Terdapat pada blister</span></div><div class="Standard" style="margin-left: 36pt;"><br />
</div><div class="Standard" style="margin-left: 21.3pt;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">2. Purulent exudates:</span></b></div><div class="Standard" style="margin-left: 39.3pt; mso-list: l21 level1 lfo31; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Dikenali sebagai PUS (nanah)</span></div><div class="Standard" style="margin-left: 39.3pt; mso-list: l21 level1 lfo31; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Pekat kerana terdapat leukocytes, tisu mati, debris dan bacteria hidup atau mati</span></div><div class="Standard"><br />
</div><div class="Standard" style="margin-left: 21.3pt;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">3. Hemorrhagic (sanguineous) exudates:</span></b></div><div class="Standard" style="margin-left: 39.3pt; mso-list: l37 level1 lfo32; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Mengandungi banyak sel darah merah</span></div><div class="Standard" style="margin-left: 39.3pt; mso-list: l37 level1 lfo32; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Menunjukkan adanya kerosakkan kapilari sehingga sel</span></div><div class="Standard" style="margin-left: 39.3pt; mso-list: l37 level1 lfo32; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Terdapat pada luka</span></div><div class="Standard" style="margin-left: 39.3pt; mso-list: l37 level1 lfo32; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Warna : merah terang atau merah gelap</span></div><div class="Standard"><br />
</div><div class="Standard" style="margin-left: 21.3pt;"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">4. Serosanguineous exudates :</span></b></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l14 level1 lfo33; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Mengandungi drainage yang jernih bercampur darah</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l14 level1 lfo33; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Terdapat pada insisi pembedahan</span></div><div class="Standard"><br />
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</div><div class="Standard"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">KOMPLIKASI PENYEMBUHAN LUKA</span></b></div><div class="Standard" style="margin-left: 35.45pt; mso-list: l9 level1 lfo34; text-indent: -18pt;"><!--[if !supportLists]--><b><span lang="EN-US" style="font-family: "Segoe Print"; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">1.<span style="font-family: "Times New Roman";"> </span></span></b><!--[endif]--><b><span lang="EN-US" style="font-family: "Segoe Print";">Hemorrhage / pendarahan</span></b></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l23 level1 lfo28; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Pendarahan massive adalah abnormal</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l23 level1 lfo28; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Internal hemorrhage boleh dikesan dengan adanya kebengkakan dan distensi kawasan luka</span></div><div class="Standard"><br />
</div><div class="Standard" style="margin-left: 35.45pt; mso-list: l9 level1 lfo34; text-indent: -18pt;"><!--[if !supportLists]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">2.<span style="font-family: "Times New Roman";"> </span></span></b><!--[endif]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Infeksi</span></b></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l19 level1 lfo35; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Terjadi kerana<b> </b>luka tercemar (contaminated) oleh mikroorganisma<b></b></span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l19 level1 lfo35; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Tanda & gejala : demam, sakit, bengkak, ada perubahan warna dan keluar discaj pada kawasan luka<b></b></span></div><div class="Standard"><br />
</div><div class="Standard" style="margin-left: 35.45pt; mso-list: l9 level1 lfo34; text-indent: -18pt;"><!--[if !supportLists]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">3.<span style="font-family: "Times New Roman";"> </span></span></b><!--[endif]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Dehisence</span></b></div><div class="Standard" style="margin-left: 46.4pt; mso-list: l4 level1 lfo36; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Luka suture rupture/koyak sebahagian atau seluruhnya</span></div><div class="Standard" style="margin-left: 46.4pt; mso-list: l4 level1 lfo36; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Kerap terjadi pada luka pembedahan abdomen</span></div><div class="Standard" style="margin-left: 46.4pt; mso-list: l4 level1 lfo36; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Dapat terjadi pada hari ke-4 atau ke-5 postoperative sebelum pembentukkan kolagen</span></div><div class="Standard"><br />
</div><div class="Standard" style="margin-left: 35.45pt; mso-list: l9 level1 lfo34; text-indent: -18pt;"><!--[if !supportLists]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">4.<span style="font-family: "Times New Roman";"> </span></span></b><!--[endif]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Evisceration</span></b></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l34 level1 lfo37; tab-stops: 42.55pt; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Penonjolan (protrusion) organ visceral melalui insisi</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l34 level1 lfo37; tab-stops: 42.55pt; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Merupakan kecemasan yang memerlukan perbaikan secara pembedahan</span></div><div class="Standard"><br />
</div><div class="Standard" style="margin-left: 35.45pt; mso-list: l9 level1 lfo34; tab-stops: 42.55pt; text-indent: -18pt;"><!--[if !supportLists]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">5.<span style="font-family: "Times New Roman";"> </span></span></b><!--[endif]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Pembentukan fistula</span></b></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l15 level1 lfo38; tab-stops: 42.55pt; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Terdapat laluan atau lubang abnormalan antara 2 organ atau antara organ dengan luar tubuh badan</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l15 level1 lfo38; tab-stops: 42.55pt; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Disebabkan penyembuhan luka yang buruk</span></div><div class="Standard"><br />
</div><div class="Standard" style="margin-left: 35.45pt; mso-list: l9 level1 lfo34; tab-stops: 42.55pt; text-indent: -18pt;"><!--[if !supportLists]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; mso-bidi-font-family: "Segoe Print"; mso-fareast-font-family: "Segoe Print";">6.<span style="font-family: "Times New Roman";"> </span></span></b><!--[endif]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Hypertrophic scars atau keloid</span></b></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l47 level1 lfo39; tab-stops: 42.55pt; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Keloid adalah pembentukan tisu parutnbesar, luas, merah, menonjol dan</span></div><div class="Standard" style="margin-left: 42.55pt; tab-stops: 42.55pt;"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">keras akibat penghasilan tisu kolagen yang berlebihan</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l47 level1 lfo39; tab-stops: 42.55pt; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Tidak membahayakan tetapi menimbulkan masalah kosmetik</span></div><div class="Standard"><br />
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</div><div align="center" class="Standard" style="tab-stops: 42.55pt; text-align: center;"><b><span lang="EN-US" style="color: #ff33cc; font-family: "Segoe Print"; font-size: 24pt;">Mencuci luka (wound dressing)</span></b></div><div class="Standard"><br />
</div><div class="Standard"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Definisi dressing</span></b></div><div class="Standard" style="margin-left: 1cm; mso-list: l47 level1 lfo39; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Dressing luka adalah tatacara steril mencuci an membersihkan luka dari tisu nekrotik dan bahan-bahan discaj yang berlebihan</span></div><div class="Standard"><br />
</div><div class="Standard"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiR57mDLDEHQB_yQPRHfDe6xVG3AYvZyXgyMD19MoFAGoFDhGxSdcfZN_ynJNSftE3Qwa5KdBJoXs2IdKiiGByfDk0_6ItPDUjl89byXKH4MED1Z8lFA6oBTwzmmZcFFwUCGn9hyYrhF6Y/s1600/images.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiR57mDLDEHQB_yQPRHfDe6xVG3AYvZyXgyMD19MoFAGoFDhGxSdcfZN_ynJNSftE3Qwa5KdBJoXs2IdKiiGByfDk0_6ItPDUjl89byXKH4MED1Z8lFA6oBTwzmmZcFFwUCGn9hyYrhF6Y/s1600/images.jpg" /></a><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Tujuan wound dressing</span></b><b><span lang="EN-US" style="font-family: "Segoe Print";"></span></b></div><div class="Standard" style="margin-left: 21.3pt; mso-list: l47 level1 lfo39; tab-stops: 1.0cm; text-indent: -14.2pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Menggalakan granulasi dan penyembuhan</span></div><div class="Standard" style="margin-left: 21.3pt; mso-list: l47 level1 lfo39; tab-stops: 1.0cm; text-indent: -14.2pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Mengelakkan kecederaan </span></div><div class="Standard" style="margin-left: 21.3pt; mso-list: l47 level1 lfo39; tab-stops: 1.0cm; text-indent: -14.2pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Mengelakkan berlakunya infeksi</span></div><div class="Standard"><br />
</div><div class="Standard"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Prinsip-prinsip semasa melakukan wound dressing</span></b></div><div class="Standard"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;"> 1.Luka terbuka boleh dicemar oleh udara</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l52 level1 lfo40; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Jaga kebersihan bilik rawatan</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l52 level1 lfo40; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Sapu dan mop lantai sejam sebelum dressing</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l52 level1 lfo40; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Jangan dedahkan luka terlalu lama semasa dressing</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l52 level1 lfo40; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Pakai mask semasa dressing</span></div><div class="Standard" style="margin-left: 36pt; tab-stops: 1.0cm;"><br />
</div><div class="Standard"><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;"> 2.Luka boleh tercemar oleh tangan, alat-alat, losyen dan dressing yang tidak steril</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l20 level1 lfo41; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Gunakan alatan steril</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l20 level1 lfo41; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Terapkan teknik asepsis surgical / sterility semasa melakukan dressing</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l20 level1 lfo41; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Satu swab untuk satu kali sapuan</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l20 level1 lfo41; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Jika pesakit ada 2 luka, bersihkan luka bersih dahulu</span></div><div class="Standard"><br />
</div><div class="Standard"><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">3.Kelembapan memudahkan pembiakan dan pergerakan mikroorganisma</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l25 level1 lfo42; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Periksa pembalut dressing set sebelum digunakan, jika basah tukar dengan yang lain</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l25 level1 lfo42; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Squeeze gauze sebelum swaqb pada luka</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l25 level1 lfo42; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Lap sekeliling luka dengan gauze kering steril jika basah</span></div><div class="Standard"><br />
</div><div class="Standard"><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">4.Cecair mengalir mengikut gravity (ke bawah)</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l8 level1 lfo43; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Halakan dressing forceps kebawah semas dressing</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l8 level1 lfo43; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Lakukan jagaan drainage tube/packing (jika ada) untuk galakkan aliran discaj</span></div><div class="Standard"><br />
</div><div class="Standard"><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">5.Darah mengangkut nutrisi dan oksigen kepada tisu</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l32 level1 lfo44; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Galakkan aliran darah untuk mempercepatkan penyembuhan </span></div><div class="Standard" style="margin-left: 36pt; mso-list: l32 level1 lfo44; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Lakukan irigasi luka pada luka yang kotor dan dalam</span></div><div class="Standard"><br />
</div><div class="Standard"><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">6.Elakkan dari kecederaan kepada kulit / selaput mukosa </span></div><div class="Standard" style="margin-left: 36pt; mso-list: l10 level1 lfo45; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Semak kekuatan lotion</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l10 level1 lfo45; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Tanggalkan plaster dengan teliti</span></div><div class="Standard"><br />
</div><div class="Standard"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Asesmen</span></b></div><div class="Standard" style="margin-left: 36pt; mso-list: l18 level1 lfo46; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Kenalpasti pesakit yang betul</span></div><div class="Standard" style="margin-left: 36pt; mso-list: l18 level1 lfo46; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Periksa arahan dressing dari nursing care plan berkaitan :</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l51 level1 lfo47; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Lotion antiseptic yang digunakan </span></div><div class="Standard" style="margin-left: 42.55pt; tab-stops: 1.0cm;"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">E.g normal saline, povidone iodine, acetic acid</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l51 level1 lfo47; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Jenis dressing<br />
E.g occlusive, non-occlusive, guna gauze, gamgee</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l51 level1 lfo47; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Close method / expose luka selepas dressing</span></div><div class="Standard"><br />
</div><div class="Standard"><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Implementasi</span></b></div><div class="Standard" style="margin-left: 36pt; mso-list: l5 level1 lfo48; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 11pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="12" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="12" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Persediaan troli yang sempurna</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l41 level1 lfo49; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Cuci tangan dan keringkan</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l41 level1 lfo49; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Pakai mask</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l41 level1 lfo49; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Tutup kipas (bila ada)</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l41 level1 lfo49; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Letakkan alat-alat steril di bahagian atas troli</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l41 level1 lfo49; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Jika menggunakan dressing towel steril untukmengalas bahagian atas troli, pastikan ia meliputi keseluruhan bahagianm atas dan bawah troli</span></div><div class="Standard"><br />
</div><div class="Standard" style="margin-left: 36pt; mso-list: l5 level1 lfo48; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Persediaan pesakit</span></b></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l30 level1 lfo50; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Pastikan pesakit sudah selesai urusan peribadi seperti makan, buang air<b></b></span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l30 level1 lfo50; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Pesakit dalam keadaan bersih dari urine atau feses <b></b></span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l30 level1 lfo50; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Beri arahan yang jelas kepada pesakit untuk elak pencemaran pada luka:<b></b></span></div><div class="Standard" style="margin-left: 78.55pt; mso-list: l36 level1 lfo51; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 10pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><b><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 10pt;">Tidak bergerak</span></b></div><div class="Standard" style="margin-left: 78.55pt; mso-list: l36 level1 lfo51; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 10pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><b><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 10pt;">Tidak menyentuh dressing / luka</span></b></div><div class="Standard" style="margin-left: 78.55pt; mso-list: l36 level1 lfo51; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 10pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><b><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 10pt;">Kurang bercakap</span></b></div><div class="Standard" style="margin-left: 78.55pt; mso-list: l36 level1 lfo51; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; font-size: 10pt; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><b><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 10pt;">Beritahu losyen yang digunakan akan menyebabkan rasa sakit / pedih</span></b></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l11 level1 lfo52; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Beri keyakinan dan tenangkan pesakit</span></div><div class="Standard"><br />
</div><div class="Standard" style="margin-left: 36pt; mso-list: l5 level1 lfo48; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol;"><img alt="*" height="13" src="file:///C:/Users/Shila/AppData/Local/Temp/msohtmlclip1/01/clip_image002.gif" width="13" /><span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><b><span lang="EN-US" style="color: #ffc000; font-family: "Segoe Print";">Persediaan persekitaran</span></b></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l6 level1 lfo53; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Periksa semua kerja membersihkan wad, menyapu, mop, mengemas katil telah dilakukan satu jam sebelum dressing</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l6 level1 lfo53; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Lakukan dressing di bilik rawatan atau di katil pesakit</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l6 level1 lfo53; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Pastikan kawasan sekeliling bebas dari bedpan, urinal, sputum mug, vomit bowl</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l6 level1 lfo53; tab-stops: 1.0cm; text-indent: -18pt;"><!--[if !supportLists]--><span lang="EN-US" style="font-family: Wingdings; font-size: 11pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><!--[endif]--><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;">Cahaya yang cukup untuk memudahkan pemerhatian luka</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l6 level1 lfo53; tab-stops: 1.0cm; text-indent: -18pt;"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;"><br />
</span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l6 level1 lfo53; tab-stops: 1.0cm; text-indent: -18pt;"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;"><span class="Apple-style-span" style="color: magenta;">done by : ZULAIHA <span class="Apple-style-span" style="background-color: #ead1dc;">(001455)</span></span></span></div><div class="Standard" style="margin-left: 42.55pt; mso-list: l6 level1 lfo53; tab-stops: 1.0cm; text-indent: -18pt;"><span lang="EN-US" style="font-family: "Segoe Print"; font-size: 11pt; mso-bidi-font-weight: bold;"><br />
</span></div></div>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com1tag:blogger.com,1999:blog-4212104789974226897.post-78334988478861380042011-08-21T21:20:00.000-07:002011-09-11T23:38:57.342-07:00KESEIMBANGAN ASID BES<div style="margin-bottom: 0in;"><span style="color: blue; font-family: Comic Sans MS, cursive;">PENGENALAN:</span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: #351c75; font-family: Comic Sans MS, cursive;">Badan secara normal akan mengekalkan keseimbangan antara asid yang dihasilkan selama metabolisma dan bes yang meneutralkan dan membantu eksresi asid.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #351c75; font-family: Comic Sans MS, cursive;">Kaeadaan cecair badan samada asid atau bes ditentukan oleh konsentrasi ion hidrogen (H+).</span></div></li>
</ul><span style="color: blue; font-family: Comic Sans MS;">PERBEZAAN ASID DAN BES:</span><br />
<br />
<span style="color: #783f04; font-family: Comic Sans MS;">ASID <span style="color: #990000;"> BES</span></span><br />
<ol><li><span style="font-family: Comic Sans MS;"><span style="color: #b45f06;">mengeluarkan H+</span> 1. <span style="color: #cc0000;">menerima H+</span></span></li>
<li><span style="font-family: Comic Sans MS;"><span style="color: #b45f06;">menerima H+ bila dilarutkan</span> 2. <span style="color: #cc0000;">bebaskan H+ bila dilarutkan</span></span></li>
<li><span style="font-family: Comic Sans MS;"><span style="color: #b45f06;">cth:Asid Hidroklorik</span> 3. <span style="color: #cc0000;">Cth:Bikarbonat</span></span></li>
</ol><br />
<div style="margin-bottom: 0in;"><span style="color: navy;"><span style="font-family: Comic Sans MS, cursive;"><span style="font-size: medium;">MEKANISMA YANG MENGATUR KESEIMBANGAN ASID-BES:</span></span></span></div><ol><li><div style="margin-bottom: 0in;"><span style="color: #6b4794;"><span style="font-family: Comic Sans MS, cursive;">Sistem Buffer</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #6b4794;"><span style="font-family: Comic Sans MS, cursive;">Sistem Respiratori</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #6b4794;"><span style="font-family: Comic Sans MS, cursive;">Sistem Renal</span></span></div></li>
</ol><br />
<div style="margin-bottom: 0in;"><span style="color: #b80047;"><span style="font-family: Comic Sans MS, cursive;">1)Sistem Buffer</span></span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">fastest acting system</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">bertindak secara kimia untuk:</span></span></div><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">menukarkan asid menjadi asid lemah</span></span></div><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">mengikat asid untuk meneutralkan kesannya</span></span></div><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">mengurangkan kesan asid pada pH darah hingga asid dikeluarkan dari badan</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">terdiri dari:</span></span></div><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">Carbonic acid-bicarbonate</span></span></div><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">Phosphate buffer sysytem</span></span></div><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">Intracellular and plasma protein</span></span></div><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">Hemaglobin buffer</span></span></div></li>
</ul><div style="margin-bottom: 0in;"><br />
</div><div style="margin-bottom: 0in;"><span style="color: #b80047;"><span style="font-family: Comic Sans MS, cursive;">2)Sistem Respiratori</span></span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">paru-paru membantu dalam mengawal pH normal dengan mengekresikan C02 dan H02</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">pHcecair badan disesuaikan dengan mengubah kadar dan kedalaman pernafasan selama 1-3 minit.</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">Dengan menambah kadar kedalaman pernafasan akan menyebabkan lebih banyak CO2 dikeluarkan dan akan menyebabkan penambahan kadar pH(alkalosis)</span></span></div></li>
</ul><div style="margin-bottom: 0in;"><br />
</div><div style="margin-bottom: 0in;"><span style="color: #b80047;"><span style="font-family: Comic Sans MS, cursive;">3)Sistem Renal</span></span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: blue;"><span style="font-family: Comic Sans MS, cursive;">pada keadaan normal ginjal menyerap semula bicarbonate dan mengeluarkan H+ bagi mengekalkan pH.</span></span></div></li>
</ul><div style="margin-bottom: 0in;"><br />
</div><div style="margin-bottom: 0in;"><br />
</div><div style="margin-bottom: 0in;"><span style="color: #355e00;"><span style="font-family: Comic Sans MS, cursive;"><span style="font-size: medium;">Definisi Keseimbangan Asid-Bes</span></span></span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: #ff420e;"><span style="font-family: Comic Sans MS, cursive;">ketidakseimbangan asid-bes terjadi jika nisbah asid-bes berubah(1:20) dan mekanisme kompensatori tidak mencukupi.</span></span></div></li>
</ul><div style="margin-bottom: 0in;"><br />
</div><ul><div style="margin-bottom: 0in;"></div></ul><br />
<div style="margin-bottom: 0in;"><span style="color: #6b4794;"><span style="font-family: Comic Sans MS, cursive;"><span style="font-size: small;">a)Asidosis Respiratori(carbonic acid excess)</span></span></span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">penyebab:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">hipoventilasi + retensi CO2</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">faktor risiko:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">-penyakit paru-paru </span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">-depresi CNS berkaitan dengan anestesia atau overdose ubat narkotic</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">manifestasi klinikal:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">i)pulse & kadar respiratori menurun</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">ii)dizzness/headache</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">iii)penurunan kesedaran/koma</span></span></div><div style="margin-bottom: 0in;"></div></li>
</ul><div style="margin-bottom: 0in;"><span style="color: #6b4794;"><span style="font-family: Comic Sans MS, cursive;"><span style="font-size: small;">b)Alkolisis Respiratori(carbonic acid deficit)</span></span></span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">penyebab:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">hiperventilasi</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">faktor risiko:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">-anxiety</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">-kesedaran CNS</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">-demam </span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">Manifestasi klinikal:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">i)pernafasan cepat & dalam</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">ii)takikardia</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">ii)resah gelisah</span></span></div><div style="margin-bottom: 0in;"></div></li>
</ul><div style="margin-bottom: 0in;"><span style="color: #6b4794;"><span style="font-family: Comic Sans MS, cursive;"><span style="font-size: small;">c)Metabolic Acidosis(bes bicarbonate deficit)</span></span></span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">penyebab:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">ketidakupayaan ginjal megekresikan H+ dan menghasilkan HCO3</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">faktor risiko:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">-renal failure</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">-diabetic ketoacidosis</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">-diare teruk</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">manefestasi klinikal:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">i)pernafasan Kussmaul's</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">ii)nausea & vomitting</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">iii)warm & dry skin</span></span></div><div style="margin-bottom: 0in;"></div></li>
</ul><div style="margin-bottom: 0in;"><span style="color: #6b4794;"><span style="font-family: Comic Sans MS, cursive;"><span style="font-size: small;">d)Alkalosis metabolik(bes bocarbonate berlebihan)</span></span></span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">penyebab:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">amaun bicarbonate melebihi nisbah normal.</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">Faktor risiko:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">-kehilangan HCI yang berlebihan</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">-pengambilan ubtan tertentu</span></span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">Manifestasi Klinikal:</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">i)paresthesia</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">ii)pernafasan lambat & cetek</span></span></div><div style="margin-bottom: 0in;"><span style="color: #4c1900;"><span style="font-family: Comic Sans MS, cursive;">iii)tetany</span></span></div></li>
</ul><div style="margin-bottom: 0in;"><br />
</div><ul><div style="margin-bottom: 0in;"></div></ul><br />
<div></div><br />
<div></div><div style="margin-bottom: 0in;"><br />
<div></div></div>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com2tag:blogger.com,1999:blog-4212104789974226897.post-56558064725373859032011-08-21T21:13:00.000-07:002011-09-11T23:33:36.771-07:00Fasa Pos Operative<b><i><u><span class="Apple-style-span" style="color: lime;">Definisi</span></u></i></b><br />
<b><br />
</b><br />
<ul><li><b>Bermula daripada selepas pembedahan, kemasukkan pesakit ke bilik pemulihan sehingga discaj dari hospital.</b></li>
</ul><span class="Apple-style-span" style="color: lime;"><b><u style="font-style: italic;">Fasa Post Operative Terbahagi dalam 2 peringka</u>t</b></span><br />
<div><ol><li><strong><span style="color: magenta;"><i>Immediate postanaethetic phase ( </i>jagaan segera selepas anestesi )</span></strong></li>
</ol><ul><li><b>bermula dari pesakit diterima dibilik pemulihan (<i>recovery room</i>) sehingga pulih dari anestesi dan dibenarkan dihantar ke wad.</b></li>
</ul><ul><li><b>bilik pemulihan terletak berhampiran dewan pembedahan.</b></li>
</ul><div><b><br />
</b></div><div><b> 2. <i>Ongoing postoperative care ( </i>jagaan postoperative selanjutnya )</b></div><div><ul><li><b>dilakukan di wad.</b></li>
</ul><div><b><br />
</b></div></div><div><b><br />
</b></div><div><span class="Apple-style-span" style="color: magenta; font-family: Georgia, "Times New Roman", serif;"><b><i><u>JAGAAN POSTOPERATIVE</u></i></b></span></div><i><b><br />
</b></i></div><div><i><span class="Apple-style-span" style="color: lime;"><b><br />
</b></span></i></div><div><span class="Apple-style-span" style="color: lime; font-family: Arial, Helvetica, sans-serif;"><b><i>Tujuan</i></b></span></div><ol><li><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif;"><b>menilai keadaan pesakit tentang fungsi kardiovaskular dan pernafasan</b></span></li>
<li><span style="font-family: Arial;"><b>mengekalkan salur pernafasan yang paten</b></span></li>
<li><span style="font-family: Arial;"><b>memastikan sirkulasi darah mencukupi</b></span></li>
<li><span style="font-family: Arial;"><b>menganalpasti komplikasi atau ketidakselesaan untuk melakukan rawatan segera</b></span></li>
<li><span style="font-family: Arial;"><b>mencegah kecederaan</b></span></li>
</ol><b><br />
</b><br />
<span style="color: purple; font-family: Arial;"><strong><em>Persediaan untuk menerima pesakit</em></strong></span><br />
<ol><li><span style="font-family: Arial;"><b>Persediaan untuk menerima pesakit selepas pembedahan</b></span></li>
</ol><ul><li><span style="font-family: Arial;"><b>katil pembedahan (post-op bed)</b></span></li>
<li><span style="font-family: Arial;"><b>emergency tray / troli dengan kelengkapan</b></span></li>
</ul><b><br />
</b><br />
<span style="color: purple; font-family: Arial;"><strong><em>A. Penjagaan segera post operative</em></strong></span><br />
<span style="color: purple; font-family: Arial;"><strong><em><br />
</em></strong></span><br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPO95PPn11j0BI8ZJMStCWYWLeYx_aTSrYTYX4hQIGSVV3oIA4c4gsKLTTJxcDLCbuYm3aLWAMz5p3Bq9XDwKyH43y-D7bmMCsv6gO8dM1pLrBNtnZTqJ9182Zdo_UZh64bJJHTkgVErk/s1600/images.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><b><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPO95PPn11j0BI8ZJMStCWYWLeYx_aTSrYTYX4hQIGSVV3oIA4c4gsKLTTJxcDLCbuYm3aLWAMz5p3Bq9XDwKyH43y-D7bmMCsv6gO8dM1pLrBNtnZTqJ9182Zdo_UZh64bJJHTkgVErk/s1600/images.jpg" /></b></a></div><b><br />
</b><br />
<span style="color: magenta; font-family: Arial;"><strong><em>1. Posisi</em></strong></span><br />
<ul><li><span style="font-family: Arial;"><b>lateral - supine dengan kepala diiringi ke sisi untuk elak lidah jatuh kebelakang dan elak aspirasi muntah</b></span></li>
</ul><span style="background-color: white; color: magenta; font-family: Arial;"><strong><em>2. Pemerhatian : setiap jam selama 6 jam dan beransur dipanjangkan masa</em></strong></span><br />
<ul><li><span style="font-family: Arial;"><b>keadaan am : tekanan darah, suhu nadi, pernafasan, warna kulit, paras kesedaran, orientasi</b></span></li>
<li><span style="font-family: Arial;"><b>luka pembedahan : samada berdarah , tiub jika ada samada berfungsi atau terlipat</b></span></li>
</ul><span style="color: magenta; font-family: Arial;"><strong><em>3. Imbangan cecair dan elektrolit</em></strong></span><br />
<ul><li><span style="font-family: Arial;"><b>pesakit masih terus dipuasakan sekurang-kurangnya 6jam atau seperti diarahkan</b></span></li>
<li><span style="font-family: Arial;"><b>periksa infusi intravena mengalir dengan baik</b></span></li>
<li><span style="font-family: Arial;"><b>rekod i/o</b></span></li>
<li><span style="font-family: Arial;"><b>jika ada kateter urinari disambungkan ke CBD</b></span></li>
</ul><span style="color: magenta; font-family: Arial;"><strong><em>3. Kekalkan saluran pernafasan yang paten</em></strong></span><br />
<ul><li><span style="font-family: Arial;"><b>perhati watak pernafasan</b></span></li>
<li><span style="font-family: Arial;"><b>posisi - lateral atau semi-prone (jika bukan kontra indikasi)</b></span></li>
<li><span style="font-family: Arial;"><b>sedutan jika sekresi berlebihan</b></span></li>
<li><span style="font-family: Arial;"><b>terapi oksigen jika perlu - melalui nasal atau mask</b></span></li>
</ul><span style="color: magenta; font-family: Arial;"><em><strong>4. Kekalkan sirkulasi yang sempurna</strong></em></span><br />
<ul><li><span style="font-family: Arial;"><b>kekalkan gantian cecair intravena seperti yang diarahkan</b></span></li>
<li><span style="font-family: Arial;"><b>transfusi darah jika diarahkan</b></span></li>
<li><span style="font-family: Arial;"><b>pemerhatian rapi untuk mengesan perdarahan (hemorrhage)</b></span></li>
</ul><span style="color: magenta; font-family: Arial;"><em><strong>5. Elak kecederaan</strong></em></span><br />
<ul><li><span style="font-family: Arial;"><b>rawat di cot bed</b></span></li>
<li><span style="font-family: Arial;"><b>temani pesakit sehingga sedar</b></span></li>
<li><span style="font-family: Arial;"><b>lakukan pemerhatian kerap</b></span></li>
<li><span style="font-family: Arial;"><b>rawat pesakit dengan hati-hati</b></span></li>
</ul><b><br />
</b><br />
<span style="color: purple; font-family: Arial;"><em><strong>Keadaan yang membolehkan pesakit post operative dipindahkan ke wad</strong></em></span><br />
<ul><li><span style="font-family: Arial;"><b>sedar diri dan orientasi</b></span></li>
<li><span style="font-family: Arial;"><b>berkeupayaan mengekalkan salur udara paten, pernafasan yang dalam dan batuk dengan senang</b></span></li>
<li><span style="font-family: Arial;"><b>tanda-tanda vital stabil dan kekal sekurang-kurangnya 30minit</b></span></li>
<li><span style="font-family: Arial;"><b>ada tindak balas reflek ( gag,menelan)</b></span></li>
<li><span style="font-family: Arial;"><b>air kencing seimbang antara masuk dan keluar ( sekurang-kurangnya 30ml/jam)</b></span></li>
<li><span style="font-family: Arial;"><b>dressing tiada penyaliran darah dari luka</b></span></li>
</ul><b><br />
</b><br />
<span style="color: purple; font-family: Arial;"><em><strong>B. Jagaan selanjutnya post-operative (subsequent care)</strong></em></span><br />
<b><br />
</b><br />
<span style="color: lime; font-family: Arial;"><em><strong>Tujuan</strong></em></span><br />
<ul><li><b> untuk menggalak penyembuhan</b></li>
<li><b>untuk mengelak komplikasi</b></li>
</ul><span style="color: lime;"><em><strong>Implementasi</strong></em></span><br />
<b><br />
</b><br />
<span style="color: magenta;"><em><strong>1. Pengurusan sakit (pain management)</strong></em></span><br />
<ul><li><b>kesakitan memuncak pada 12 hingga 36 jam selepas pembedahan. berkurangan pada hari 2 hingga 3 post-op</b></li>
<li><b>peringkat awal pesakit diberi patent-controlled analgesia (PCA) atau continuous atau diberi setiap 2 hingga 6jam selama 36jam</b></li>
<li><b>ubat dikurangkan secara beransur dan kemudian diganti dengan anti-inflamatori atau analgesic lain</b></li>
<li><b>tanggungjawab JR : menilai kesan ubat , melakukan tindakan nin-farmakologi iaitu demahan suam,backdrup,posisi dan lainnya</b></li>
</ul><span style="color: magenta;"><em><strong>2. Posisi</strong></em></span><br />
<ul><li><b>spinal anaesthesia -lie flat 8 hingga 12 jam</b></li>
<li><b>general anestesi</b></li>
<li><b>setelah sedar : semi fowler</b></li>
</ul><em><strong><span style="color: magenta;">3. Senaman</span></strong></em><br />
<ul><li><b>deep breathing and counghing exercise</b></li>
<li><b>senaman kaki</b></li>
</ul><em><strong><span style="color: magenta;">4. Pengerakan dan ambulasi</span></strong></em><br />
<ul><li><b>tujuan : mengelakkan masalah respiratori, sirkulatori, urinari, GIT dan kelemahan otot</b></li>
<li><b>elak letak bantal dibawah lutut kerana menghalang aliran darah ke dari anggota bawah</b></li>
</ul><span style="color: magenta;"><em><strong>5. Hidrasi</strong></em></span><br />
<ul><li><b>tujuan : mengganti cecair yang hilang semasa pembedahan, mengekalkan fungsi renal dan kardiovaskular, mencairkan mukus</b></li>
<li><b>kekalkan IV infusi seperti yang diarahkan</b></li>
</ul><em><strong><span style="color: magenta;">6. Diet</span></strong></em><br />
<ul><li><b>kekalkan berpuasa (NBM) sehingga arahan doktor</b></li>
<li><b>jenis diet bergantung kepada jenis pembedahan</b></li>
</ul><strong><em><span style="color: magenta;">7. Eliminasi Urine</span></em></strong><br />
<ul><li><b>bantu dan galak pesakit kencing</b></li>
<li><b>ases bladder distension</b></li>
</ul><em><strong><span style="color: magenta;">8. Suction (sedutan)</span></strong></em><br />
<ul><li><b>perlu disambungkan kepada tiub saluran, samada continuous atau intermitten</b></li>
<li><b>pemerhatian samada tersekat atau berfungsi</b></li>
</ul><em><strong><span style="color: magenta;">9. Penjagaan luka</span></strong></em><br />
<ul><li><b>perhatikan luka pembedahan untuk memastikan luka bersih, kering, tidak ada tanda perdarahan</b></li>
<li><b>lakukan dressing dengan teknik asepsis apabila diarahkan</b></li>
<li><b>buka jahitan atau klip pada tarikh yang ditetapkan</b></li>
</ul><em><strong><span style="color: magenta;">10. Pendidikan Kesihatan</span></strong></em><br />
<ul><li><b>diet : makanan seimbang</b></li>
<li><b>kebersihan diri : untuk elak jangkitan</b></li>
<li><b>penjagaan luka : jaga luka tetap bersih untuk galak penyembuhan dan tiada komplikasi</b></li>
<li><b>ubatan : ambil ubat seperti yang diarahkan doktor</b></li>
<li><b>rawatan susulan : untuk pemeriksaab luka atau buka jahitan</b></li>
<li><b>aktiviti : elak aktiviti berat, lakukan harian secara beransur sesuia kemampuan</b></li>
</ul><b><br />
</b><br />
<strong><em><span style="color: lime;">KOMPLIKASI POST OPERATIVE</span></em></strong><br />
<b><br />
</b><br />
<span style="color: magenta;"><em><strong>1. Renjatan</strong></em></span><br />
<ul><li><b>kegagalan sirkulasi menyebabkab kekurangan perfusi</b></li>
<li><b>sebab : sebarang keadaan yang boleh menurunkan tekanan darah</b></li>
<li><b>jenis renjatan : hipovolemia, hemorrarghia, neurogenik, cardiogenik</b></li>
<li><b>manifestasi klinikal renjatan : gangguan aras kesedaran , kulit sejuk dan pucat, kardiovaskular, respiratori, suhu badan, keluaran urine, dahaga/haus</b></li>
<li><b>rawatan renjatan : hentikan sebarang perdarahan, kekelkan saluran pernafasan, baringkan pesakit dalam keadaan "flat"</b></li>
</ul><span style="color: magenta;"><em><strong>2. Perdarahan (hemorrhage)</strong></em></span><br />
<ul><li><b>penutupan vascular tidak berkesan</b></li>
<li><b>perubahan dalam koagulasi</b></li>
<li><b>pendarahan primer : 24 jam selepas pembedahan</b></li>
</ul><span style="color: magenta;"><em><strong>3. Paralytic ileus</strong></em></span><br />
<ul><li><b>kelumpuhan usus, tiada pergerakkan peristalsis berkaitan dengan : immobility ( pesakit tidak bergerak ), ubatan kesakitan, anaesthesis</b></li>
<li><b>rawatan : ases distensi abdomen</b></li>
<li><b>teruskan berpuasa sehingga peristalsis kembali</b></li>
</ul><em><strong><span style="color: magenta;">4. Infeksi</span></strong></em><br />
<ul><li><b>berkaitan dengan : insisi surgical, kurang nutrisi dan cecair, kehadiran pathogen</b></li>
<li><b>rawatan : pemerhatian berlaku jangkitan, strict antiseptic technique, antibiotic</b></li>
</ul><em><strong><span style="color: magenta;">5. Kelegaan salur pernafasan tidak efektif</span></strong></em><br />
<ul><li><b>berkaitan dengan : sekresi pekat, tidak berupaya mengeluarkan</b></li>
<li><b>manifestasi klinikal : pernafasan berbunyi, pernafasan cetek, batuk tiada kahak, oksigen saturasi rendah</b></li>
<li><b>rawatan : galakkan senaman pernafasan dan batuk mendalam, beri minuman 2500 ml tiap hari cecair kecuali ada kontraindikasi lakukan sedutan jika perlu</b></li>
</ul><span style="color: magenta;"><em><strong>6. Thromboembolism</strong></em></span><br />
<ul><li><b>keadaan bekuan darah ( thrombus ) yang berbentuk pada sesuatu tempat dalam salur darah</b></li>
<li><b>manifestasi klinikal : merah dibahagian terlibat, bengkak / edema dibahagian terlibat, sakit, gangguan fungsi</b></li>
<li><b>rawatan : ases tanda dan simtom</b></li>
<li><b>pemberian anticoagulan (heparin)</b></li>
<li><b>elak tekanan dibawah lutut untuk elak sekatan vena</b></li>
</ul><span style="color: magenta;"><em><strong>7. Retensi Urine</strong></em></span><br />
<ul><li><b>kegagalan mengosongkan pundi kencing sementara mungkin berlaku disebabkan kesan anestesi</b></li>
<li><b>manifestasi klinikal : keluar kencing sedikit-sedikit, resah gelisah, mengadu sakit dan tekanan kawasan pelvis</b></li>
<li><b>rawatan : demahan beg air panas, buka paip - pesakit dengarkan bunyi air, siram air suam ke vulva - perempuan, bantu berdiri - laki-laki</b></li>
</ul><br />
<br />
<span style="background-color: magenta; color: lime;"><strong><em>Wan Jofarnorsheila Binti Megat Johari</em></strong></span><br />
<span style="background-color: magenta; color: lime;"><strong><em>001461</em></strong></span><br />
<strong><br />
<em></em></strong>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com0tag:blogger.com,1999:blog-4212104789974226897.post-74947471318468279892011-08-21T20:13:00.000-07:002011-09-11T23:39:49.174-07:00ELEKTROLIT<div style="margin-bottom: 0in;"><span style="color: orange; font-family: Comic Sans MS, cursive;">DEFINISI:</span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">bahan-bahan yang terkandung dalam cecair ekstrasel dan intrasel mempunyai kuasa elektrik untuk memecah didalam air kepada ions bercas positif dan negatif.</span></div></li>
</ul><div style="margin-bottom: 0in;"><span style="color: #134f5c;"></span></div><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Ions bercaj positif dikenali CATIONS:</span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Na+ (sodium/natrium)</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">K+ (potassium/kalium)</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Ca++ (calcium)</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Mg++(magnesium)</span></div></li>
</ul><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Ions bercaj negatif dikenali ANIONS:</span></div><ul><li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">CI-(chloride)</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">PO4-(phospate)</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">HCO3-(bicarbonate)</span></div></li>
</ul><div style="margin-bottom: 0in;"><span style="color: orange; font-family: Comic Sans MS, cursive;">LOKASI ELEKTROLIT:</span></div><ol><li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Intrasel: Potassium,Magnesium,Phospate.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Ekstrasel: Sodium.Calcium,Chloride,Bicarbonate.</span></div></li>
</ol><div style="margin-bottom: 0in;"><span style="color: #134f5c;"></span></div><div style="margin-bottom: 0in;"><span style="color: orange; font-family: Comic Sans MS, cursive;">FUNGSI ELEKTROLIT:</span></div><ol><li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Mengekalkan keseimbangan osmotik diantara cecair intrasel dan ekstrasel.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Menentukan imbangan asid bes dalam badan.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Mengatur kawal aktiviti neuromuskular dengan sempruna.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Mengekalkan keadaan yang betul untuk reaksi kimia didalam badan.</span></div><div style="margin-bottom: 0in;"><span style="color: #134f5c;"></span></div></li>
</ol><div style="margin-bottom: 0in;"><br />
</div><div style="margin-bottom: 0in;"></div><div style="margin-bottom: 0in;"><span style="color: orange; font-family: Comic Sans MS, cursive;">FUNGSI SODIUM/NATRIUM:</span></div><ol><li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Kawal konsentrasi dan isipadu ECF.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Kesan kepada pengagihan cecair antara ECF dan ICF.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Konsentrasi normal Na+ intravaskular untuk mengelakkan retensi air dan kehilangan air berlebihan.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Elektrokimia untuk kontraksi oto dan penyalur impulse saraf.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Penting dalam atur kawal asid bes.</span></div></li>
</ol><div style="margin-bottom: 0in;"><span style="color: #134f5c;"><br />
</span></div><div style="margin-bottom: 0in;"><span style="color: orange; font-family: Comic Sans MS, cursive;">FUNGSI POTASSIUM:</span></div><ol><li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Memainkan peranan penting tekanan osmotik untuk mengekalkan kandungan cecair sel yang normal.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Mempengaruhi imbangan asid be.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Penting bagi semua tisu otot berfungsi normal,khasnya aktiviti otot kardiak.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Diperlukan untuk menukar glukosa ke glikogen.</span></div></li>
</ol><div style="margin-bottom: 0in;"><span style="color: #134f5c;"><br />
</span></div><div style="margin-bottom: 0in;"><br />
</div><div style="margin-bottom: 0in;"></div><div style="margin-bottom: 0in;"><span style="color: orange; font-family: Comic Sans MS, cursive;">FUNGSI FOSFORUS:</span></div><ol><li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">komponen penting dalam struktur gigi dan tulang.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Metabolisma sel untuk penyerapan glukos dan gliserol dalam usus dan penghasilan enzim untuk proses oksidasi dan penghasilan tenaga.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Menjaga imbangan asid bes.</span></div></li>
</ol><div style="margin-bottom: 0in;"><span style="color: #134f5c;"><br />
</span></div><div style="margin-bottom: 0in;"><span style="color: orange; font-family: Comic Sans MS, cursive;">FUNGSI KALSIUM:</span></div><ol><li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Penting dalam pembekuan darah.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Membantu mengawal atau kontraksi dan relaksasi otot.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Berperanan penting dalam transmisi impuls saraf.</span></div></li>
<li><div style="margin-bottom: 0in;"><span style="color: #134f5c; font-family: Comic Sans MS, cursive;">Mempengaruhi ketelapan sel.</span></div></li>
</ol><div style="margin-bottom: 0in;"><br />
</div><div style="margin-bottom: 0in;"></div><div style="margin-bottom: 0in;"><span style="background-color: #eeeeee; color: #a64d79; font-family: Segoe Print;">DONE BY:</span></div><div style="margin-bottom: 0in;"><span style="background-color: #eeeeee; color: #a64d79; font-family: Segoe Print;">AZEYA</span></div><div style="margin-bottom: 0in;"><span style="background-color: #eeeeee;"><br />
<span style="color: #a64d79;"></span></span></div>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com0tag:blogger.com,1999:blog-4212104789974226897.post-68398766797841073292011-08-21T20:11:00.000-07:002011-08-21T20:11:22.283-07:00INFLAMMASI<span style="color: purple;">DEFINISI</span><br />
<ul><li><span style="background-color: white; color: #38761d;">respons pertama imuniti badan kepada infeksi dan iritasi yang menyerang badan.</span></li>
<li><span style="background-color: white; color: #38761d;">merupakan satu proses segera di mana tisu badan bertindak kepada kecederaan fizikal /serangan mikrobe pathogen.</span></li>
<li><span style="background-color: white; color: #38761d;">adalah tindakbalas tisu vaskular dan sel-sel darah putih dan tisu pengikat untuk membantu tisu yang diserang dengan membentuk eksudasi protein.</span></li>
</ul><span style="color: purple;">PENYEBAB INFLAMMASI</span><br />
<ul><li><span style="color: #0b5394;">kecederaan fizikal-jatuh,terbakar,kecederaan jalan raya</span></li>
<li><span style="color: #0b5394;">mikrob-bakteria,virus,parasit,fungi</span></li>
<li><span style="color: #0b5394;">terkena bahan kimia-asid,alkali,organik</span></li>
<li><span style="color: #0b5394;">kekurangan bekalan darah ke tisu</span></li>
</ul><span style="color: purple;">FUNGSI INFLAMMASI</span><br />
<ul><li><span style="color: #741b47;">memusnahkan bahan asing</span></li>
<li><span style="color: #741b47;">menghentikan pendarahan</span></li>
<li><span style="color: #741b47;">memakan tisu-tisu nekrosis dan bangkai mikrob</span></li>
<li><span style="color: #741b47;">membersihkan tempat yang terlibat</span></li>
<li><span style="color: #741b47;">membawa bekalan darah,nutrien dan oksigen yang betambah</span></li>
<li><span style="color: #741b47;">membantu dalam proses penyembuhan</span></li>
</ul><span style="color: purple;">FAKTOR YANG MEMPENGARUHI INFLAMMASI</span><br />
<ul><li><span style="color: #b45f06;">bekalan darah</span></li>
<li><span style="color: #b45f06;">tahap nutrisi</span></li>
<li><span style="color: #b45f06;">usia</span></li>
<li><span style="color: #b45f06;">penyakit-eg:diabetes,uraemia,cirrhosis liver</span></li>
<li><span style="color: #b45f06;">edema/dehidrasi</span></li>
<li><span style="color: #b45f06;">pengambilan ubat-eg;steroid,kemoterapi</span></li>
</ul><span style="color: purple;">KESAN INFLAMMASI</span><br />
<ol><li><span style="color: #a64d79;">Setempat/Lokal</span></li>
<li><span style="color: #a64d79;">Am</span></li>
</ol><span style="color: purple;">KESAN SETEMPAT</span><br />
<ul><li>Boil/Furuncle</li>
</ul><img class="rg_hi" data-height="73" data-width="73" height="320" id="rg_hi" src="data:image/jpg;base64,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" style="height: 73px; width: 73px;" width="320" /><br />
<br />
<ul><li>Abscess</li>
</ul><img class="rg_hi" data-height="194" data-width="259" height="194" id="rg_hi" src="data:image/jpg;base64,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" style="height: 194px; width: 259px;" width="259" /><br />
<ul><li>Carbuncle</li>
</ul><img class="rg_hi" data-height="185" data-width="272" height="185" id="rg_hi" src="data:image/jpg;base64,/9j/4AAQSkZJRgABAQAAAQABAAD/2wCEAAkGBhQSERUUEhQVFBQVGBgWFhQUFxUXFBcVGBYVFxcVFxcXHCYeFxojGRQUHy8gJCcpLCwsFSAxNTAqNSYrLCkBCQoKDgwOGg8PFywcHCQsLCwsKSkpLCksKSkpKSksKSkpKSkpKSwpKSkpKSkpKSkpLCksLCwsLCkpKSwpKSkpLP/AABEIALkBEAMBIgACEQEDEQH/xAAbAAACAwEBAQAAAAAAAAAAAAADBAECBQYAB//EADkQAAEDAgIIBQQBAwMFAQAAAAEAAhEDITFBBBJRYXGBkfAFIqGxwRMy0eHxFEJygrLCBiMzUnMV/8QAGQEAAwEBAQAAAAAAAAAAAAAAAAEDAgQF/8QAIxEBAQEBAAICAwEAAwEAAAAAAAECEQMSE2EhMUFRFCIyBP/aAAwDAQACEQMRAD8A4gMgQMAhVAmXBBeF1MsbxV41SM1gLotK0eXFYul0NUrmt7eLXHM9LrykKEVN5eUhe1UBC8paLhEIngPz+0cCjHwvQoIXpQEhagqktaGmLTA5Th3gssNRdHrxaBe07O7LWaGkakWN8hMQ3dhjBQvqyTcEZ2tOzaUN1UC8zjhe/wATPogVXkkA2wiLATeI5rdoTUdMGBhHYEQo1TF4E4YT7yjaxIgAaotrQAOU/tLsde2fUnesgw4YDzHYG7duHsg6RSjE3wI2DfvR3vsA0kuOJk9OXeCXLJEgZdSCJHqihWnUEEb5nPghgwvFEpAT8cj8wshZzzA2kdlVYy8jKMfdFq0yCdxx2SgOsnTF0kjIRN/z3uQWUiSAM0dgwnME7pQTUvItaEUlFCsGT36rzwJss8CqkhS1q8BbuUcCq8iuiTKpqp8CqtTZJAGaqn/CaMumMEpPyHYvQHph4QHhdLJT6ckrI8Z0eBK39Fb5nLP8YoyCuK/+nfzvjc0FVSQoVHE8r1GRv/d1ReQFkQA4DO3OyEmmkfUkbSRsyKcBZzb98FLWHoE62jrScveQe+aqKYnPs7OCfD4VIPSyIylsv8/jJN0tEE3Nj8XMbcPVeFL+4CJuN+PfJPg4E5gjVJmDaPTgLqdIoOxOwHfGFvwjAicMINovGXexXN26xuBaJvEgiOcpgt9TyGdwaO+fRCiRhEX49xCb/pzUcbAQJkbTfmr/ANKA65ndjbAevulwygouicOHr6KaTDItIBsL49j0T1ZgAAaJbMSDnB9oCk12saBAkZnPECE+EDS0EPwGraeYx9bJSo0AxlF/e2/Jab6obRk/c+18rLJrMMg5GYPBZOzi76mUzGHBBa63D1VagvhCol0j9B4jgHQd5m57yQH0zq7d+4T6IIeYjkrMqWg2EySn0kOYRz/KswATuw2TI9MU2+gC120EH2mTwPVL0qYJvhf0BhPgBpYhXgCQRhsxRhSgGBNhHMTCt/TyBEnaJzN/VEgKloj4VdYZBPOEDmZtlFrbbJTVE7jhxRYA4WloQc0WskaDZcF0OiaOpW8W8ePZvPCXeE29qXeF1ucGiYeN6B4s3Yr1nRB3ounU9ZgK5PJOad/ivcccVpLIcUJNeINh5SwhOOTX4rwCsG3AVWhXnqP0mXF6DQZ2fowEwykNboTwt6kk9VXQaEmTsPI7UctiL4w2M8Zv09luHINowBnCABnht94Xv6QcJP4/YRKFEt2Y6xwwj9q9RhLRuMdbzvwS/TXOgVmCzWHec7nHliifT8kbL77dj1V6VHVvyHKf2ndQfTnAiLbYm/sjpydZdLRbEnMgnZlh3miV4bBi2XD4RKNTVlpwIn3w6q2nEOsN07YAstMgNJEloMECPX8KrqUyJ/t6xh1TEarQMY6xP59lZtHzWgwBz2+pRRITddrQJkXECwg3PqByXtIIg6wBtIPDBGfSMyMfS4H7Q9JBM2w1eFv25BFKhNtbOf59T6Ijm65BNhrEDc0XAjorBpkzBgCJ4W9SmjTbLhFm59Lb8AiQM3SsdbEZdP4ulXmT+LLQq0iT/kbDaBYBU0jRdUxEm2Gc4z7JWFwgdyluSM5hvbZfLOIUikJAkSLSMOKXBw7o2kgTOYk54uJPwg0GDV1sv2f0hvZAtbsqwYQ0O5EbsLrVpyDNcA8DZEDrb1K88Q7Ze3pHwhlmsYvIzzIi3NXidWcukj2smT1R0OM3tfjePykKrb2Rq2kTu2+qFTjvgflKgTw6nL11WjUoCxfBtGz2ldIxsBc2nb4M8h2oEtUCbqBLVAu957M8Tswo2gVQ+kheK/YUh4HpUeUrn8sdPg1y8JeNaPeVlFq6fxyjaVz9anhwWJ+h5c/9g/pWlHpUpNsNiljIFxxPwj0KcYce+SbEijGarjGBtttP69E46hFtwM/jnCt9Ma3IR6pz6WBjD0E2R1qZJ3mcojmUy0nPIk84IHqqfaRad355orGOnCNgHHG/dk7Tk/xH07b/AGHZKmoSZynCDl37ImkUDA1be9s1elouZInqemSOw/WlqdMfccQFfRz5zac91rc80y7w6L4ndh0V20JJmRGIkCU/YvSgUaY+p5zaOZx/aLToWJFiTA4E/wAJilQDTYG2yDzM8VapWDQQBliAR6m+JPRZttbmZP2Q0rRAHC/8g4JbSKVidv4Jjqm6ji4XteZPoquwiNoH8Leb/qWp/jPFMxe15PFANI2i2ZtdOPoyYEx+r8E5oujCZOyGtAnd8It4JO0D+gJZrvkRERHtySVXSx9oadknGc/crf09uqyCPNsyEnMbeSxqdAa09znxhYmv63rPPwSFMwRBg3iMclDdFuXbTYc++i0NJ0jENvkXG43lJa5AIxNsdl7DqnKxcp+mBIJxDr8wPZed5QLXNxw2IOvFzjlsQqlcuLRssi0fo4xwc2cCOoIIv09krVbLonbE4YTirfVgAYyD1uAg03QROydxiy31hQMtOP5nDoqAyURgwz9rQpo0pdbaISokb/htOwhalV8CBmgaDQ1WojbmVHOfbTt1r0w1qrUrUCertSdQLtecyvFR5CucpPiCMQum8UHkK5fVspbUy3Pr/UprG0i0iNia0CtYhUrMk2xUp+FtXvFKDZF7T0TFGCbXEoLKMkSbc1pUGBoAHXEpXQmXiIbfHYMkUMkQ02Ge/wDKm2Z/KZ0dgyWLVc57Q9H0Zoyk7042kcuZXm2+E1ojCfc7BnxS66c4kL/0QM427BTTfDhq3N+MCyPUZBtsi0ei9TbrESLzcxffbPgjq+fD39QH+hJGPIzwtaVT6ZbIc0W3E/sLS0fyi8xgBbGRcjhuKO/RZMlu7Wbds4CZmDzzTmmdeLn8YctdeHRzIG++Sq7RdYkuBiZk28oG2OC16nhod5SLjEGG2jEEEbDYiED/APIaMjbAzaeH4T6jfFSZ0Vh+1hJ2uNrGbTBwySulaJDrNcP8rD5XQUxvkxA1ZB3WiPRUdo4gm04nWkeljhnfFZ9+M3xdc6dAdjGO0Q3cBNpRj4Y+mJdBzsbRYbFuUoAmXRtkNAzEbt+5KaVRcSPN9174wJI73o97Wp4ZIxNIq2uTfKIk8UH+gMTGO/y52O3gtJ+iZmAOF78+5VXszcbDIY84wR7fxO+L+1mDQjnhsGfHYmaWgMIJe1oGW3gj0QDJEHvDgvOBfMxHeFkroekYmkeHGfJhNgfjck62hOGDY6X2rfewC2J/9jldDq4Xx34XWppG4c7WF854cUKPx30WxpDQSLYjYka9MDDD5lUl6lcgaTDSIy+ZWl4HoOsdc8uKy6NLWdG9djo7QxoS1pvxY7e1erYQMV6mxUbe5RmBW8eORPzeT3v4/TWrhJVE9WCTqBUQZfiTZYVzA0eV1fiX2Fc1NljTWVGkCwTTQk2O8wTzQo6WytTcmGGL495IdFu1NUKZJ8oJOwXPILCsSxusZI5J1jQAg02FMtZjbr+Ak6MRejTlwGG9auj6MG6sEDHre42JDRWtOOG4TfZbBabG+WIvI3cfjosujM4A9upAM+a44Zei63RvC9GrNE/eG2IGq45kGLWMwsWpo/1CHzDgA24s+BaNl7StLRHajQ0t89/MHRbgcMMd+SxZavddzyXlT4H4SX13MvqwTBFiMgSBtHFNeKaEKbzFg6QYi0E+U3M3Ge3gijTC0scHAEAggWcM8xsOO9Jaa9pAPW1u8cVqfpjW7axvEHkOA1pOWs0W4TgMLIdKm6PtBzkPjfkFo1wHNdAJ2E4bSCYxueqVFBkfbBH90wc9mPJPrPA3Mc6xEDaSYPG6WqeHOdiARuNotkMbJms24lxO6J/RwzRtGcBZwdOyYxIjDKARgs9a9S50UNZrOJIGzbwv7pPS5s2ANm2Lt289y1HuttnCTfkRil9IdIw3zjc54dwj2h+v5+mYdEjKTvkEZbkL+jDvuHz+k9qDfyn8Tmg1Iyx4m2+/dljo1mF6mjwCA0EbQlywxEg5J2s02mwhJVHxhJ3fz8Jxz6hJ9G+Mpaq2B3fenpxz5flKVXTlb1VI57CRF753H6QNIpmZytZO1BJEWxVC3y8FpGwv4fRH1FtuuQNix6btVy1NFacTiVTE7Wda9c2GWBGYhtCMwLpcrSqlLPTNUpV6AzfFfsK5WrUgLqvFPsK5YslY03lTRRLlpYJWiyEw/BSqmT2g0ARJzNhwwWxoZqUiC0QYkEi+WHRIeHgQLxETGz8rf0jxQGm0QDq2Frwpar0PFj8TkIvoWDg6STcXBBnsozdH435KWMG2c90zkpdWEDPjtv0WXRcyUSlR9NhPf8JllIYdO8rIVLCfYY5C2Q4ptgOzft2Y9FiqyL0Nt4A43tmc05ouk3uMM+8cfQbAgU6c+u3dHqiQbY/yj2K5a1KpcwBYQcdZ0NFrYCFTSXQIkNnACPbE2lKaNpWrAvjLjad/yrvr60+YgWOV3XHLFa9pxn0LuBjaZzOWzDehsxg26+0ojqRyiM+KhzOSlapMoLADYc15jfNlxNuIgnuArspWw4/lWqMtgPfvFZmgXcwX1ewqVqFr47rdUVjIuEQE8+7JewZ1Sif42j+R1QnNth+lp1Kc97ckjVpGdh6BOFWbUbnJtlAHp0QnNJxywtYJ2ownKNt0Fp9dnqf0VbMSsJ1NHi5skNIgFbR0N9SwGtlqgX477TdLVqTbgi4GFrFa7xP4/ZgOMQrESi6fogYRnrCRG2cEJl4W3DfxbKWcPMOK2mBZbmj6jVrMCv45+HN5P2KwIzAhsCMxVTN1SlqhTFVLPQCHiX2Fc22nGK6PxI+QrnhV1ljbeUsF0ZwsoIFoVicd6lVIf0F1ojZ0WrTfAiM81jaG4tIha31ZMzzUrOvQ8Pk5ngzqkWkotI4ZxmckAPPDejU2rNXmunqHlDiAIttk7+fyjMlKUgZuexgnGd95/pT06IapttA5390yWgel96UZTO/km6A47wpWko5i82iZF01qEixHHFEND+UvYdLtZl3mjChIRPp8++/2iAJdFpf6Y3e6o5ia1UMt48VkFHC+0qjgnf6eZOW9ANEZcOaYKuMXg8roTXAmcu5kcE+0FuIB44LPrsvgOPfFU/EYKvaML+44dEm9oBMHHHZ1yTdRkZD54JGo0DA8pWppm0U6U9o/7cA2uLRhgszS3wfMLn7s5KdoaXqyCA7jkgOGvNha9rRPLb7q0krn3uszTNDcPMbBJUBbgndL3pRrbLc/Dl1/qP728VrNCyKf3t4rYYujH6cu/wBisR2oLUVpVEx6qXeUao5LPcgiPih8hXP0RZbviR8hVP8Ao/wunXrhtQw333KelMsgFFZktf8A6s8Kp0NILKJltuR2LKDYIU6pDlEJyk+EpRcmWvU66cGWuTVIpSk5HY5TrrxT1F99+9aGjn+Vn6PjPcLVoiVHVdEo1PuSmA2EvQafnvcnBhA2qVMSnH6RmCPXZ87lWm2MEem2/ZCyygMH4w6oraQjpgOt15tPGO93e1WDcoxM98/dBdAczsXXnDmjhp7tyUakoPoH08v4S9Rpy63lOup9+6D9PJHTlCY3Dd1nCUlXpXIT4pEWN+vTeg1qMnBbJjaXRnDLCI9UnWoWW1U0fnvWfVp442Of8IlKsCvSgnGeKHS0ksnC4WrpFDYs2to6vnTn3lnVSgMCarU0uBiFXNc2wmt87b3larFks+8cVqtXVj9OPf7HYitKA0orSqJiVHJZ7leo5Ac5AA0lmsIStLRtQyDCbcUJ5SpwppdzKE4YcFfSnYKALqG1sDh15TFNCp05TVKhwUq6MiMunaI2KtPR7cvlN6PQm6lrrqwY0aj+cVpUmwPdA0dg2cHZp2jTPTby9VLUq0ooeOH7Tejgb0KnQ7+U1RpELHKdojGg7O8UT6AXqdNHa1Z4z0P6e5TrYZIobx6BST6o4OqccVAbh7WRHScfhec05ooALVGoM0XU7heNLYlxrqgYOKU0hnmwnhwTupGEckvWpzhitcBF7dySrMnJaT28OCVqDiEQMivQWZpFJbOkNjZyWbpLFTKemRXpJJ1O/VaekBIVDBXRly7IRDhxC02lZ2kDzDZKfaV14cOxgURrkAFEDlRhD3oLnKXFCcUMoc5Be5WeUB7lmtQGsZIRtHZtS2tLk1SUNWL4hxibpG/cJSkxOUmKGtOvGTlB3fNO0O7JSiLfCfoHJRunTmH6FWLiOCYY+TxucktTamabc/2p21SQzSnvemWvKBTICYadyyBmorZjFCa1EA3cEmVw3K90RrFWkydyu1sb0+F140oG1QRuRI6oeteO/wBpF1S699QjapBPfyhGZw5j2TNDqm5BdU2KzkB4P8pytIfVnAJaq/v8qzztQqjeu1blLhWrwlIVm7k7Vp4pSqCqTTNZleluv1WfXoLXqkpCuSVWWIajF0mgY4JhpRqu9Lg5dF04rh8mRgVYOQgVYFWQKUNPY9oIcL5EiZ2QpNYbR1XGryn7nx1r6o2hL1K42jquaULN0bp6LRuTtNoXGBFao2L539O6aZiThZNUyNq4AJhmIU7heeb6fRqJbmQNidokd+6+aNxbxR8ln4vtSf8A0fT6hSeIy9E3Tg5hfJxkmNHwPD8JfD9tf8j6fV21GxJI62F4TFEh2Bnhfv8AS+Q0/t72hM6H9zf9Xyl8P2P+R3+ProuikwJv0J9l8io4nvYn6WA4tR8P2Pm7/H1Mg4R3yCkWuflfMWZd5le0z7T3kl8X2Pk+n1FzTHvOW/BVLhsv06HNfMR9r/8AE+wXqf2D/BvuEfF9j5Pp9M9+Co4n458Fwh/8v+koYwf/AJj/AGpfF9tfJ9O7LUB7Q6eh+bLjdAwH/wBD/vKFR/8ALV4j/kl8fP6c8n0651PGyAaPFYei/wB/+X/EIf8AdyHuj0b92vUYUo+icVjUMXcfgo7PuH+Kfrwvfo9akUhVpJkflY2k/c3/AFf7VvMY1RatJAfSC9W+5n+J+FV/5VYhrgRftQ9I0lrGkuIAjmUHSO+qxfHMW8D8Lozq8cW88r//2Q==" style="height: 185px; width: 272px;" width="272" /><br />
<ul><li>Sinus</li>
</ul><img class="rg_hi" data-height="194" data-width="259" height="194" id="rg_hi" src="http://t1.gstatic.com/images?q=tbn:ANd9GcRCwiUcWrff-wKGecY_JBcRZZ8IU-4Xbhd1PPs3nM0hmogJzHDW4g" style="height: 194px; width: 259px;" width="259" /><br />
<ul><li>Fistula</li>
</ul><img class="rg_hi" data-height="194" data-width="259" height="194" id="rg_hi" src="http://t3.gstatic.com/images?q=tbn:ANd9GcSSIqMjGzbNtKfdbGD-OUYtFMTW3R80BdkgEHDuGqzxoqpyGX_H" style="height: 194px; width: 259px;" width="259" /><br />
<ul><li>Ulcer</li>
</ul><img class="rg_hi" data-height="256" data-width="197" height="256" id="rg_hi" src="data:image/jpg;base64,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" style="height: 256px; width: 197px;" width="197" /><br />
<ul><li>Cellulitis</li>
</ul><img class="rg_hi" data-height="183" data-width="275" height="183" id="rg_hi" src="http://t3.gstatic.com/images?q=tbn:ANd9GcQcams5S2uMFIt5_PkSHUY4aGORYdxhEI9JkwSMbdDmU7sxv-5C" style="height: 183px; width: 275px;" width="275" /><br />
<br />
<span style="color: purple;">KESAN GENERAL/AM</span><br />
<ul><li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #351c75;">Toksemia</span></li>
<li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #351c75;">Septisemia</span></li>
<li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #351c75;">Pyemia</span></li>
<li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #351c75;">Lymphangitis</span></li>
<li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #351c75;">Lymphadenitis</span></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: purple;">TANDA INFLAMMASI LOKAL</span></div><ul style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #bf9000;">Kemerahan(redness)-akibat vasodilatasi</span></li>
<li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #bf9000;">Kepanasan/heat(local temperatuure)-haba yang dirasa kerana pertamahan pengaliran darah</span></li>
<li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #bf9000;">Bengkak(Swelling):mediator meningkatkan permeability salur darah > histamine, bradykinin, prostaglandin, serotonin</span></li>
<li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #bf9000;">Kesakitan(pain) > hujung saraf ditekan oleh cecair berlebihan</span></li>
<li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #bf9000;">kehilangan fungsi(loss of function) > sakit sebabkan tidak mahu bergerak</span></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: purple;">TANDA INFLAMMASI SISTEMIK</span></div><ul><li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #45818e;">Demam-akibat tindakan leukosit dan makrofaj</span></div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #45818e;">Leukositosis-tinggi paras WBC kerana reaksi kepada serangan benda asing</span></div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #45818e;">ESR tinggi kerana pertempuran dengan serangan</span></div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #45818e;">Nausea/sakit kepala-tindakan badan kepada serangan awal infeksi</span></div></li>
<li><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="color: #45818e;">Letih dan lesu-reaksi kepada inflammasi</span></div></li>
</ul><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div class="separator" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; clear: both; text-align: center;"></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com1tag:blogger.com,1999:blog-4212104789974226897.post-88227731919044570412011-08-13T01:07:00.000-07:002011-09-11T23:40:44.867-07:00surgical crews<strong><span style="color: red; font-size: large;"><em>MENANGGAL BENANG BEDAH/SUTUR</em></span></strong><br />
<span style="color: red;"><br />
</span><br />
<br />
<strong><span style="color: #990000;">SUTUR</span></strong><br />
<br />
<span style="font-family: Arial;"><em><span style="color: blue; font-family: Times New Roman;"><strong>DEFINISI</strong></span></em></span><br />
<span style="font-family: Arial;"><span style="font-family: Times New Roman;">1.Bahan yang digunakan untuk menjahit.</span></span><br />
<span style="font-family: Arial;"><span style="font-family: Times New Roman;">2.Doktor mengunakan jarum surgikal</span> untuk mencantumkan kulit,organ-organ</span><span style="font-family: Arial;"> dalaman,</span><br />
<span style="font-family: Arial;"> saluran darah</span><span style="font-family: Arial;">dan semua tisu dalam badan yang telah luka melalui</span><br />
<span style="font-family: Arial;"> kecederaan ataupun pembedahan.</span><br />
<br />
<em><span style="color: blue; font-family: Arial;"><strong>TUJUAN SUTUR</strong></span></em><br />
<ul><li><span style="font-family: Arial;">Menutup/mencantumkan luka</span></li>
<li><span style="font-family: Arial;">Membantu dalam proses penyembuhan luka</span></li>
<li><span style="font-family: Arial;">Mengekalkan/menetapkan kedudukan <em>prosthesis</em></span></li>
<li><span style="font-family: Arial;">cth:tiub saluran/drain</span></li>
</ul><em><span style="color: blue; font-family: Arial;"><strong>KAEDAN ALTERNATIF PENUTUPAN LUKA</strong></span></em><br />
<ul><li><span style="font-family: Arial;">Staple</span></li>
<li><span style="font-family: Arial;">Tape(steri-strips)</span><span style="font-family: Arial;"> </span><span style="color: blue; font-family: Arial;"><em><strong></strong></em></span></li>
</ul><span style="color: blue; font-family: Arial;"><em><strong>SAIZ SUTUR</strong></em></span><br />
<br />
<ul><li><span style="font-family: Arial;">Dinyatakan dalam bentuk angka</span></li>
<li><span style="font-family: Arial;">Menggunakan angka 0(sifar)</span></li>
<li><span style="font-family: Arial;">Jumlah bilanagan sifar yang semakin banyak,bermaksud diameter sutur semakin berkurangan</span></li>
</ul><em><span style="color: blue; font-family: Arial;"><strong>CORAK SUTUR/JAHITAN</strong></span></em><br />
<ul><li><span style="font-family: Arial;"><em>simple interrupted suture</em></span></li>
<li><em><span style="font-family: Arial;">continuous suture</span></em></li>
<li><em><span style="font-family: Arial;">blanket continuous suture</span></em></li>
<li><em><span style="font-family: Arial;">mattress suture</span></em></li>
<li><em><span style="font-family: Arial;">retention suture</span></em></li>
</ul><strong><span style="color: blue; font-family: Arial;">SIMPLE INTERRUPTED SUTUR</span></strong><br />
<ul><li><span style="font-family: Arial;">setiap sutur disimpul secara berasingan di sepanjang luka</span></li>
<li><span style="font-family: Arial;">paling biasa digunakan oleh doktor ntuk menjahit luka pada kulit klien</span></li>
</ul><span style="color: blue; font-family: Arial;"><strong>CONTINUOUS SUTURE</strong></span><br />
<ul><li><span style="font-family: Arial;">sutur adalah dijahit secara berterusan di sepanjang luka klien</span></li>
<li><span style="font-family: Arial;">menggunakan satu sutur/benang untuk dijahit pada luka klien</span></li>
</ul><span style="font-family: Arial;"><span style="color: blue;"><strong>BLANKET CONTINUOUS</strong> <strong>SUTURE</strong></span></span><br />
<ul><li><span style="font-family: Arial;">dua sutur dijahit selari di sepanjang luka</span></li>
<li><span style="font-family: Arial;">sesuai dijahit pada bahagian badan yang tegang</span></li>
</ul><strong><span style="color: blue; font-family: Arial;">RETENTION SUTURE</span></strong><br />
<ul><li><span style="font-family: Arial;">sutur dijahit secara berasingan di sepanjang luka</span></li>
<li><span style="font-family: Arial;">tiub getah dimasukkan disetiap sutur</span></li>
<li><span style="font-family: Arial;">sesuai digunakan untuk mencantum luka pada bahagian abdomen klien yang gemuk</span></li>
</ul><strong><span style="color: blue; font-family: Arial;">BILAKAH SUTUR DITANGGALKAN?</span></strong><br />
<span style="font-family: Arial;"><strong>-</strong>Muka:3-5 hari selepas pembedahan</span><br />
<span style="font-family: Arial;">-Kepala:7-10 hari</span><br />
<span style="font-family: Arial;">-Kaki&Tangan:10-14 hari</span><br />
<br />
<strong><span style="color: blue; font-family: Arial;">PERALATAN YANG DIPERLUKAN</span></strong><br />
<span style="font-family: Arial;"><strong>-</strong>Semburan antiseptik</span><br />
<span style="font-family: Arial;">-Gunting benang bedah steril</span><br />
<span style="font-family: Arial;">-Stitch cutter</span><br />
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<strong><span style="color: blue; font-family: Arial;">PRINSIP MENANGGAL SUTUR</span></strong><br />
<span style="font-family: Arial;">1.Mula dengan jahitan kedua</span><br />
<span style="font-family: Arial;">2.Menanggal sutur secara berselang-seli</span><br />
<span style="font-family: Arial;">3.Gunting bahagian sutur yang berdekatan dengan kulit</span><br />
<span style="font-family: Arial;">4.Pastikan sutur pada atas kulit tidak tertarik ke bawah luka klien</span><br />
<span style="font-family: Arial;">5.Tanggalkan sutur dengan menarik ke arah luka</span><br />
<br />
<strong><span style="color: blue; font-family: Arial;">KEMAHIRAN PENTING</span></strong><br />
<span style="font-family: Arial;">1.Teknik mencuci luka jahitan</span><br />
<span style="font-family: Arial;">2.Teknik memegang gunting</span><br />
<span style="font-family: Arial;">3.Teknikn memegang <em>tooth dissecting forceps</em></span><br />
<span style="font-family: Arial;">4.Teknik mengepit sutur</span><br />
<span style="font-family: Arial;">5.Teknik meletakkan gunting benang bedah</span><br />
<span style="font-family: Arial;">6.Teknik menanggal sutur</span><br />
<span style="font-family: Arial;">7.Teknik menyembur dengan semburan antiseptik </span><br />
<span style="font-family: Arial;">8.Teknik merekod dalam laporan jururawat</span><br />
<span style="color: blue; font-family: Arial;"> </span><span style="font-family: Arial;"></span><br />
<strong><span style="color: blue; font-family: Arial;">TEKNIK MENCUCI LUKA JAHITAN</span></strong><br />
<span style="font-family: Arial;">1.Cuci insisi luka dahulu</span><br />
<span style="font-family: Arial;">2.Cuci bahagian luka yang jauh</span><br />
<span style="font-family: Arial;">3.Cucu bahagian luka yang dekat</span><br />
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<strong><span style="color: blue; font-family: Arial;">TEKNIK MEMEGANG GUNTING</span></strong><br />
<span style="font-family: Arial;">**Pegang gunting dengan tangan dominan</span><br />
<span style="font-family: Arial;"> </span><br />
<strong><span style="background-color: white; color: blue; font-family: Arial;">TEKNIK MEMEGANAG TOOTH DISSECTING FORCEPS</span></strong><br />
<span style="font-family: Arial;"><strong>**</strong>Pegang tooth dissecting forceps dengan tangan tidak dominan</span><br />
<br />
<span style="color: blue; font-family: Arial;"><strong>TEKNIK MENGEPIT SUTUR</strong></span><br />
<span style="font-family: Arial;"><strong>**</strong>Kepit simpulan sutur dengan tooth dissecting forceps</span><br />
<span style="font-family: Arial;">**Tarik sutur ke atas</span><br />
<br />
<strong><span style="color: blue; font-family: Arial;">TEKNIK MELETAKKAN GUNTING</span></strong><br />
<span style="font-family: Arial;"><strong>**</strong>Letakkan gunting di bawah simpulan sutur </span><br />
<span style="font-family: Arial;">**Gunting sutur</span><br />
<span style="font-family: Arial;">**Memberi tekanan lembut pada luka </span><br />
<br />
<strong><span style="color: blue; font-family: Arial;">TEKNIK MENANGGAL SUTUR</span></strong><br />
<span style="font-family: Arial;">**Tarik sutur menghala ke insisi luka</span><br />
<span style="font-family: Arial;">**Letakkan sutur yang ditanggal ke atas goz</span><br />
<br />
<strong><span style="color: blue; font-family: Arial;">TEKNIK MENYEMBUR ANTISEPTIK</span></strong><br />
<span style="font-family: Arial;">**Pegang botol dgn tangan dominan</span><br />
<span style="font-family: Arial;">**Goncang botol semburan</span><br />
<span style="font-family: Arial;">**Buka penutup botol</span><br />
<span style="font-family: Arial;">**Letakkan jari telunjuk di atas pemicit semburan</span><br />
<span style="font-family: Arial;">**Tonggegkan botol semburan</span><br />
<span style="font-family: Arial;">**Sembur sedikit semburan di kawasan udara</span><br />
<span style="font-family: Arial;">**Halakan bukaan semburan 90' atas luka </span><br />
<span style="font-family: Arial;">**Sembur luka dari jarak 15-20cm dari luka</span><br />
<span style="font-family: Arial;">**Tambah semburan 2-3 kali mengikut saix luka klien</span><br />
<br />
<span style="color: blue; font-family: Arial;"><strong>TEKNIK MEREKOD DALAM LAPORAN JURURAWAT</strong></span><br />
<span style="font-family: Arial;">**Guna pen hitam</span><br />
<span style="font-family: Arial;">**Tarikh</span><br />
<span style="font-family: Arial;">**Masa</span><br />
<span style="font-family: Arial;">**Jenis jahitan</span><br />
<span style="font-family: Arial;">**Jumlah sutur yang di keluarkan</span><br />
<span style="font-family: Arial;">**Keadaan cantuman luka</span><br />
<span style="font-family: Arial;">**Keadaan klien</span><br />
<br />
<br />
<img class="rg_hi" data-height="158" data-width="248" height="158" id="rg_hi" src="http://t3.gstatic.com/images?q=tbn:ANd9GcSRH_v4rORj6bGMOsut2z0ESzD4_vNhgKp4qAxjYofHuoueFDFF" style="height: 158px; width: 248px;" width="248" /> <img class="rg_hi" data-height="197" data-width="256" height="197" id="rg_hi" src="http://t1.gstatic.com/images?q=tbn:ANd9GcT0XqYbcGCQE_QLdhAbZpa9K1ufriMTYgLtwt-LzmroIW6ttnX1GQ" style="height: 197px; width: 256px;" width="256" /><br />
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<strong><em><span style="color: purple;">DONE BY:-</span><span style="color: magenta;">AZLIZA SUZANA ISMAIL (001420)</span></em></strong>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com0tag:blogger.com,1999:blog-4212104789974226897.post-87850388905737055502011-08-12T19:03:00.000-07:002011-09-11T23:44:56.558-07:00Tiub saliran (drainage tube)<div style="background-color: #eeeeee; color: #351c75;"><smallfrac m:val="off"><dispdef><lmargin m:val="0"><rmargin m:val="0"><defjc m:val="centerGroup"><wrapindent m:val="1440"><intlim m:val="subSup"><narylim m:val="undOvr"></narylim></intlim></wrapindent></defjc></rmargin></lmargin></dispdef></smallfrac></div><div class="MsoNormal" style="background-color: #eeeeee; color: #351c75;"><span style="font-family: "Kristen ITC";">Definisi:</span></div><div class="separator" style="background-color: #eeeeee; clear: both; color: #351c75; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9Wfy4OBbUt0Ps6TicAsQcR60Rj073XK-OMhBlVIgchjGevUXVR_RJg7bsb6t0SG-7pt3vMIfeTZbXBm_EpQ559j6lxRTNwG-EGU0Df16OYbsOzU9FFvjGrrHE5f4nM82Dc-gPI-VICV4/s1600/Disposable_Drainage_Tube.summ.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="170" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9Wfy4OBbUt0Ps6TicAsQcR60Rj073XK-OMhBlVIgchjGevUXVR_RJg7bsb6t0SG-7pt3vMIfeTZbXBm_EpQ559j6lxRTNwG-EGU0Df16OYbsOzU9FFvjGrrHE5f4nM82Dc-gPI-VICV4/s200/Disposable_Drainage_Tube.summ.jpg" width="200" /></a></div><ul style="background-color: #eeeeee; color: #351c75;"><li><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Satu tiub yg di gunakan utk mengalirkan cecair dari kaviti tubuh ke permukaan luar selepas pembedahan/prosuder.</span></li>
</ul><div class="MsoListParagraph" style="background-color: #eeeeee; color: #351c75; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">gg</span></div><div class="MsoListParagraph" style="background-color: #eeeeee; color: #351c75; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">ttTujuan pemasangan:</span></div><ul style="background-color: #eeeeee; color: #351c75;"><li><span style="font-family: "Kristen ITC";">mengalirkan cecair/nanah/darah/serous/cecair hempedu dari kaviti tubuh utk mempercepatkan penyembuhan dan elak infeksi.</span></li>
</ul><ul style="background-color: #eeeeee; color: #351c75;"><li><span style="font-family: "Kristen ITC";">pengaliran adalah mengikut tarikan graviti atau dipasangkan pada tiub penyedut(vakum).</span></li>
</ul><div style="background-color: #eeeeee; color: #351c75;"><br />
</div><div style="background-color: #eeeeee; color: #351c75;"><br />
</div><div style="background-color: #eeeeee; color: #351c75;"><span style="font-family: "Kristen ITC";">Lokasi Pemasangan:</span></div><ul style="background-color: #eeeeee; color: #351c75;"><li><span style="font-family: "Kristen ITC";">dipasang pd satu tebukan lebih kurang i inci dari luka tuk mengelakkan kontaminasi luka dan mengalakkan penyembuhan luka.</span></li>
</ul><div style="background-color: #eeeeee; color: #351c75;"><span style="font-family: "Kristen ITC";"> </span> <smallfrac m:val="off"><dispdef><lmargin m:val="0"><rmargin m:val="0"><defjc m:val="centerGroup"><wrapindent m:val="1440"><intlim m:val="subSup"><narylim m:val="undOvr"></narylim></intlim></wrapindent><br />
<span style="font-family: "Kristen ITC";">Jenis-jenis Drain:</span><span style="font-family: "Kristen ITC";"> </span></defjc></rmargin></lmargin></dispdef></smallfrac></div><div style="background-color: #eeeeee; color: #351c75;"><smallfrac m:val="off"><dispdef><lmargin m:val="0"><rmargin m:val="0"><defjc m:val="centerGroup"><wrapindent m:val="1440"><intlim m:val="subSup"><narylim m:val="undOvr"></narylim></intlim></wrapindent></defjc></rmargin></lmargin></dispdef></smallfrac></div><div class="MsoListParagraphCxSpFirst" style="background-color: #eeeeee; color: #351c75; margin-left: 1.5in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">1.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Tiub silicon</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 1.5in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">2.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Corrugated Drain</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 1.5in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">3.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Penrose Drain</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 1.5in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">4.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">T-tube </span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 1.5in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">5.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Redivac Drain</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 1.5in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">6.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Portex Drain</span></div><div class="MsoListParagraphCxSpLast" style="background-color: #eeeeee; color: #351c75; margin-left: 1.5in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">7.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Hemovac Jackson Drain</span></div><div class="MsoListParagraphCxSpLast" style="background-color: #eeeeee; color: #351c75; margin-left: 1.5in; text-indent: -0.25in;"><br />
</div><div class="MsoListParagraphCxSpLast" style="background-color: #eeeeee; color: #351c75; margin-left: 1.5in; text-indent: -0.25in;"><smallfrac m:val="off"><dispdef><lmargin m:val="0"><rmargin m:val="0"><defjc m:val="centerGroup"><wrapindent m:val="1440"><intlim m:val="subSup"><narylim m:val="undOvr"></narylim></intlim></wrapindent></defjc></rmargin></lmargin></dispdef></smallfrac></div><div class="MsoListParagraphCxSpFirst" style="background-color: #eeeeee; color: #351c75; margin-left: 0in; text-indent: 1.5in;"><span style="font-family: "Kristen ITC";">cara pengaliran: </span></div><div class="MsoListParagraphCxSpFirst" style="background-color: #eeeeee; color: #351c75; margin-left: 0in; text-indent: 1.5in;"><span style="font-family: "Kristen ITC";"></span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">a)<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Open drain</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2.5in; text-indent: -0.25in;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Satu bahagian hujung dimasukkan ke dalam luka dan satu hujung lagi terbuka di luar.</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2.5in; text-indent: -0.25in;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Ditutupi oleh dressing.</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">b)<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Closed Drain</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2.25in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">i.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Gravity Drainage</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2.75in; text-indent: -0.25in;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Tiub dipasang terus ke beg plastic steril/botol utk memebentuk satu sisitem pengaliran gravity tertutup.</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2.75in; text-indent: -0.25in;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Aliran cecair mengikut tarikan gravity dan bekas penerima diletakkan pada tempat yang rendah dari rongga luka.</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2.25in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">ii.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Under Water Seal</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2.75in; text-indent: -0.25in;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Tiub pengaliran dilitupi dengan air pada paras rendah dari rongga luka.</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2.75in; text-indent: -0.25in;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Elak udara atau cecair masuk semula.</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2.25in; text-indent: -0.25in;"><span style="font-family: "Kristen ITC";">iii.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Suction Drainage</span></div><div class="MsoListParagraphCxSpMiddle" style="background-color: #eeeeee; color: #351c75; margin-left: 2.75in; text-indent: -0.25in;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Tiub pengaliran disambungkan ke dalam satu botol yang bervakum.</span></div><div class="MsoListParagraphCxSpLast" style="background-color: #eeeeee; color: #351c75; margin-left: 2.75in; text-indent: -0.25in;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Membentuk satu system penyedutan portable dan tertutup.</span></div><div class="MsoListParagraphCxSpLast" style="background-color: #eeeeee; color: #351c75; margin-left: 2.75in; text-indent: -0.25in;"><br />
</div><div style="background-color: #eeeeee; color: #351c75;"><smallfrac m:val="off"><dispdef><lmargin m:val="0"><rmargin m:val="0"><defjc m:val="centerGroup"><wrapindent m:val="1440"><intlim m:val="subSup"><narylim m:val="undOvr"></narylim></intlim></wrapindent></defjc></rmargin></lmargin></dispdef></smallfrac></div><div class="MsoNormal" style="background-color: #eeeeee; color: #351c75;"><span style="font-family: "Kristen ITC";">Kebaikan cara Pengaliran Tertutup:</span></div><ul style="background-color: #eeeeee; color: #351c75;"><li><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Amaun discaj dapat disukat dengan tepat.</span></li>
<li><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Elak kemsukkan mikroorganisma</span></li>
<li><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Mengurangkan potensi infeksi pada luka</span></li>
<li><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Luka dapat dikekalkan dalam keadaan kering</span></li>
</ul><smallfrac m:val="off" style="background-color: #eeeeee; color: #351c75;"><dispdef><lmargin m:val="0"><rmargin m:val="0"><defjc m:val="centerGroup"><wrapindent m:val="1440"><intlim m:val="subSup"><narylim m:val="undOvr"></narylim></intlim></wrapindent><br />
<div class="MsoListParagraphCxSpFirst"><span style="color: #351c75; font-family: "Kristen ITC";">Indikasi tiub pengaliran:</span></div><ul><li><span style="color: #351c75;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Selepas major operation</span></span></li>
<li><span style="color: #351c75;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Abses</span></span></li>
<li><span style="color: #351c75;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Pneumotoraks</span></span></li>
<li><span style="color: #351c75;"><span style="font-family: Symbol;">·<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Kristen ITC";">Gangguan salur gastrousus</span></span></li>
</ul><div><span style="color: #351c75; font-family: "Kristen ITC";">komplikasi Drainage tiub:</span></div><ul><li><span style="color: #351c75; font-family: "Kristen ITC";">luka tidak sembuh dengan baik</span></li>
<li><span style="color: #351c75; font-family: "Kristen ITC";">boleh berlaku fistula</span></li>
<li><span style="color: #351c75; font-family: "Kristen ITC";">infeksi</span></li>
<li><span style="color: #351c75; font-family: "Kristen ITC";">adhesion(tiub melekat pd tisu)</span></li>
</ul><span style="font-family: "Kristen ITC";"><span style="background-color: white;"></span></span><div></div><div></div><div></div><div></div><div></div><div></div><div></div><div><smallfrac m:val="off"><dispdef><lmargin m:val="0"><rmargin m:val="0"><defjc m:val="centerGroup"><wrapindent m:val="1440"><intlim m:val="subSup"><narylim m:val="undOvr"></narylim></intlim></wrapindent></defjc></rmargin></lmargin></dispdef></smallfrac></div><div class="MsoListParagraph" style="color: #bf9000; margin-left: 1in;"><a href="http://www.youtube.com/watch?v=I-FKZEwPvIE">http://www.youtube.com/watch?v=I-FKZEwPvIE</a></div><br />
<span style="font-family: "Kristen ITC";"><br />
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<div><span style="font-family: "Kristen ITC";"> </span> </div><div class="MsoListParagraphCxSpLast" style="margin-left: 1.5in; text-indent: -0.25in;"><br />
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<div style="background-color: #eeeeee; color: #351c75;"></div>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com2tag:blogger.com,1999:blog-4212104789974226897.post-56477371566728262442011-08-09T03:34:00.001-07:002011-09-09T10:02:10.053-07:00<div align="center" class="MsoNormal" style="margin: 0in 0in 10pt; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="color: #d99594; font-family: Algerian; font-size: 20pt; line-height: 115%;">PENGENALAN ANESTHESIA</span></b></div><div align="center" class="MsoNormal" style="margin: 0in 0in 10pt; text-align: center;"><br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif";">Terminologi</span></b><span style="font-family: "Times New Roman","serif";">:-</span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-align: left;"><span style="font-family: "Times New Roman","serif";">AN = ‘not’, ‘without’</span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-align: left;"><span style="font-family: "Times New Roman","serif";">ANESTHETHOS = ‘perceptible’, ‘able to feel’</span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-align: left;"><span style="font-family: Wingdings;">à</span><span style="font-family: "Times New Roman","serif";">perkataan anesthesia berasal dari bahasa Greek.</span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif";">Jenis-jenis anesthesia</span></b><span style="font-family: "Times New Roman","serif";">:-</span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-align: justify;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjs1DeXXuHtQOxKJUwFPbDzfISCwwZiMJfy0TNbKQtLqJVxsvLOZ53_v-wiORspJwEh8q73Se3-FV4pQNH3aF8XS6MPRf5wdioc1czO6y2B__xI1FL-BIVOOhcPZRlpngGnbynvwdrf3NQ/s1600/imagesCA2NT3QH+local.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" naa="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjs1DeXXuHtQOxKJUwFPbDzfISCwwZiMJfy0TNbKQtLqJVxsvLOZ53_v-wiORspJwEh8q73Se3-FV4pQNH3aF8XS6MPRf5wdioc1czO6y2B__xI1FL-BIVOOhcPZRlpngGnbynvwdrf3NQ/s1600/imagesCA2NT3QH+local.jpg" /></a><span style="font-family: "Times New Roman","serif";"></span></div><ul><li><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; mso-list: l1 level1 lfo1; text-align: justify; text-indent: -0.25in;"><span style="font-family: Symbol;"><span style="font-family: "Times New Roman";"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="color: red; font-family: "Times New Roman","serif";">Local anesthesia</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif";"> </span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif";"></span></b></div></li>
</ul><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; mso-list: l2 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Ketidakwujudan sensori/rasa(sakit,sentuh, panas atau sejuk)pada kawasan setempat tanpa hilang kesedaran.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 56.25pt; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; mso-list: l2 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Kaedah local anesthesia</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 42pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">a.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Suntikan: <b style="mso-bidi-font-weight: normal;">ke dalam kulit</b> (intracutaneous) atau tisu (subtaneous) di bahagian pembedahan </span></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; text-align: center;"><span style="font-family: "Times New Roman","serif";">Contoh ubatan: lidocaine (xyloine)</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 42pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">b.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Topical application: dilakukan <b style="mso-bidi-font-weight: normal;">sapuan</b> ke atasa kulit, membran mukosa.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 42pt; mso-add-space: auto; text-align: justify;"><span style="font-family: "Times New Roman","serif";"> : disapukan k eatas kulit 30-60 minsebelum pembedahan.</span></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 42pt; mso-add-space: auto; text-align: center;"><span style="font-family: "Times New Roman","serif";">Contoh ubatan: EMLA (Eutetic Mixture of Local Anesthesia) cream</span></div><div align="center" class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 42pt; mso-add-space: auto; text-align: center;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 42pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">c.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Spray: dilakukan <b style="mso-bidi-font-weight: normal;">semburan</b> ke atas kulit, menbran atau mukosa.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 42pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-align: center; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Contoh ubatan: Ethyl chloride spray</span><span style="font-family: "Times New Roman","serif";"></span></span></div><div align="center" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 10pt 42pt; mso-add-space: auto; text-align: center;"><br />
</div><div align="center" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 10pt 42pt; mso-add-space: auto; text-align: center;"><br />
</div><ul><li><div align="center" class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 10pt 42pt; mso-add-space: auto; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQdcTE2E1K3ouj4QaNxLM_WJdfqM3rOncsJuAcbN5zv0tKyfYGUxcypage6pHtMw1V3K4C5BevqN9WwRe241RVgpbOmIvchQcli4fu5JLDyOpqI-9s_U3XyfEONFcnDXTSdx9nwuRaErs/s1600/images+1.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" naa="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQdcTE2E1K3ouj4QaNxLM_WJdfqM3rOncsJuAcbN5zv0tKyfYGUxcypage6pHtMw1V3K4C5BevqN9WwRe241RVgpbOmIvchQcli4fu5JLDyOpqI-9s_U3XyfEONFcnDXTSdx9nwuRaErs/s1600/images+1.jpg" /></a><span style="font-family: "Times New Roman","serif";"><span style="font-family: Symbol;"><span style="font-family: "Times New Roman";"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="color: red; font-family: "Times New Roman","serif";">Regional anesthesia</span></b></span> </div></li>
<li><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -0.25in;"></div></li>
</ul><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; mso-list: l2 level1 lfo4; text-align: justify; text-indent: -0.25in;"><span style="font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Pemberian suntikan agen anesthesia ke saraf tertentu untk hentikan stimuli sensori dan motor ke tempat yang perlu dibedah.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; mso-list: l2 level1 lfo4; text-align: justify; text-indent: -0.25in;"><span style="font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Jenis-jenis regional anesthesia</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">a.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Epidural anesthesia: </span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1.25in; mso-add-space: auto; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">-<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Memasukkan agen bius ke dalam ruang epidural iaitu kawasan dalam spinal column tetapi di luar dura meter melalui kateter.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1.25in; mso-add-space: auto; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">-<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Patient tetap sedar sepenuhnya.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1.25in; mso-add-space: auto; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">-<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Digunakan dalam pembedahan obsetrik, pembedahan vascular ke atas,ekstremiti bawah.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1.25in; mso-add-space: auto; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">-<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Boleh juga di gunakan sebagai pain management.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">b.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Spinal anesthesia:</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1.25in; mso-add-space: auto; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">-<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Agen bius disuntik ke dalam sub arachnoid space (masuk ke cecair cerebrospinal)</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1.25in; mso-add-space: auto; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">-<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Dilakukan dengan cara lumbar puncture.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1.25in; mso-add-space: auto; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">-<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Melumpuhkan tisu saraf (impuls sensori dan motori)</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1.25in; mso-add-space: auto; mso-list: l3 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">-<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Untuk pembedahan pada bahagian abdomen bawah,perineum dan kaki.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1.25in; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">c.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Brachial plexus block</span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 10pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">d.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Ankle block</span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 10pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 10pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRBBLCOIxaoSfFYGkLRP51BDkFZdvHljGJPn6l6Xck7uO6IVV5Gv7O64N_Jsako7lpnoOF9EN9xxEGvHrvEY2jtUXZ0oA-f3fb_9qopcMBji6kQ3g32uZnUtGeyaJdts2yCiUwiIBupwE/s1600/untitled+2.bmp" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" naa="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRBBLCOIxaoSfFYGkLRP51BDkFZdvHljGJPn6l6Xck7uO6IVV5Gv7O64N_Jsako7lpnoOF9EN9xxEGvHrvEY2jtUXZ0oA-f3fb_9qopcMBji6kQ3g32uZnUtGeyaJdts2yCiUwiIBupwE/s1600/untitled+2.bmp" /></a><span style="font-family: "Times New Roman","serif";"></span> </div><ul><li><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -0.25in;"><span style="font-family: Symbol;"><span style="font-family: "Times New Roman";"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="color: red; font-family: "Times New Roman","serif";">General anesthesia</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif";"></span></b></div></li>
</ul><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; mso-list: l2 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Keadaan tiada sensasi dan kesedaran.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.5in; mso-list: l2 level1 lfo3; text-align: justify; text-indent: -0.25in;"><span style="font-family: Wingdings;">Ø<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Tujuan GA</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">a.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Analgesia: tiada rasa sakit semasa di bedah.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">b.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Hypnosis: menyebabkan tidak sedar diri</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">c.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Amnesia: hilang ingatan langsung semasa pembedahan dilakukan.</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">d.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Homeostasis: mengawal kestabilan fisiologi badan.</span></div><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 10pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;"><span style="font-family: "Times New Roman","serif";">e.<span style="font-family: "Times New Roman";"> </span></span><span style="font-family: "Times New Roman","serif";">Relaksasi: tiada ketegangan pada bahagian tubuh badan termasuk otot dan tulang.</span></div><br />
<div class="MsoListParagraph" style="line-height: 150%; margin: 0in 0in 10pt 1.25in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -0.25in;"></div></div>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com0tag:blogger.com,1999:blog-4212104789974226897.post-58269465025864987342011-07-27T19:07:00.000-07:002011-07-28T06:17:49.410-07:00JAGAAN PREOPERATIF<i><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="background-color: white;"><span class="Apple-style-span" style="color: purple;">DEFINISI FASA PREOPERATIF</span></span></span></span></i><br />
<br />
<ul><li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Fasa preoperatif bermula dari doktor menetapkan pembedahan kemudian pesakit membuat keputusan untuk menjalani pembedahan ->sehingga pesakit dihantar ke dalam dewan bedah.</span></li>
</ul><div><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span class="Apple-style-span" style="font-size: large;"><i><span class="Apple-style-span" style="color: purple;">JAGAAN PADA FASA PREOPERATIF</span></i></span></span><br />
<span class="Apple-style-span" style="color: magenta; font-family: Georgia, 'Times New Roman', serif;"><span class="Apple-style-span" style="font-size: large;"><i><br />
</i></span></span><br />
<span class="Apple-style-span" style="color: magenta; font-family: Georgia, 'Times New Roman', serif; font-size: large; font-style: italic;">ASESMEN</span><br />
<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"> </span><br />
<table border="1" bordercolor="#000000" cellpadding="4" cellspacing="0" style="font-size: x-large; font-style: italic;"><colgroup><col width="128*"></col> <col width="128*"></col> </colgroup><tbody>
<tr valign="TOP"> <td width="50%"><b><span class="Apple-style-span" style="background-color: white; color: #741b47; font-size: small;">DATA SUBJEKTIF</span></b><br />
<ul><li><span class="Apple-style-span" style="font-size: small; font-style: normal;"><span class="Apple-style-span" style="color: #073763;">Status kesihatan sekarang</span><br />
-status kesihatan am dan penyakit kronik<br />
</span></li>
<li><span class="Apple-style-span" style="font-size: small; font-style: normal;"><span class="Apple-style-span" style="color: #073763;">Alergi</span><br />
-ubatan,makanan,latex,sabun<br />
</span></li>
<li><span class="Apple-style-span" style="font-size: small; font-style: normal;"><span class="Apple-style-span" style="color: #073763;">Ubatan</span><br />
-pengambilan ubatan dan herba<br />
</span></li>
<li><span class="Apple-style-span" style="font-size: small; font-style: normal;"><span class="Apple-style-span" style="color: #073763;">Sejarah pembedahan sebelumnya</span><br />
</span></li>
<li><span class="Apple-style-span" style="font-size: small; font-style: normal;"><span class="Apple-style-span" style="color: #073763;">Status mental/psikososial</span><br />
-reaksi terhadap pembedahan<br />
-mampu memahami dan respon terhadap pembedahan<br />
</span></li>
<li><span class="Apple-style-span" style="font-size: small; font-style: normal;"><span class="Apple-style-span" style="color: #073763;">merokok</span><br />
-perokok lebih berisiko mendapat komplikasi postoperatif<br />
</span></li>
</ul><span class="Apple-style-span" style="font-size: small;"><br />
</span></td> <td width="50%"><b><span class="Apple-style-span" style="color: #741b47; font-size: small;">DATA OBJEKTIF</span></b><br />
<ul><li><span class="Apple-style-span" style="font-size: small; font-style: normal;"><span class="Apple-style-span" style="color: #073763;">Pemeriksaan fizikal</span><br />
-sistem kardiovaskular<br />
-sistem respiratori<br />
-sistem persarafan<br />
-sistem urinari<br />
-sistem pencernaan<br />
-sistem muskuloskeletal<br />
-sistem integumen<br />
</span></li>
<li><span class="Apple-style-span" style="font-size: small;"><span class="Apple-style-span" style="font-style: normal;"><span class="Apple-style-span" style="color: #073763;">Penyiasatan makmal</span><br />
-complete blood glucose(CBC)<br />
-urinalysis<br />
-Chest X-ray<br />
-ECG<br />
-Pregnancy test<br />
-C&S</span><br />
</span></li>
</ul></td> </tr>
</tbody></table><br />
<div style="color: magenta; font-style: italic; margin-bottom: 0in;"><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><br />
</span></div><div style="font-style: italic; margin-bottom: 0in;"><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span class="Apple-style-span" style="background-color: white;"><span class="Apple-style-span" style="color: #38761d;">PERSEDIAAN FASA PREOPERATIF</span></span></span></div><div style="color: magenta; font-style: italic; margin-bottom: 0in;"><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">1)Preoperative consent</span></div><div style="margin-bottom: 0in;"></div><ul><li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Pesakit menandatangani borang kebenaran bersetuju menjalani pembedahan.</span></li>
<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">
<li><i>Informed consent</i>-klien telah diberi informasi dan terlibat dalam membuat keputusanyang mempengaruhi kesihatannya.</li>
</span></ul><div><span class="Apple-style-span" style="color: magenta; font-family: Georgia, 'Times New Roman', serif;"><i>2)Persediaan psikologikal</i></span><br />
<br />
<ul><li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">aspek psikologikal pembedahan:anxiety,ketakutan,harapan.</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">tindakan yang dilakukan:-galak klien meluahkan masalah,beri maklumat mengenai pembedahan kepada klien,guna bahasa mudah difahami dan tunjuk sikap empati</span></li>
</ul><div><span class="Apple-style-span" style="color: magenta; font-family: Georgia, 'Times New Roman', serif;"><i>3)Persediaan fizikal</i></span></div><div><div class="separator" style="clear: both; text-align: center;"></div><ul><li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Nutrisi dan cecair </span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Eliminasi</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Hygiene</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Ubatan</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Barang berharga</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Rehat dan tidur</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Skin preparation</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Prostheses/barang palsu</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Ases vital sign</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Arahan lain</span></li>
</ul><div><span class="Apple-style-span" style="color: magenta; font-family: Georgia, 'Times New Roman', serif;"><i>4)Persediaan spiritual</i></span></div></div><div><ul><li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Galak pesakit sembahyang ikut agama masing-masing</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Izinkan orang alim bantu jika klien minta</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Galak pesakit banyak berdoa dan istighfar </span></li>
</ul><div><span class="Apple-style-span" style="color: magenta; font-family: Georgia, 'Times New Roman', serif;"><i>5)Preoperative teaching</i></span></div></div><div><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Tujuan:</span></div><div><ul><li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Meningkatkan kepuasan pesakit</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Mengurangkan komplikasi:infeksi,pendarahan</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Mengurangkan vomiting,sakit,fear,anxiety dan stress selepas pembedahan</span></li>
</ul><div><span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif;"><br />
</span></div><div><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span class="Apple-style-span" style="color: #cc0000;">4 Dimensi preoperative teaching yang penting diberi kepada klien</span></span></div><div><ol><li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span class="Apple-style-span" style="color: #674ea7;">Informasi kepada klien:</span> memberi maklumat kepada tentang tatacara yang perlu dilalui pesakit,tujuan pembedahan dan tatacara pembedahan,rasa yang akan dilalui klien selepas pembedahanjangkaan klien dirawat selepas pembedahan,berpuasa selepas pembedahan,minta ubat analgesia jika sakit,guna loceng jika perlu bantuan dan persediaan akhir sebelum ke dewan bedah.</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span class="Apple-style-span" style="color: #674ea7;">Sokongan psikososial untuk kurangkan anxiety.</span></span></li>
<li><span class="Apple-style-span" style="color: #674ea7; font-family: Georgia, 'Times New Roman', serif;">Peranan klien dan orang-orang yang menyokongnya selama persediaan preoperatif,prosedur pembedahan dan fasa posoperatif.</span></li>
<li><span class="Apple-style-span" style="color: #674ea7; font-family: Georgia, 'Times New Roman', serif;">Skills training:</span></li>
</ol><span class="Apple-style-span" style="color: #674ea7; font-family: Georgia, 'Times New Roman', serif;"><ul><li><span class="Apple-style-span" style="color: #134f5c;"><span class="Apple-style-span" style="background-color: white;">Deep breathing exercise</span></span></li>
<li><span class="Apple-style-span" style="color: #134f5c;"><span class="Apple-style-span" style="background-color: white;">Effective coughing</span></span></li>
<li><span class="Apple-style-span" style="color: #134f5c;"><span class="Apple-style-span" style="background-color: white;">Senaman kaki</span></span></li>
<li><span class="Apple-style-span" style="color: #134f5c;"><span class="Apple-style-span" style="background-color: white;">Pergerakan dan ambulasi</span></span></li>
<li><span class="Apple-style-span" style="color: #134f5c;"><span class="Apple-style-span" style="background-color: white;">Incentive spirometry</span></span></li>
</ul><div><span class="Apple-style-span" style="color: purple;"><br />
</span></div><div><span class="Apple-style-span" style="color: purple;">Persediaan pagi sebelum pembedahan</span></div><div><ul><li><span class="Apple-style-span" style="color: black;">kebersihan diri,gaun OT</span></li>
<li><span class="Apple-style-span" style="color: black;">teruskan pesakit berpuasa</span></li>
<li><span class="Apple-style-span" style="color: black;">suruh pesakit kencing,periksa enema telah diberi</span></li>
<li><span class="Apple-style-span" style="color: black;">make-up,pewarna kuku telah bersih</span></li>
<li><span class="Apple-style-span" style="color: black;">semak nota pesakit</span></li>
<li><span class="Apple-style-span" style="color: black;">semak vital sign</span></li>
<li><span class="Apple-style-span" style="color: black;">beri premedikasi sesuai arahan</span></li>
<li><span class="Apple-style-span" style="color: black;">semak check list</span></li>
<li><span class="Apple-style-span" style="color: black;">hantar pesakit ke OT</span></li>
</ul><div><span class="Apple-style-span" style="color: #990000;"><br />
</span></div><div><span class="Apple-style-span" style="color: #990000;">Hantar pesakit ke OT</span></div></div></span></div></div><div><br />
<ul><li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">pastikan pesakit selamat naik ke troli</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">tentukan tangan dan kaki selamat</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">naikkan pengadang troli</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">selimutkan pesakit</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">bawa bersama preoperative equipment yang ada:antiembolism stocking atau inhaler</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">jururawat berada di bahagian kepala pesakit dan porter tolak bahagian kaki</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">hati-hati bila masuk 'lift' agar tiada kecederaan berlaku</span></li>
</ul><div><span class="Apple-style-span" style="color: #bf9000; font-family: Georgia, 'Times New Roman', serif;"><br />
</span></div><div><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span class="Apple-style-span" style="color: #bf9000;">Serah pesakit di OT</span></span></div><div><ul><li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">serah pesakit kepada circulating nurse atau jururawat anesthesis</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">beritahu semua maklumat yang relevan kepada circulating nurse</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">'verify' semua yang ada de check list</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">beritahu pesakit,jururawat akan datang ambil pesakit bila pembedahan telah tamat</span></li>
</ul><div><span class="Apple-style-span" style="color: #741b47; font-family: Georgia, 'Times New Roman', serif;"><br />
</span></div><div><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span class="Apple-style-span" style="color: #741b47;">Perancangan discaj</span></span></div><div><ul><li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Beritahu pesakit dan keluarga jangkaan masa tinggal di wad</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Beritahu pesakit apa yang perlu disediakan di rumah bila discaj</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Siapa akan bantu pesakit di rumah</span></li>
<li><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Atur tentang kerja dan lawatan susulan</span></li>
</ul></div></div></div><div><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><i><br />
</i></span></div></div><br />
<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"></span><br />
<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"></span><br />
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AAAAAAkACQCZAgAAyyIAAAAA" o:spid="_x0000_i1025" style="height: 278.25pt; visibility: visible; width: 462.75pt;" type="#_x0000_t75"> <v:imagedata cropbottom="-142f" o:title="" src="file:///C:\Users\NURHAS~1\AppData\Local\Temp\msohtmlclip1\02\clip_image001.png"> <o:lock aspectratio="f" v:ext="edit"> </o:lock></v:imagedata></v:shape></span></i></span></div></div><div class="O0" style="language: en-US; margin-bottom: 0pt; margin-left: .38in; margin-top: 0pt; text-align: left; text-indent: -.38in;"></div></div>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com1tag:blogger.com,1999:blog-4212104789974226897.post-2994993475716471622011-07-25T10:47:00.000-07:002011-09-11T23:43:03.115-07:00PENGENALAN PEMBEDAHAN<div style="text-align: left;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0paP96ZKOxoLehinJV-fwImAt6sHtRVKICs1doflkxessRbtVylaP62wp5EL_DrVHxOfDKOYTQBJqQOnarX2jchqgsaj8jkWbMq4YYc2mflGxz2XidzIvi1Ewpuzml6D0GRRa4Op2M8I/s1600/operation26-3.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="170" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0paP96ZKOxoLehinJV-fwImAt6sHtRVKICs1doflkxessRbtVylaP62wp5EL_DrVHxOfDKOYTQBJqQOnarX2jchqgsaj8jkWbMq4YYc2mflGxz2XidzIvi1Ewpuzml6D0GRRa4Op2M8I/s200/operation26-3.jpg" width="200" /></a></div><b>DEFINISI PEMBEDAHAN </b>- The art and science of treating diseases, injuries and deformities by operation and instrumentation.</div><br />
<b>TUJUAN PEMBEDAHAN</b>:-<br />
<ul><li>Diagnostik : mengesahkan diagnosis </li>
<li>Ablatif / curative : membuang / mengeluarkan bahagian tubuh yang berpenyakit</li>
<li>Palliative : untuk melegakan atau mengurangkan simptom penyakit.</li>
<li>Konstruktif : memulihkan fungsi atau membaiki kecacatan.</li>
<li>Transplant : mengganti struktur organ yang tidak berfungsi lagi dari satu individu ke individu lain.</li>
<li>Rekonstruktif : memulihkan fungsi atau penampilan akibat trauma atau proses penyakit.</li>
</ul><b>JENIS - JENIS PEMBEDAHAN</b><br />
<br />
1. PERINGKAT KEUTAMAAN <br />
a) Elective Surgery<br />
- Dirancang ikut pilihan klien<br />
- Tujuan untuk mempertingkatkan kehidupan<br />
- Sekiranya ditunda tidak akan memudaratkan nyawa<br />
- Dilakukan mengikut lapang surgeon<br />
b) Urgent Surgery<br />
- Dalam tempoh 24 - 48 jam<br />
c) Emergency surgery<br />
- Perlu dilakukan serta merta ( ASAP )<br />
<br />
2. PERINGKAT RISIKO<br />
a) Minor Surgery<br />
- Pembedahan kecil dan mudah<br />
- Risiko rendah dan komplikasi minima<br />
- Pembedahan masa singkat<br />
- Dilakukan sebagai pesakit luar<br />
b) Major Surgery<br />
- Perlu masuk wad, tidak boleh di klinik luar<br />
- Risiko tinggi dan boleh bahayakan nyawa<br />
- Melibatkan organ badan yang yang mustahak<br />
- Potensi komplikasi atau pendarahan yang banyak selepas pembedahan<br />
<br />
<b>FAKTOR YANG MEMPENGARUHI PERINGKAT RISIKO</b><br />
<br />
a) Umur<br />
- Bayi dan warga emas lebih berisiko daripada kanak-kanak dan dewasa<br />
b) General health<br />
- Malnutrition<br />
- Obesity<br />
- Cardiac conditions<br />
- Blood coagulation disorder<br />
- Systemic disorder (renal, respiratory, liver, neurology)<br />
c) Status nutrisi<br />
- Nutrisi yang mencukupi untuk pembaikan tisu<br />
- Klien malnutrisi berisiko mengalami jangkitan pada luka, gangguan cecair dan elektrolit dan lambat dalam penyembuhan luka <br />
d) Ubatan<br />
- Anticoagulants : meningkatkan pembekuan darah<br />
- Transquilizers : berisiko terjadi depresi respiratory<br />
- Corticosteroids : mempengaruhi penyembuhan luka dan menurunkan imuniti<br />
- Diuretics : mempengaruhi keseimbangan cecair dan elektrolit<br />
c) Status mental<br />
- Gangguan mental<br />
- Anxiety<br />
- Takut akan mati, sakit dan kehilangan organ tubuh<br />
<br />
<b> PASUKAN PEMBEDAHAN </b><br />
<br />
<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSMWL8V4MXkIBiBpS8JGEAM_SD3sAOW44hPlsy5bA_LgEFqpgC1fkTToZ8MrDWz7Ja2Y7I-3hn6TLbMF1tk8uKmh_hKCrAanwD5qbngSwBE5kMFyY8QRPWb-81bqP4GLPiTzzGo5imjS4/s1600/surgery_team.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="163" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSMWL8V4MXkIBiBpS8JGEAM_SD3sAOW44hPlsy5bA_LgEFqpgC1fkTToZ8MrDWz7Ja2Y7I-3hn6TLbMF1tk8uKmh_hKCrAanwD5qbngSwBE5kMFyY8QRPWb-81bqP4GLPiTzzGo5imjS4/s200/surgery_team.jpg" t$="true" width="200" /></a> A. STERILE SURGICAL TEAM</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> - The Surgeons</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> - The Physician's Assistants</div> - Registered Nurse First Assistant<br />
- Scrub Nurse<br />
<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> </div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> B. NON-STERILE SURGICAL TEAM</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> - The Anesthesiologist</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> - The Nurse Anesthetish</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> - The Circulating Nurse</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> - Radiology and Laboratory Technicians ( if necessary )</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> - Pathologists ( if necessary )</div> - Nurse's Aids<br />
<br />
<strong><u>JAGAAN PERIOPERATIF</u></strong><br />
<br />
<b>Definisi</b> : Pengurusan pesakit yang menjalani pembedahan bermula daripada memberi keizinan<br />
pembedahan sehinggalah pesakit discaj dari hospital.<br />
<br />
<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><b>FASA PEMBEDAHAN PERIOPERATIF</b></div><br />
a) Fasa Preoperatif<br />
<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> - Dari keputusan pembedahan dibuat hingga klien dipindahkan ke meja pembedahan</div> b) Fasa Intraoperatif<br />
- Dari klien berada di meja pembedahan hingga dipindahkan ke wad pemulihan<br />
c) Fasa Postoperatif<br />
<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> - Sejak klien masuk ke wad pemulihan hingga pemulihan seluruhnya</div><br />
<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><b>MATLAMAT PERAWATAN PERIOPERATIF</b></div><ol><li style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Pesakit bebas dari kecederaan</li>
<li>Pesakit bebas dari infeksi</li>
<li>Keseimbangan cecair dan elektrolit dikekalkan</li>
<li>Integriti kulit yang normal dikekalkan</li>
<li>Menunjukkan kefahaman tindakbalas fisiologi dan psikologi </li>
<li>Pesakit melibatkan diri dalam proses rehabilitasi</li>
</ol><br />
<br />
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<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"> BY : NORIAH BAKRI ( 001432 )</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
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</div>Surgical Crewshttp://www.blogger.com/profile/16475689710497303568noreply@blogger.com0