LP FAM

LAPORAN PENDAHULUAN

LAPORAN PENDAHULUAN

GANGGUAN SISTEM REPRODUKSI

GANGGUAN SISTEM REPRODUKSI

(

( MANAJEMEN

MANAJEMEN ASUHAN

ASUHAN FIBRO

FIBRO ADENOMA

ADENOMA MAMAE)

MAMAE)

Mata Kuliah : Kepea!ata" Me#i$al %e#ah

Mata Kuliah : Kepea!ata" Me#i$al %e#ah

D&'e"

D&'e" $&&#i"at&&

$&&#i"at&& : : N'

N' hi'*e"

hi'*e" Da+a"i$

Da+a"i$ SKep,

SKep, M

M Kep

Kep

Oleh : Oleh :   Maiati   Maiati Ni+ Ni+ -./012-./012

PROGRAM STUDI PROFESI NERS

PROGRAM STUDI PROFESI NERS

STIKES

STIKES 3I4ATA

3I4ATA HUSADA

HUSADA SAMARINDA

SAMARINDA

5/-1

5/-1

1 1

HALAMAN PEMGESAHAN

HALAMAN PEMGESAHAN

GANGGUAN

GANGGUAN SISTEM

SISTEM REPRODUKSI

REPRODUKSI

ASUHAN

ASUHAN KEPERA3ATAN

KEPERA3ATAN FIBRO

FIBRO ADENOMA

ADENOMA MAMAE

MAMAE

/leh : /leh :   Maiati   Maiati Ni+ Ni+   P-./012P-./012

Telah Di'etu6ui Oleh D&'e"

Telah Di'etu6ui Oleh D&'e" Pe+%i+%i"7 #a" Pe8ept&Pe+%i+%i"7 #a" Pe8ept& Pa#a

Pa#a Ta"77al, Ta"77al, -9 -9 Fe%uai Fe%uai 5/-15/-1

D&'e"

D&'e" K&&#i"at& K&&#i"at& Pe+%i+%i"7 Pe+%i+%i"7 Kli"i$Kli"i$ Kepea!ata"

Kepea!ata" Me#i$al Me#i$al Be#ah Be#ah Kepea!ata" Kepea!ata" Me#i$al Me#i$al Be#ahBe#ah

N'

N' i'*e" i'*e" Da+a"i$, Da+a"i$, SKep SKep M$ep M$ep Pe8ept&Pe8ept& Ni$ --/.51--/5

a

Pa*u#aa a#alah &7a" *a"7 %epea" #ala+ p&'e' la$ta'i, 'e#a"7$a" pa#a pia &7a" i"i ti#a$ %e$e+%a"7 #a" ti#a$ +e+ili$i ;u"7'i #ala+ p&'e' la$ta'i 'epeti pa#a !a"ita (u#i+ete) Pa*u#aa teleta$ a"taa i7a $eti7a #a" $etu6uh 'eta te%e"ta"7 le%a"*a #ai li"ea paa'te"ali'  'a+pai a<illai' a"tei& #a" +e#ia"a  Beat #a" u$ua" pa*u#aa %e=aia'i 'e'uai peta+%aha" u+u, pa#a +a'a pu%eta' +e+%e'a, #a" %eta+%ah %e'a 'ela+a $eha+ila" #a" 'e'u#ah +elahi$a", #a" +e"6a#i at&pi pa#a u'ia la"6ut

%

Setiap pa*u#aa te#ii ata' -2 'a+pai 52 l&%u' $ele"6a *a"7 +a'i"7>+a'i"7 +e+pu"*ai 'alua" $e papilla +a++a *a"7 #i'e%ut #u$tu' la$ti;eu' #a" #ipi'ah$a" &leh 6ai"7a" le+a$ *a"7 %e=aia'i 6u+lah"*a Dia"taa $ele"6a 'u'u #a" ;a'ia pe$t&ali', 6u7a #i a"taa $ulit #a" $ele"6a te'e%ut te#apat 6ai"7a" le+a$ Di a"taa l&%u' te'e%ut te#apat 6ai"7a" i$at *a"7 #i'e%ut li7a+e"tu+ 8&&pe *a"7 +eupa$a" t&"6&la" 6ai"7a" pa*u#aa, *a"7 %e'atu #e"7a" lapi'a" lua ;a'ia 'upe;i'iali' *a"7 %e;u"7'i 'e%a7ai 'tu$tu pe"*&$&"7 #a" +e+%ei a"7$a u"tu$ pa*u#aa Jai"7a" i$at +e+i'ah$a" pa*u#aa #ai &t&t>&t&t #i"#i"7 #a#a, &t&t pe$t&ali' #a" a"tei&

Pe+%uluh #aah +a++ae %ea'al #ai atei +a+aia i"te"a #a" atei t&a$ali' lateali' ?e"a 'upe=i'iali' +a+ae +e+pu"*ai %a"*a$ a"a't&+&'a *a"7 %e+uaa $e =e"a +a+aia i"te"a #a" =e"a t&a$ali' i"te"a@epi7a'ti$a, 'e%a7ia" %e'a %e+uaa $e =e"a t&a$ali' lateali' Alia" li+;e #ai pa*u#aa $ua"7 le%ih .2 $e a$'ila, 'e%a7ia" la7i $e $ele"6a teuta+a #ai %a7ia" *a"7 'e"tal #a" +e#ial #a" a#a pula alia" $e $ele"6a i"tepe$t&ali'

U"tu$ le%ih 6ela' #ai a"at&+i pa*u#aa #apat #ilihat pa#a 7a+%a %ei$ut: Ga+%a -- A"at&+i Pa*u#aa

3

FIBRO ADENOMA MAMMAE

Pe"7etia" Pa*u#aa

8

Pe$e+%a"7a" #a" ;u"7'i pa*u#aa #i+ulai &leh %e%a7ai h&+&" E'te&7e" #i$etahui +ea"7'a"7 pe$e+%a"7a" #u$tu' +a+ilai' P&7e'te&" +e+ulai pe$e+%a"7a" l&%ulu'>l&%ulu' pa*u#aa 6u7a #i;ee"'ia'i 'el epitelial

Pa*u#aa +e"7ala+i ti7a +a8a+ peu%aha" *a"7 #ipe"7auhi &leh h&+&", a"taa lai" : a Peu%aha" peta+a a#alah +ulai #ai +a'a hi#up a"a$ +elalui +a'a hi#up pu%eta', +a'a

;etilita', 'a+pai $e $li+a$teiu+, #a" +e"&pau'e Se6a$ pu%eta' pe"7auh e't&7e" #a" p&7e'te&" *a"7 #ip&#u$'i &=aiu+ #a" 6u7a h&+&" hip&;i'e, telah +e"*e%a%$a" #u$tu' %e$e+%a"7 #a" ti+%ul"*a a'i"u' 

% Peu%aha" $e#ua a#alah peu%aha" 'e'uai #e"7a" #au hai# Se$ita hai $e>1 hai#, pa*u#aa +e"6a#i le%ih %e'a #a" pa#a %e%eapa hai 'e%elu+ hai# %ei$ut"*a te6a#i pe+%e'aa" +a$'i+al Ka#a"7>$a#a"7 ti+%ul %e"6&la" *a"7 "*ei #a" ti#a$ ata Sela+a %e%eapa hai +e"6ela"7 hai#, pa*u#aa +e"6a#i te7a"7 #a" "*ei 'ehi"77a pe+ei$'aa" ;i'i$ teuta+a palpa'i ti#a$ +u"7$i" #ila$u$a" Be7itu hai# #i+ulai, 'e+ua"*a %e$ua"7

8 Peu%aha" $eti7a te6a#i pa#a +a'a ha+il #a" +e"*u'ui Pa#a +a'a $eha+ila", pa*u#aa +e"6a#i %e'a $ae"a epitel #u$tu' l&%ul #a" #u$tu' al=e&lu' %ep&li;ea'i, #a" tu+%uh #u$tu' %au Se$e'i h&+&" p&la$ti" #ai hip&;i'i' a"tei& +e+i8u la$ta'i Ai 'u'u #ip&#u$'i &leh 'el>'el al=e&lu' +e"7i'i a'i"u', $e+u#ia" #i$elua$a" +elalui #u$tu' $e puti"7 'u'u

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Se8aa 'e#eha"a ;i%&a#e"&+a #apat #i$la'i;i$a'i$a" +e"6a#i ti7a +a8a+: Fi'i&l&7i Pa*u#aa

B Fi%& A#e"&+a Ma++ae (FAM - Pe"7etia"

5 Kla'i;i$a'i Fi%&a#e"&+a Ma++ae a) &++ " Fi%& #e"&+a

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Gia"t ;i%&a#e"&+a a#alah tu+& 6i"a$ pa*u#aa *a"7 +e+ili$i u$ua" #e"7a" #ia+ete le%ih #ai 2 8+ Se8aa $e'eluuha" i"'i#e" 7ia"t ;i%&a#e"&+a 'e$ita 9 #ai 'eluuh $a'u' ;i%&a#e"&+a Gia"t ;i%&a#e"&+a %ia'a"*a #ite+ui pa#a !a"ita ha+il #a" +e"*u'ui Gia"t ;i%&a#e"&+a #ita"#ai #e"7a" u$ua" *a"7 %e'a #a" pe+%e'aa" +a''a e"$ap'ula'i pa*u#aa *a"7 8epat Gia"t ;i%&a#e"&+a #apat +eu'a$ %e"tu$ pa*u#aa #a" +e"*e%a%$a" ti#a$ 'i+eti' $ae"a u$ua""*a *a"7 %e'a, 'ehi"77a pelu #ila$u$a" pe+&t&"7a" #a" pe"7a"7$ata" teha#ap tu+& i"i

Ju=e"ile ;i%&a#e"&+a %ia'a te6a#i pa#a e+a6a pee+pua", #e"7a" i"'i#e" /,2>5 #ai 'eluuh $a'u' ;i%&a#e"&+a Se$ita -/>52 pa'ie" #e"7a" 6u=e"ile ;i%&a#e"&+a +e+ili$i le'i *a"7 +ultiple atau %ilateal-1 Tu+& 6e"i' i"i le%ih %a"*a$ #ite+u$a" pa#a &a"7 A;i$a #a" I"#ia Baat #i%a"#i"7$a" pa#a &a"7 Kau$a'ia Fi%&a#e"&+a +a++ae 6u7a #apat #i%e#a$a" 'e8aa hi't&l&7i a"taa lai"

- Fi%&a#e"&+a Pei8a"ali8ulae

4a$"i $ele"6a %e%e"tu$ %ulat #a" l&"6&"7 #ilapi'i epitel 'elapi' atau %e%eapa lapi' - Fi%&a#e"&+a i"ta8a"ali8ulae

4a$"i 6ai"7a" i$at +e"7ala+i p&li;ea'i le%ih %a"*a$ 'ehi"77a $ele"6a %e%e"tu$ pa"6a"7> pa"6a"7 (ti#a$ teatu) #e"7a" lu+e" *a"7 'e+pit atau +e"7hila"7 Pa#a 'aat +e"6ela"7 hai# #a" $eha+ila" ta+pa$ pe+%e'aa" 'e#i$it #a" pa#a 'aat +e"&pau'e te6a#i e7e'i

Ga+%a -5 Fi%&a#e"&+a Ga+%a - &++&" Fi%&a#e"&+a

5 %) Gia"t Fi%&a e" +a

Ga+%a -2 Ju=e"ile F&%&a#e"&+a

a Se8aa +a$&'$&pi$ : tu+& %e'i+pai, %e!a"a putih $ea%u>a%ua", pa#a pe"a+pa"7 ta+pa$  6ai"7a" i$at %e!a"a putih, $e"*al

% A#a %a7ia" *a"7 +e"&"6&l $e pe+u$aa" 8 A#a pe"e$a"a" pa#a 6ai"7a" 'e$ita # A#a %ata' *a"7 te7a'

e Bila #ia+ete +e"8apai -/ C -2 8+ +u"8ul Fi%&a#e"&+a a$'a'a ( Gia"t Fi%&a#e"&+a ) ; Me+ili$i $ap'ul #a" '&lite

7 Be"6&la" #apat #i7ea$$a" h Petu+%uha""*a la+%at

i Mu#ah #ia"7$at #e"7a" l&$al 'u7e*

 6 Bila 'e7ea #ita"7a"i ti#a$ +e"*e%a%$a" $e+atia"

Sa+pai 'aat i"i pe"*e%a% FAM +a'ih %elu+ #i$etahui 'e8aa pa'ti, "a+u" %e#a'a$a" ha'il pe"elitia" a#a %e%eapa ;a$t& i'i$& *a"7 +e+pe"7auhi ti+%ul"*a tu+& i"i a"taa lai":

a U+u

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AN A  EJA A

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8 Paita' #a" Ri!a*at Me"*u'ui A"a$

Pe"uu"a" paita' +e"i"7$at$a" i"'i#e" te6a#i"*a FAM, teuta+a +e"i"7$at pa#a $el&+p&$ !a"ita "ullipaa Pe"7ala+a" +e"*u'ui +e+ili$i pea" *a"7 pe"ti"7 #ala+ peli"#u"7a" teha#ap i'i$& $e6a#ia" FAM

# Pe"77u"aa" H&+&"

Dipe$ia$a" %ah!a ;i%&a#e"&+a +a++ae te6a#i $ae"a $epe$aa" teha#ap pe"i"7$ata" h&+&" e't&7e" Pe"77u"aa" $&"ta'ep'i *a"7 $&+p&"e" uta+a"*a a#alah e't&7e" +eupa$a" ;a$t& i'i$& *a"7 +e"i"7$at$a" $e6a#ia" FAM Be#a'a$a" pe"elitia" *a"7 #ila$u$a" #i Depat+e"t &; Su7e*, U"i=e'it* &; O$lah&+a Health S8ie"8e' e"te (O7a", -1), #ilap&$a" p&p&'i pe"#eita FAM *a"7 +e"77u"a$a" $&"ta'ep'i #e"7a" $&+p&"e" uta+a e't&7e" a#alah 'e$ita 0/

e O%e'ita'

Beat %a#a" *a"7 %ele%iha" (&%e'ita') #a" IMT *a"7 le%ih #ai "&+al +eupa$a" ;a$t& i'i$& te6a#i"*a FAM Be#a'a$a" pe"elitia" Bi#7&li, et all #i$etahui %ah!a IMT  / $7@+5 +e"i"7$at$a" i'i$& $e6a#ia" FAM (OR592,I 2 -/9>/) ati"*a !a"ita #e"7a" IMT  / $7@+5 +e+ili$i i'i$& 5,92 $ali +e"#eita FAM #i%a"#i"7$a" !a"ita #e"7a" IMT  / $7@+5 ; Ri!a*at Kelua7a

Ti#a$ a#a ;a$t& 7e"eti$ #i$etahui +e+pe"7auhi i'i$& ;i%&a#e"&+a Na+u", i!a*at $elua7a $a"$e pa*u#aa pa#a $elua7a ti"7$at peta+a #ilap&$a" &leh %e%eapa pe"eliti %ehu%u"7a" #e"7a" pe"i"7$ata" i'i$& tu+& i"i-1 Dai %e%eapa pe"elitia" +e"u"6u$$a" a#a"*a i'i$& +e"#eita FAM pa#a !a"ita *a"7 i%u #a" 'au#aa pee+pua" +e"7ala+i pe"*a$it pa*u#aa Dilap&$a" 5.  #ai pe"#eita FAM +e+ili$i i!a*at $elua7a +e"#eita pe"*a$it pa#a pa*u#aa (O7a", -1)51 Ti#a$ 'epeti pe"#eita #e"7a" ;i%&a#e"&+a tu"77al, pe"#eita +ultiple ;i%&a#e"&+a +e+ili$i i!a*at pe"*a$it $elua7a *a"7 $uat +e"#eita pe"*a$it pa#a pa*u#aa

7 Ste''

Ste'' %eat #apat +e"i"7$at$a" p&#u$'i h&+&" e"#&7e" e't&7e" *a"7 6u7a a$a" +e"i"7$at$a" i"'i#e" FAM Be#a'a$a" pe"elitia" Bi#7&li, et all #i$etahui &a"7 *a"7 +e"7ala+i 'te'' +e+ili$i i'i$& le%ih ti"77i +e"#eita FAM (OR-9 I 2--0>-.0) ati"*a &a"7 *a"7 +e"7ala+i 'te'' +e+ili$i i'i$& -,9 $ali +e"#eita FAM #i%a"#i"7$a" #e"7a" &a"7 *a"7 ti#a$ 'te''

Fi%&a#e"&+a +eupa$a" tu+& 6i"a$ pa*u#aa *a"7 'ei"7 #ite+u$a" pa#a +a'a ep&#u$'i *a"7 #i'e%a%$a" &leh %e%eapa $e+u"7$i"a" *aitu a$i%at 'e"'iti=ita' 6ai"7a" 'ete+pat *a"7 %ele%iha" teha#ap h&+&" e't&7e" 'ehi"77a $elai"a" i"i 'ei"7 #i7&l&"7$a" #ala+ +a+a* #i'pla'ia Fi%&a#e"&+a %ia'a"*a #ite+u$a" pa#a $ua#a" lua ata', +eupa$a" l&%u' *a"7 %e%ata' 6ela', +u#ah #i7ea$$a" #ai 6ai"7a" #i 'e$ita"*a Fi%&a#e"&+a +a++ae %ia'a"*a ti#a$ +e"i+%ul$a" 7e6ala #a" #ite+u$a" 'e8aa $e%etula" Fi%&a#e"&+a %ia'a"*a #ite+u$a" 'e%a7ai %e"6&la" tu"77al, tetapi 'e$ita -/>-2 !a"ita *a"7 +e"#eita ;i%&a#e"&+a +e+ili$i %e%eapa %e"6&la" pa#a $e#ua pa*u#aa

Pe"*e%a% +u"8ul"*a %e%eapa ;i%&a#e"&+a pa#a pa*u#aa %elu+ #i$etahui 'e8aa 6ela' #a" pa'ti Hu%u"7a" a"taa +u"8ul"*a %e%eapa ;i%&a#e"&+a #e"7a" pe"77u"aa" $&"ta'ep'i &al %elu+ #apat #ilap&$a" #e"7a" pa'ti Selai" itu a#a"*a $e+u"7$i"a" pat&7e"e'i' *a"7 %ehu%u"7a" #e"7a" hipe'e"'iti=ita' 6ai"7a" pa*u#aa l&$al teha#ap e't&7e", ;a$t& +a$a"a" #a" ;a$t& i!a*at $elua7a atau $etuu"a" Ke+u"7$i"a" lai" a#alah %ah!a ti"7$at ;i'i&l&7i e't&7e" pe"#eita ti#a$ +e"i"7$at tetapi 'e%ali$"*a 6u+lah e'ept& e't&7e" +e"i"7$at Pe"i"7$ata" $epe$aa" teha#ap e't&7e" #apat +e"*e%a%$a" h*pepla'ia $ele"6a 'u'u #a" a$a" %e$e+%a"7 +e"6a#i $a'i"&+a

9 Peningkatan

konsistensi mammae

Nurisi kurang dari kebutuhan tubuh Suplai nutrisi ke  aringan lain !ipermetabolis ke aringan "ensuplai nutrisi ke aringan tumor

#elemahan genes sel$sel %ang men%ertai &angguan produksi hormon esterogen

'aktor predisposisi dan resiko nggi teradin%a '(" )usia* genek* pola makan* stres* pekeraan+

,erbentukn%a sel$sel neoplask

-erat badan !iperplasi pada

sel mammae

"assa tumor mendesak ke aringan luar "ammae memben kak "endesak  aringan sekitar "enekan aringan pada mammae Per.usi aringan terganggu /lkus

PATOFISIO OGI FAM (FIBROADENOMA MAMMAE)

&3 integritas kulit dan  aringan

"endesak sel s%ara. "endesak pembuluh darah

N%eri 0nterupsi sel s%ara.  Pengeluaran transmier

0n.eksi

(liran darah terhambat h%poia -akteri patogen Nerosa aringan (nietas #urang pengetahuan &3 bod% image

"ammae asimetrik /kuran mammae abnormal

&3 keboksigenasi kspansi paru menurun

0nltrasi pleuro parietale

Pembedahan iskonnuitas

 aringan uka terkontaminasi

bakeri patogen a%a tahan tubuh menurun

a Bi&p'i

% Pe+%e#aha" 8 H&+&"al

# PET ( P&'it&" E+i'i&" T&+&7a;i ) e Ma++&7a;i

; A"7i&7a;i 7 MRI

h T C S8a"

i F&t& R&"te" ( < C a* )  6 Bl&&# Stu#*

Pe"8e7aha" pi+e +eupa$a" upa*a u"tu$ +e+petaha"$a" &a"7 *a"7 'ehat a7a tetap 'ehat atau +e"8e7ah &a"7 *a"7 'ehat +e"6a#i 'a$it K&"'ep #a'a #ai pe"8e7aha" pi+e a#alah u"tu$ +e"uu"$a" i"'i#e" pe"*a$it52 aa *a"7 #ila$u$a" a#alah #e"7a" +e"7hi"#ai ;a$t&> ;a$t& tete"tu *a"7 #apat +ea"7'a"7 petu+%uha" 'el>'el tu+& a"taa lai":

- Me"8e7ah tepapa"*a #e"7a" at atau %aha" *a"7 #apat +e+i8u %e$e+%a"7"*a 'el>'el tu+& ;i%&a#e"&+a, 'epeti +e"7$&"'u+'i +a$a"a" *a"7 te$&"ta+i"a'i #e"7a" %aha" atau at>at h&+&"al, +e"7hi"#ai pe+a$aia" pil $&"ta'ep'i #e"7a" $&+p&"e" uta+a e't&7e" Pe"77u"aa" at te'e%ut 6i$a #ipa$ai teu' +e"eu' a$a" +e"*e%a%$a" te6a#i"*a peu%aha" 6ai"7a" pa#a pa*u#aa *a"7 +e"i"7$at$a" a"7$a $e6a#ia" FAM5 Selai" itu +e"7hi"#ai tepapa #e"7a" at P&l*8*8li8 a&+ati8 h*#&8a%&"' (PAH') *a"7 %e'i;at $a'i"&7e"i$

- Me"77u"a$a" atau +e"7$&"'u+'i at #a" %aha" *a"7 #apat +e"uu"$a" $e6a#ia" FAM a"taa lai" #e"7a" +e"7$&"'u+'i %uah #a" 'a*ua" Pe"77u"aa" alat $&"ta'ep'i &al 6u7a #apat +e"uu"$a" i'i$& te6a#i"*a FAM

- Pe+ei$'aa" Pa*u#aa Se"#ii (SADARI) Pe+ei$'aa" teha#ap pa*u#aa 'e"#ii #ila$u$a" 'etiap %ula" 'e8aa teatu De"7a" +ela$u$a" pe+ei$'aa" 'e"#ii 'e8aa teatu +a$a $e'e+pata" u"tu$ +e"e+u$a" tu+& #ala+ u$ua" $e8il le%ih %e'a,

- 'ehi"77a #apat #e"7a" 8epat #ila$u$a" ti"#a$a" pe"7&%ata" 0 Pe+ei$'aa" Dia7"&'ti$

Fi%&a#e"&+a #apat #i#ia7"&'a #e"7a" ti7a 8aa, *aitu #e"7a" pe+ei$'aa" ;i'i$ (phi'*8al e<a+i"ati&"), pe+ei$'aa" a#i&l&7i (#e"7a" ;&t& th&a< #a" +a++&7a;i atau ulta'&"&7a;i), #e"7a" Fi"e Nee#le A'piati&" *t&l&7* (FNA)

a Pe+ei$'aa" Fi'i$

Pa#a pe+ei$'aa" ;i'i$ pe"#eita #ipei$'a #e"7a" 'i$ap tu%uh #u#u$ te7a$ atau %e%ai"7 atau $e#ua>#ua"*a Ke+u#ia" #ipehati$a" %e"tu$ $e#ua pa*u#aa, !a"a $ulit, t&"6&la", le$u$a", a#a"*a $ulit %e%i"ti$, 'epeti $ulit 6eu$, ul$u', #a" %e"6&la" Ke+u#ia" #ila$u$a" palpa'i #e"7a" telapa$ 6ai ta"7a" *a"7 #i7ea$$a" pelaha">laha" ta"pa te$a"a" pa#a 'etiap $ua#a" pa*u#aa-9 Palpa'i #ila$u$a" u"tu$ +e"7etahui u$ua", 6u+lah, #apat %e7ea$> 7ea$, $e"*al atau $ea' #ai %e"6&la" *a"7 #ite+u$a"/ Dila$u$a" pe+i6ata" halu' pa#a puti"7 'u'u u"tu$ +e"7etahui pe"7eluaa" 8aia", #aah atau "a"ah #ai $e#ua puti"7 'u'u aia" *a"7 $elua #ai puti"7 'u'u hau' #i%a"#i"7$a" Pe"7eluaa" 8aia" #ilua +a'a la$ta'i #apat #i'e%a%$a" &leh %e%a7ai $elai"a" 'epeti ;i%&a#e"&+a atau %ah$a" $a'i"&+a

% Ma++&7a;i

Pe+ei$'aa" +a++&7a;i teuta+a %epea" pa#a pa*u#aa *a"7 +e+pu"*ai 6ai"7a" le+a$ *a"7 #&+i"a" 'eta 6ai"7a" ;i%&7la"#ule *a"7 elati; 'e#i$it Pa#a +a++&7a;i, $e7a"a'a" #apat +e+%ei$a" ta"#a>ta"#a pi+e #a" 'e$u"#e Ta"#a pi+e %eupa ;i%&'i' ea$ti;, 8&+et 'i7" (Stelata), a#a"*a pe%e#aa" *a"7 "*ata a"taa u$ua" $li"i' #a" a#i&l&7i', a#a"*a +i$&$la'i;i$a'i, a#a"*a 'pi$ulae, #a" #ite"'i pa#a 'tu$tu pa*u#aa Ta"#a 'e$u"#e %eupa eta$'i, pe"e%ala" $ulit, %eta+%ah"*a =a'$ulai'a'i, $ea#aa" #aeah tu+& #a" 6ai"7a" ;i%&7la"#ula ti#a$ teatu, i";ilta'i #ala+ 6ai"7a" lu"a$ #i %ela$a"7 +a++a #a" a#a"*a +eta'tati' $e $ele"6a (7a+%aa" i"i ti#a$ $ha') Ma++&7a;i #i7u"a$a" u"tu$ +e"#ia7"&'a !a"ita #e"7a" u'ia tua 'e$ita 0/>./ tahu"

8 Ulta'&"&7a;i (USG)

U"tu$ +e"#ete$'i lu$a>lu$a pa#a #aeah pa#at pa*u#aa u'ia +u #a $ae"a ;i%&a#e"&+a pa#a !a"ita +u#a te%al, 'ehi"77a ti#a$ telihat #e"7a" %ai$ 6i$a +e"77u"a$a" +a++&7a;i Pe+ei$'aa" i"i ha"*a +e+%e#a$a" a"taa le'i atau tu+& *a"7 '&li# #a" $i'ti$ Pe+ei$'aa" 7a%u"7a" a"taa USG #a" +a++&7a;i +e+%ei$a" $etepata" #ia7"&'a *a"7 ti"77i

Teapi u"tu$ ;i%&a#e"&+a te7a"tu"7 #ai %e%eapa hal 'e%a7ai %ei$ut: a U$ua"

% Te#apat a'a "*ei atau ti#a$ 8 U'ia pa'ie"

# Ha'il %i&p'i

Kae"a ;i%&a#e"&+a +a++ae a#alah tu+& 6i"a$ +a$a pe"7&%ata" *a"7 #ila$u$a" ti#a$ pelu #e"7a" pe"7a"7$ata" +a++ae 4a"7 pelu #ipehati$a" a#alah %e"tu$ #a" u$ua""*a 'a6a Pe"7a"7$ata" +a++ae hau' +e+pehati$a" %e%eapa ;a$t& *aitu ;a$t& ;i'i$ #a"

11  Pe"atala$'a"aa" Me#i

p'i$&l&7i pa'ie" Apa%ila u$ua" #a" l&$a'i tu+& te'e%ut +e"*e%a%$a" a'a 'a$it #a" ti#a$ "*a+a" pa#a pa'ie" +a$a #ipelu$a" pe"7a"7$ata"

Teapi pe"7a"7$ata" tu+& i"i #i'e%ut #e"7a" %i&p'i e$'i'i *aitu pe+%e#aha" #e"7a" +e"7a"7$at 'eluuh 6ai"7a" tu+& %e'eta 'e#i$it 6ai"7a" 'ehat #i'e$ita"*a Teapi #e"7a" &pea'i pe"7a"7$ata" tu+& i"i ti#a$ a$a" +eu%ah %e"tu$ pa*u#aa tetapi ha"*a a$a" +e"i"77al$a" 6ai"7a" paut *a"7 a$a" #i7a"ti$a" 6ai"7a" "&+al 'e8aa pelaha"

a Si'te+ I"te7u+e"

-) Pehati$a" : "*ei, %e"7$a$, ;le%iti', ul$u' 5) I"'pe$'i $e+eaha"  7atal, eite+a ) Pehati$a" pi7+e"ta'i $ulit

9) K&"#i'i 7u'i, 7i7i, +u$&'a  li#ah % Si'te+ Ga't&i"te'ti"ali'

-) Ka6i ;e$!e"'i, +ulai, #ua'i, %eat i"7a""*a +ual  +u"tah 'etelah pe+%eia" $e+&theapi

5) O%'e=a'i peu%aha" $e'ei+%a"7a" 8aia"  ele$t&lit ) Ka6i #iae  $&"'tipa'i

9) Ka6i a"&e$'ia

2) Ka6i : 6au"#i8e, "*ei a%#&+e" $ua#a" ata' $a"a" 8 Si'te+ He+at&p&eti$

-) Ka6i Net&pe"ia Ka6i ta"#a i";e$'i Au'$ulta'i pau

Pehati$a" %atu$ p&#u$ti;  "a;a' #i'p"&e Ka6i 'uhu

5) Ka6i T&+%&'it&pe"ia :  2////@+ C +e"e"7ah,  5////@+ C %eat ) Ka6i A"e+ia

3a"a $ulit, 8apila* e;ill

Di'p"&e, le+ah, palpita'i, =eti7& # Si'te+ Re'piat&i$  Ka#i&=a'$ula

-) Ka6i teha#ap ;i%&'i' pau *a"7 #ita"#ai : Di'p"&e, $ei"7, %atu$ "&" p&#u$ti; C teuta+a %le&+i'i"

) La$u$a" pe+ei$'aa" EKG e Si'te+ Neu&+u'$ula

-) Pehati$a" a#a"*a peu%aha" a$ti;ita' +&t&i$ 5) Pehati$a" a#a"*a pae'te'ia

) E=alua'i e;le$'

9) Ka6i ata$'ia, le+ah, +e"*eet $a$i 2) Ka6i 7a"77ua" pe"#e"7aa" 0) Di'$u'i$a" ADL

; Si'te+ 7e"it&ui"ai -) Ka6i ;e$!e"'i BAK

5) Pehati$a" %au, !a"a, $e$euha" ui"e ) Ka6i : he+atuia, &li7uia, a"uia

9) M&"it& BUN, $eati"i"

a N*ei a$ut %ehu%u"7a" #e"7a" $eu'a$a" 6ai"7a" '*aa;, 'upla* =a'$ulai'a'i atau e;e$ 'a+pi"7 theap*@ti"#a$a", #ita"#ai #e"7a" :

DS :

 Klie" +e"7eluh$a" a'a "*ei

 Mei"7i' $ae"a "*ei (;a8ial +a'$ &; pai")

 Le+ah #a" i'tiahat $ua"7 DO :

 Ga"77ua" t&"u' &t&t

 Ga"77ua" pila$u

 Re'p&" aut&"&+i8

N*ei %e$ua"7@#apat teata'i #e"7a" $iteia :

 Melap&$a" a'a "*ei *a"7 'u#ah teata'i (a'a "*ei %e$ua"7)

 Dapat +&"7&"t&l ADL' 'e+i"i+al +u"7$i"

 Dapat +e"#e+&"ta'i$a" $etea+pila" ela$'a'i #a" a$ti=ita' #i=e'i&"al 'e'uai 'itua'i i"#i=i#u

I"#epe"#e"t :

-) Ka6i i!a*at "*ei 'epeti l&$a'i ;e$!e"'i  #ua'i #a" i"te"'ita' ('$ala - C -/) #a" upa*a u"tu$ +e"7ua"7i "*ei

5) Bei $e"*a+a"a" #e"7a" +e"7atu p&'i'i $lie" #a" a$ti=ita' #i=e'i&"al

13 5 Re"8a"a Kepea!ata

) D&&"7 pe"77u"aa" 'te'' +a"a7e+e"t 'epeti teh"i$ ela$'a'i, =i'uali'a'i, $&+u"i$a'i theapeuti$ +elalui 'e"tuha"

9) E=alua'i@K&"t&l %e$ua"7"*a a'a "*ei Se'uai$a" pe+%eia" +e#i$a'i 'e'uai $e%utuha""*a K&la%&a'i :

-) Ke+%a"7$a" e"8a"a +a"a7e+e"t pe"a"7a"a" 'a$it #e"7a" $lie" #a" #&$te 5) Bei a"al7eti$ 'e'uai i"#i$a'i #a" #&'i' *a"7 tepat

% Ga"77ua" 7a"%aa" #ii (%&#* i+a7e) %ehu%u"7a" #e"7a" ti"#a$a" pe+%e#aha" #ita"#ai #e"7a" :

DS :

 ?e%ali'a'i peu%aha" p&la hi#up

 Rea$'i $eta$uta" #a" +e"&la$ peu%aha" pa#a %a7ia" tu%uh

 Ti#a$ #apat +e"ei+a peu%aha" 'tu$tu #a" ;u"7'i tu%uh

 Pea'aa"@pa"#a"7a" "e7ati; teha#ap tu%uh

 Me"7u"7$ap$a" $eputu'a'aa"

 Me"7u"7$ap$a" $eta$uta" #it&la$

 Me"7u"7$ap$a" $ele+aha" DO :

 Me"&la$ u"tu$ +elihat #a" +e"*e"tuh %a7ia" tu%uh *a"7 %eu%ah

 Me"7ua"7i $&"ta$ '&'ial

 Pe &$upa'i #e"7a" %a7ia" tu%uh@;u"7'i tu%uh *a"7 hila"7

 Me"&la$ pe"6ela'a" peu%aha" tu%uh

 Ti#a$ +au tuut %eta"77u"7 6a!a% #ala+ pea!ata" #ii Ga+%aa" #ii %e$e+%a"7 'e8aa p&'iti; #e"7a" $iteia :

 Me"7eti te"ta"7 peu%aha" pa#a tu%uh

 Me"ei+a 'itua'i *a"7 te6a#i pa#a #ii"*a

 Mulai +e"7e+%a"7$a" +e$a"i'+e $&pi"7 pe+e8aha" +a'alah

 Me"u"6u$$a" pe"*e'uaia" teha#ap peu%aha"

 Dapat +e"ei+a ealita

 Hu%u"7a" i"tepe'&"al a#e$uat I"#epe"#e"t :

-) Di'$u'i #e"7a" $lie" te"ta"7 #ia7"&'a #a" ti"#a$a" 7u"a +e+%a"tu $lie" a7a #apat a$ti;  $e+%ali 'e'uai ADL'

5) Re=ie!@a"ti'ipa'i e;e$ 'a+pi"7 $aita" #e"7a" ti"#a$a" *a"7 #ila$u$a" te+a'u$ e;e$ *a"7 +e"77a"77u a$ti=ita' 'e$'ual

9) Bei i";&+a'i@$&"'eli"7 'e'ei"7 +u"7$i" 2) Bei #&&"7a"@'upp&t p'i$&l&7i'

0) Gu"a$a" 'e"tuha" pea'aa" 'ela+a +ela$u$a" i"tea$'i (petaha"$a" $&"ta$ +ata) K&la%&a'i :

-) Re;e $lie" pa#a $el&+p&$ p&7a+ tete"tu 5) Re;e pa#a 'u+%e@ahli lai" 'e'uai i"#i$a'i

8 Re'i$& ti"77i 7a"77ua" i"te7ita' 6ai"7a"@$ulit %ehu%u"7a" #e"7a" e;e$ teat+e"t I"te7ita'  6ai"7a"@$ulit a#e$uat #e"7a" $iteia :

 I"#e"ti;i$a'i i"te=e"'i pa#a $&"#i'i>$&"#i'i $hu'u'

 Pati'ipa'i a$ti; #ala+ teh"i$ 7u"a pe"8e7aha" $&+pli$a'i@ +e"i"7$at$a" pe"*e+%uha" I"#epe"#e"t :

-) Ka6i $&"#i'i $ulit #ai e;e$ 'a+pi"7 : &%e$a", pe"*e+%uha" la+%at 5) D&&"7 $lie" u"tu$ ti#a$ +e"77au$ aea *a"7 te$e"a 7a"77ua"

) Saa"$a" $lie" u"tu$ +e"7hi"#ai pe+a$aia" 8ea+ $ulit, 'alep #a" p&!#e 6i$a %u$a" &#e@i6i" #ai #&$te atau pea!at"*a

9) Atu p&'i'i 'e'uai $e%utuha" K&la%&a'i :

-) A#+i"i'ta'i pe+%eia" a"ti#&te 'e'uai i"#i$a'i

5) Bei$a" theapi $&+pe' ha"7at #a" #i"7i" 'e'uai petu"6u$

# Kua"7 pe"7etahua" ($e%utuha" %ela6a) te"ta"7 pe"*a$it, p&7"&'i' #a" ti"#a$a" *a"7 #i%utuh$a" %ehu%u"7a" #e"7a" i";&+a'i *a"7 $ua"7, i"tepeta'i *a"7 $eliu, #ita"#ai #e"7a" : DS :

 Beta"*a te"ta"7 +a'alah *a"7 #ia'a$a""*a

 Me+i"ta i";&+a'i te"ta"7 $ea#aa" pe"*a$it"*a

 Me"7ata$a" $&"'ep'i *a"7 $eliu te"ta"7 pe"*a$it"*a DO :

 Ti#a$ +e"7e"al p&7"&'a #a" ti"#a$a" *a"7 #ila$u$a"

 Ti#a$ tahu #a+pa$ %ila ti#a$ #ila$u$a" ti"#a$a" pe+%e#aha"

Klie" +e"7e"al #a" +e"7etahui i";&+a'i pe"*a$it, p&7"&'a, #a" ti"#a$a" *a"7 pelu #ila$u$a" #e"7a" $iteia :

 Me"7ata$a" $ea$uata" #ai i";&+a'i *a"7 #i#apat te"ta"7 #ia7"&'a, ti"#a$a" #a" $e'iapa" @pe"ei+aa" #ii ata' pea!ata"

 Dapat +e+%e"a$a" p&'e#u *a"7 #i%utuh$a"

 Me"6ela'$a" #a" +ee'p&" ti"#a$a" *a"7 #ila$u$a" 15

 Me"7i"#e"ti;i$a'i @ +e"77u"a$a" 'u+%e @ahli #e"7a" tepat

 Bepati'ipa'i pa#a $e7iata" pea!ata" #a" pe"7&%ata" I"#epe"#e"t :

-) Re=ie! te"ta"7 hal>hal *a"7 $hu'u' +e"7e"ai #ia7"&'a, alte"ati; ti"#a$a" #a" haapa" +e"#ata"7 #e"7a" pe'ep'i *a"7 a#e$uat

5) Jela'$a", %ei 7a+%aa" #a" $a6i pe'ep'i $lie" te"ta"7 "e&pla'+a #a" pe"a"7a"a""*a Kait$a" #e"7a" pe"7ala+a" #ai $lie" *a"7 'a+a

) Jela'$a" #a" ta"*a $lie" u"tu$ $&+u"i$a'i (u+pa" %ali$) #a" +e"7$&e$'i $&"'ep'i *a"7 $eliu te"ta"7 pe"*a$it *a"7 #i#eita"*a

9) Re=ie! +e#i$a'i 'e8aa $hu'u' #a" 8aa>8aa pe"77u"aa" &%at

2) Jela'$a" 8aa pea!ata" $ulit $hu'u'"*a aea i"8i'i p&'t "e&pla'+a

0) D&&"7 $lie" u"tu$ +e"77u"a$a" 'u+%e @ ahli 7u"a +e"7&"t&l 'tatu' $e'ehata""*a .) La$u$a" pe #i'8ha7e pla""i"7 'e'uai i"#i$a'i

(S#P P:S, :P '(" N(N( N0; N:;

NO NANDA NO ( TUJUAN ) NI ( INTER?ENSI )

-N*ei a$ut (//-5) D&+ai" -5 ($e"*a+a"a") NO : K&"t&l "*ei (-0/2) NI : Ma"a6e+e" "*ei (-9//)

De;i"i'i : Pe"7ala+a" 'e"'&i #a" e+&'i&"al *a"7 ti#a$ +e"*e"a"7$a" *a"7 +u"8ul a$i%at $eu'a$a" 6ai"7a" *a"7 a$tual atau p&te"'ial atau #i7a+%a$a" #ala+ hal $eu'a$a"

'e#e+i$ia" upa (I"te"ati&"al A''&8iati&" ;& the 'tu#* &; Pai") a!ita" *a"7 ti%a>ti%a atau la+%at #ai i"te"'ita' i"7a" hi"77a %eat #e"7a" a$hi *a"7 #apat #ia"ta'ipa'i atau #i pe#i$'i #a"

%ela"7'u"7 , 0 %ula"

Bata'a" $aa$tei'ti$: Peu%aha" 'elea +a$a" Peu%aha" #ala+ paa+ete ;i'i&l&7i$ ( +i': TD, "a#i, pe"apa'a", 'atua'i O5) Diap&e'i'

Peila$u #i'ta$'i (+i': %e6ala" +&"#a +a"#i, a$ti=ita' %eula"7)

Bu$ti "*ei +e"77u"a$a" 'ta"#a 8he8$li't peila$u "*ei u"tu$ +ee$a *a"7 ti#a$ +a+pu %e$&+u"i$a'i 'e8aa =e%al

Me"7e$pe'i$a" peila$u (+i': 7eli'ah, +e"a"7i', !a'pa#a) E$'pe'i !a6ah teha#ap "*ei (+i': +ata $ua"7 %e8aha*a, ta+pa$ $a8au, 7ea$a" +ata %epe"8a atau +e"etap pa#a 'atu ;&$u')

Si$ap +eli"#u"7i

De;i"i'i : Ti"#a$a" pi%a#i u"tu$ +e"7&"t&l "*ei

N*ei te$&"t&l 'ela+a  6a+, #e"7a" $iteia ha'il

Me"7e"al ;a$t&>;a$t& pe"*e%a%

(-, 5,,9,2)

Me"7e"al &"'et "*ei (-,5,,9,2) Ti"#a$a" pet&l&"7a" "&" ;a+a$&l&7i (-,5,,9,2)

Me"77u"a$a" a"al7eti$ *a"7 #ie$&+e"#a'i$a" (-,5,,9,2) Melap&$a" 7e6ala>7e6ala "*ei $epa#a ti+ $e'ehata" (-,5,,9,2) N*ei te$&"t&l (-,5,,9,2) I"#i$at& '$ala:

ti#a$ pe"ah +e"u"6u$$a"  6aa"7 +e"u"6u$$a"

$a#a"7>$a#a"7 +e"u"6u$$a" 'ei"7 +e"u"6u$$a"

'e8aa $&"'i'te" +e"u"6u$$a" Ti"7$at "*ei (5-/5)

De;i"i'i : $epaaha" "*ei *a"7 #ia+ati atau #ilap&$a"

N*ei %e$ua"7 'ela+a  6a+, #e"7a" $iteia ha'il

Melap&$a" "*ei (-,5,,9,2) Fe$ue"'i "*ei (-,5,,9,2)

La+a"*a epi'&#e "*ei (-,5,,9,2) E$'pe'i "*ei !a6ah (-,5,,9,2) Peu%aha" e'pia'i ate

(-,5,,9,2)

De;i"i'i : pe"7ua"7a" atau e#u$'i "*ei 'a+pai pa#a ti"7$at $e"*a+a"a" *a"7 #apat #itei+a &leh pa'ie"

La$u$a" pe"7$a6ia" "*ei 'e8aa $&+pehe"'i; te+a'u$ l&$a'i, $aa$tei'ti$, &"'et@#ua'i, ;e$ue"'i, $ualita', i"te"'ita' #a" ;a$t& pe"8etu'

+&"it& e'p&"

$eti#a$"*a+a"a" 'e8aa =e%al #a" "&" =e%al

Pa'ti$a" pa'ie" +e"ei+a pea!ata" a"al7eti$ #e"7a" tepat

Gu"a$a" 'tate7i $&+u"i$a'i *a"7 e;e$ti; u"tu$ +e"7etahui e'p&" pe"ei+aa" pa'ie" teha#ap "*ei

E=alua'i $ee;e$ti;a"

pe"77u"aa" $&"t&l "*ei M&"it&i"7 peu%aha" "*ei %ai$ a$tual +aupu" p&te"'ial Se#ia$a" li"7$u"7a" *a"7 "*a+a"

Kua"7i ;a$t&>;a$t& *a"7 #apat +e"a+%ah u"7$apa" "*ei

A6a$a" pe"77u"aa" teh"i$ ela$'a'i 'e%elu+ atau 'e'u#ah "*ei %ela"7'u"7 

K&la%&a'i #e"7a" ti+

$e'ehata" lai" u"tu$ +e+ilih ti"#a$a" 'elai" &%at u"tu$ +ei"7a"$a" "*ei

Ti"7$at$a" i'tiahat *a"7 a#e$uat u"tu$ +ei"7a"$a"

Ti#a$ a#a haapa"

F&$u' +e"*e+pit (+i':pe'ep'i !a$tu, p&'e' %epi$i

teha+%at)

Si$ap +eli"#u"7i aea "*ei P&'i'i u"tu$ +e"7hi"#ai "*ei Peila$u +eli"#u"7i

Melap&$a" peila$u "*ei Pupil #ilata'i

F&$u' #ii 'e"#ii

Lap&a" #ii +e"77u"a$a" '$ala "*ei *a"7 'ta"#at ( +i':'$ala !a6ah !&"7 %a$e, '$ala "ilai "u+ei$, '$ala =i'ual a"al&7)

Lap&a" #ii +e"77u"a$a" i'tu+e"t "*ei *a"7 'ta"#a ( +i': M8Gill Pai"

ue'ti&""ae, %ie; Pai" I"=e"t&*)

Fa$t& *a"7 %ehu%u"7a": A7e" 8e#ea %i&l&7i (+i': i";e$'i, i'8he+i8, "e&pla'+a) A7e" 8e#ea $i+ia (+i': te%a$a, 8ap'ai8i", +eth*le" 8hl&i#e, +u'ta# a7e") A7e" 8e#ea ;i'i$ ( +i': a%'e', a+puta'i, lu$a %a$a,

tep&t&"7, p&'e#u &pea'i, tau+a, latiha" %ele%ih)

Peu%aha" te$a"a" #aah (-,5,,9,2)

Kehila"7a" "a;'u +a$a" (-,5,,9,2) I"#i$at& '$ala : Beat u$up %eat Se#a"7 Ri"7a" Ti#a$ a#a "*ei Ma"a6e+e" pe"7&%ata" (51/) De;i"i'i : Fa'ilita'i pe"77u"aa" *a"7 a+a" #a" e;e$ti; e'ep #a" &%at %e%a'

Te"tu$a" &%at *a"7 #i%utuh$a" pa'ie" #a" 8aa +e"7el&la 'e'uai #e"7a" a"6ua"@ #&'i' M&"it& e;e$ teaupeti$ #ai pe"7&%ata"

M&"it& ta"#a #a" 7e6ala 'eta e;e$ 'a+pi"7 #ai &%at

M&"it& i"tea$'i &%at

A6a$a" pa#a pa'ie" $elua7a 8aa +e"7ata'i e;e$ 'a+pi"7 pe"7&%ata"

Pe"7el&laa" a"al7eti$

Pei$'a pei"tah +e#i' te"ta"7 &%at, #&'i'  ;e$ue"'i &%at a"al7eti$

Pei$'a i!a*at ale7i pa'ie" Pilih &%at %e#a'a$a" tipe #a" %eat"*a "*ei

Pilih 8aa pe+%eia" I? atau IM u"tu$ pe"7&%ata", 6i$a

+u"7$i"

M&"it& =ital 'i7" 'e%elu+ #a" 'e'u#ah pe+%eia" a"al7eti$ Kel&la 6a#!al pe+%eia" a"al7eti$ *a"7 'e'uai E=alua'i e;e$ti;ita' #&'i'

a"al7eti$, &%'e=a'i ta"#a #a" 7e6ala e;e$ 'a+pi"7, +i'al #epe'i pe"a;a'a", +ual  +u"tah, +ulut $ei"7, 

K&la%&a'i #7" #&$te u"tu$ &%at, #&'i'  8aa pe+%eia" *7 #ii"#i$a'i$a"

Te"tu$a" l&$a'i "*ei, $aa$tei'ti$, $ualita', #a" $epaaha" 'e%elu+

pe"7&%ata"

Bei$a" &%at #e"7a" pi"'ip 2 %e"a

Pe+%eia" A"al7e'i$ (55-/) De;i"i'i : Me"77u"a$a" a7e" ;a+a$&l&7i$ u"tu$

+e"7hila"7$a" atau +e"7ua"7i "*ei

Te"tu$a" l&$a'i, $aa$tei'ti$, $ualita', #a" #ea6at "*ei 'e%elu+ pe+%eia" &%at e$ i"'tu$'i #&$te te"ta"7  6e"i' &%at, #&'i', #a" ;e$ue"'i

e$ i!a*at ale7i

Pilih a"al7e'i$ *a"7 #ipelu$a" atau $&+%i"a'i #ai a"al7e'i$ $eti$a pe+%eia" le%ih #ai 'atu Te"tu$a" piliha" a"al7e'i$ te7a"tu"7 tipe #a" %eat"*a "*ei

Te"tu$a" a"al7e'i$ piliha", ute pe+%eia", #a" #&'i' &pti+al Pilih ute pe+%eia" 'e8aa I?, IM u"tu$ pe"7&%ata" "*ei 'e8aa teatu

M&"it& =ital 'i7" 'e%elu+ #a" 'e'u#ah pe+%eia" a"al7e'i$ peta+a $ali

Bei$a" a"al7e'i$ tepat !a$tu teuta+a 'aat "*ei he%at E=alua'i e;e$ti=ita' a"al7e'i$, 19

ta"#a #a" 7e6ala (e;e$ 'a+pi"7 5 Re'i$& i";e$'i (////9) D&+ai" -- ($ea+a"a" @ peli"#u"7a") Kela' - (i";e$'i)

De;i"i'i : Pe"i"7$ata" e'i$& +a'u$"*a &7a"i'+e pat&7e"

Fa$t&>;a$t& e'i$& : P&'e#u I";a'i; 

Keti#a$8u$upa" pe"7etahua" u"tu$ +e"7hi"#ai papaa" pat&7e"

Tau+a

Keu'a$a" 6ai"7a" #a" pe"i"7$ata" papaa" li"7$u"7a"

Ruptu +e+%a" a+"i&" A7e" ;a+a'i (i+u"&'upe'a") Mal"uti'i Pe"i"7$ata" papaa" li"7$u"7a" pat&7e" I+&"u'upe'i Keti#a$a#e$uata" i+u+ %uata"

Ti#a$ a#e$uat petaha"a" 'e$u"#e (pe"uu"a" H%, Leu$&pe"ia, pe"e$a"a" e'p&"

NO :

K&"t&l e'i$& (-/5)

De;i"i'i : i"#a$a" i"#i=i#u u"tu$ +e"7eti, +e"8e7ah,

+e"7eli+i"a'i atau +e"7ua"7i a"8a+a" i";e$'i

Klie" #a" $elua7a +a+pu +e"u"6u$$a" $e+a+pua" +e"8e7ah i";e$'i #ala+ !a$tu  6a+ #e"7a" $iteia ha'il :

Me"7i#e"ti;i$a'i ;a$t& i'i$& i";e$'i -,5,,9,2

Me"7etahui peila$u *a"7 %ehu%u"7a" #e"7a" i'i$& i";e$'i -,5,,9,2

Me"7i#e"ti;i$a'i ta"#a #a" 7e6ala i";e$'i -,5,,9,2

Me+petaha"$a" li"7$u"7a" *a"7 %e'ih -,5,,9,2

Me"8u8i ta"7a" -,5,,9,2

I"#i$at& '$ala:

Ti#a$ pe"ah +e"u"6u$$a" Jaa"7 +e"u"6u$$a"

Ka#a"7>$a#a"7 +e"u"6u$$a"

NI :

K&"t&l I";e$'i (029/) De;i"i'i : +e+i"i+al$a" pe&leha" #a" ta"'+i'i #ai a7e" i";e$'iu'

Be'ih$a" li"7$u"7a" 'etelah #ipa$ai pa'ie" lai"

Petaha"$a" te$"i$ i'&la'i Bata'i pe"7u"6u"7 %ila pelu I"'tu$'i$a" pa#a pe"7u"6u"7 u"tu$ +e"8u8i ta"7a" 'aat %e$u"6u"7 #a" 'etelah %e$u"6u"7 +e"i"77al$a" pa'ie"

Gu"a$a" 'a%u" a"ti+i$&%ia u"tu$ 8u8i ta"7a"

u8i ta"7a" 'etiap 'e%elu+ #a" 'e'u#ah ti"#a$a" $pea!ta" Gu"a$a" %a6u, 'au"7 ta"7a" 'e%a7ai alat peli"#u"7

Petaha"$a" li"7$u"7a" a'epti$ 'ela+a pe+a'a"7a" alat

Ga"ti leta$ I? pei;e #a" li"e 8e"tal #a" #e''i"7 'e'uai #e"7a" petu"6u$ u+u+ Gu"a$a" $atete i"te+ite" u"tu$ +e"uu"$a" i";e$'i $a"#u"7 $e"8i"7

Ti#a$ a#e$uat petaha"a" tu%uh pi+e ($ulit ti#a$ utuh, tau+a 6ai"7a", pe"uu"a" $e6a 'ilia, 8aia" tu%uh 'tati', peu%aha" 'e$e'i pH,

peu%aha" pei'talti$) Pe"*a$it $&"i$

Se8aa $&"'i'te" +e"u"6u$$a" pelu

I";e8ti&" P&te8ti&" (p&te$'i teha#ap i";e$'i) (022/) De;i"i'i : pe"8e7aha" #a" #ete$'i +u#ah teha#ap i";e$'i pa#a pa'ie" *a"7 %ee'i$& M&"it& ta"#a #a" 7e6ala i";e$'i 'i'te+i$ #a" l&$al

M&"it& hitu"7 7a"ul&'it, 3B M&"it& $ee"ta"a" teha#ap i";e$'i

Bata'i pe"7u"6u"7

Sai"7 pe"7u"6u"7 teha#ap pe"*a$it +e"ula

Pataha"$a" te$"i$ a'pe'i' pa#a pa'ie" *a"7 %ee'i$& Petaha"$a" te$"i$ i'&la'i $@p Bei$a" pea!ata" $uliat pa#a aea epi#e+a

I"'pe$'i $ulit #a" +e+%a" +u$&'a teha#ap $e+eaha", pa"a', #ai"a'e

I'pe$'i $&"#i'i lu$a @ i"'i'i %e#ah

D&&"7 +a'u$$a" "uti'i *a"7 8u$up

D&&"7 +a'u$a" 8aia" D&&"7 i'tiahat

I"'tu$'i$a" pa'ie" u"tu$ +i"u+ a"ti%i&ti$ 'e'uai e'ep A6a$a" pa'ie" #a" $elua7a ta"#a #a" 7e6ala i";e$'i A6a$a" 8aa +e"7hi"#ai i";e$'i

Lap&$a" $e8ui7aa" i";e$'i Lap&$a" $ultu p&'iti; 



Ga"77ua" 8ita tu%uh (//--1) D&+ai" 0 : Pe'ep'i #ii

Kela'  : 8ita tu%uh De;i"i'i :

K&";u'i #ala+ 7a+%aa" +e"tal te"ta"7 #ii>;i'i$ i"#i=i#u

Bata'a" $aa$tei'ti$ :

Be;&$u' pa#a ;u"7'i +a'a lalu Be;&$u' pa#a pe"a+pila" +a'a lalu

Ga"77ua" ;u"7'i tu%uh Ga"77ua" 'tu$tu tu%uh Me"&la$ +e"ei+a peu%aha" Me"*e+%u"*i$a" %a7ia" tu%uh

Pea'aa" "e7ati; te"ta"7 tu%uh

Peu%aha" 7a*a hi#up Fa$t& *a"7 %ehu%u"7a" : e#ea

Ga"77ua" ;u"7'i p'i$&'&'ial Pe"*a$it

Peu%aha" ;u"7'i $&7"iti;  Peu%aha" ;u"7'i tu%uh P&7a+ pe"7&%ata" P&'e#u pe+%e#aha"

NO :

ita tu%uh (-5//)

De;i"i'i : pe'ep'i teha#ap pe"a+pila" #a" ;u"7'i tu%uh 'e"#ii

S$ala Out8&+e I"#i$at& :

Ga+%aa" i"te"al #ii -,5,,9,2 Ke'e'uaia" a"taa i#eal tu%uh, ealita' tu%uh #e"7a"

pe"a+pila" tu%uh -,5,,9,2 De'$ip'i %a7ia" tu%uh *a"7 te$e"a -,5,,9,2

Kepua'a" #e"7a" ;u"7'i tu%uh -,5,,9,2

Si$ap teha#ap +e"*e"tuh %a7ia" tu%uh *a"7 te$e"a -,5,,9,2

Pe"*e'uaia" teha#ap peu%aha" ta+pila" ;i'i$ -,5,,9,2

Pe"*e'uaia" teha#ap peu%aha" 'tatu' $e'ehata" Ketea"7a" :

Ti#a$ pe"ah p&'iti;  Jaa"7 p&'iti; 

Ka#a"7>$a#a"7 p&'iti;  Sei"7 p&'iti; 

NI :

Pe"7ua"7a" $e8e+a'a" (215/)

De;i"i'i : Me"7ua"7i te$a"a", $eta$uta", ;ia'at, +aupu" $eti#a$"*a+a"a" te$ait

#e"7a" 'u+%e>'u+%e %aha*a *a"7 ti#a$ tei#e"ti;i$a'i

A$ti=ita' :

Gu"a$a" pe"#e$ata" *a"7 te"a"7 #a" +e*a$i"$a"

N*ata$a" #e"7a" 6ela' haapa" teha#ap peila$u $lie"

Paha+i 'itua'i $i'i' *a"7 te6a#i pa#a pe'pe$ti; $lie" D&&"7 $elua7a u"tu$

+e"#a+pi"7i $lie" #e"7a" 8aa *a"7 tepat

De"7a$a" $lie"

Peti+%a"7$a" $e+a+pua" $lie" u"tu$ +e"7a+%il $eputu'a"

Ta"'i'i pe$e+%a"7a" Tau+a

9

De;i'ie"'i pe"7etahua" (//-50)

D&+ai" 2 (pe'ep'i @ $&7"i'i) Kela' 9 ($&7"i'i)

De;i"i'i :

Ti#a$ a#a"*a atau $ua"7"*a i";&+a'i $&7"iti; 'ehu%u"7a" #e"7a" t&pi8 'pe'i;i$

Bata'a" $aa$tei'ti$ : +e+=e%ali'a'i$a" a#a"*a +a'alah, $eti#a$a$uata" +e"7i$uti i"'tu$'i, peila$u ti#a$ 'e'uai

Fa$t& *a"7 %ehu%u"7a" : $ete%ata'a" $&7"iti;,

i"tepeta'i teha#ap i";&+a'i *a"7 'alah, $ua"7"*a

$ei"7i"a" u"tu$ +e"8ai i";&+a'i, ti#a$ +e"7etahui 'u+%e>'u+%e i";&+a'i

NO :

Pe"7etahua" : p&'e' pe"*a$it (-1/)

De;i"i'i : ti"7$at pe+aha+a" *a"7 #i'a+pai$a" te"ta"7 p&'e' pe"*a$it tete"tu #a" $&+pli$a'i"*a

Pe"7etahua" $lie" %eta+%ah 'ela+a  6a+ #e"7a" $iteia ha'il $lie" atau $elua7a #apat +e"*e%ut$a" #a" +e"7eti: Fa$t& pe"*e%a% #a" ;a$t& *a"7 %e$&"ti%u'i (-,5,,9,2)

Fa$t& e'i$& (-,5,,9,2) Ta"#a #a" 7e6ala (-,5,,9,2) P&'e' pe6ala"a" pe"*a$it (-,5,,9,2)

P&te"'ial $&+pli$a'i (-,5,,9,2) Ta"#a #a" 7e6ala $&+pli$a'i pe"*a$it (-,5,,9,2)

I"#i$at& S$ala :

Ti#a$ a#a pe"7etahua" Pe"7etahua" te%ata' Pe"7etahua" 'e#a"7 Pe"7etahua" %a"*a$

NI :

Pe"7a6aa" : P&'e' Pe"*a$it (20/5)

De;i"i'i : Me+%a"tu pa'ie" u"tu$ +e+aha+i i";&+a'i *a"7 %ehu%u"7a" #e"7a" p&'e' pe"*a$it 'e8aa 'pe'i;i$

Bei$a" pe"ilaia" te"ta"7 ti"7$at pe"7etahua" pa'ie" te"ta"7 p&'e' pe"*a$it *a"7 'pe'i;i$

Jela'$a" pat&;i'i&l&7i #ai pe"*a$it #a" %a7ai+a"a hal i"i %ehu%u"7a" #e"7a" a"at&+i #a" ;i'i&l&7i, #e"7a" 8aa *a"7 tepat

Ga+%a$a" ta"#a #a" 7e6ala *a"7 %ia'a +u"8ul pa#a pe"*a$it, #e"7a" 8aa *a"7 tepat

Ga+%a$a" p&'e' pe"*a$it, #e"7a" 8aa *a"7 tepat I#e"ti;i$a'i $e+u"7$i"a" pe"*e%a%, #e"7"a 8aa *a"7 tepat

Se#ia$a" i";&+a'i pa#a pa'ie" te"ta"7 $&"#i'i, #e"7a" 8aa *a"7 tepat

Hi"#ai 6a+i"a" *a"7 $&'&"7 Se#ia$a" %a7i $elua7a atau SO i";&+a'i te"ta"7 $e+a6ua" pa'ie" #e"7a" 8aa *a"7 tepat 23

Pe"7etahua" 'a"7at %a"*a$ Di'$u'i$a" peu%aha" 7a*a hi#up *a"7 +u"7$i" #ipelu$a" u"tu$ +e"8e7ah $&+pli$a'i #i +a'a *a"7 a$a" #ata"7 #a" atau p&'e' pe"7&"t&la" pe"*a$it

Di'$u'i$a" piliha" teapi atau pe"a"7a"a"

Du$u"7 pa'ie" u"tu$ +e"7e$'pl&a'i atau

+e"#apat$a" 'e8&"# &pi"i&" #e"7a" 8aa *a"7 tepat atau #ii"#i$a'i$a"

E$'pl&a'i $e+u"7$i"a" 'u+%e atau #u$u"7a", #e"7a" 8aa *a"7 tepat

Ru6u$ pa'ie" pa#a 7up atau a7e"'i #i $&+u"ita' l&$al, #e"7a" 8aa *a"7 tepat I"'tu$'i$a" pa'ie" +e"7e"ai ta"#a #a" 7e6ala u"tu$

+elap&$a" pa#a pe+%ei pea!ata" $e'ehata", #e"7a" 8aa *a"7 tepat

DAFTAR PUSTAKA

ape"it&, L*"#a Juall (-) E#i'i 5 (te6e+aha")

Pe"e%it %u$u Ke#&$tea" EG Ja$aata

ape"it&, L*"#a Juall (5///) E#i'i 1 (te6e+aha") Pe"e%it %u$u

R e " 8 a" a ' u h a"  D & $u + e " t a' i K e p e a ! a ta "

D&e"7e', Mail*"" E (-) E#i'i  (te6e+aha") Pe"e%it %u$u Ke#&$tea" EG Ja$ata

E"7a+, Ba%aa (-1)

Bu$u Ke#&$tea" EG Ja$ata

Ju"a#i, Pu"a!a" (-15) Ja$ata: Me#ia Ae'8ulapiu' Fa$ulta' Ke#&$tea" U"i=e'ita' I"#&"e'ia

L&"7, Ba%aa  (-0) ?&lu+e I (te6e+aha") 4a*a'a" I$ata" Alu+"i Pe"#i#i$a" Kepea!ata" Pa6a6aa" Ba"#u"7

Ma"'6&e, Ai;, et all (-) Ae'8ullapiu'

  (-9)

S&et&+& Sua%a*a

25

R e " 8 a" a ' u h a" K e p e a ! at a "

Re"8a"a 'uha" Kepea!ata" Me#i$al Be#ah ?&lu+e 5, (te6e+aha") Pe"e%it

Kapita Sele$ta Ke#&$tea",

P e a ! a ta " M e # i$ a l B e # a (

Kapita Sele$ta Ke#&$tea" Fa$ulta' Ke#&$tea" UI : Me#ia