Analisa Asuhan Keperawatan Pada Pasien Penyakit Paru Obstruktif Kronis dan Tuberkulosis Paru dengan Intervensi Pursed Lips Breathing Kombinasi Diafragmatic Breathing

Sari

ABSTRACT

Chronic Obstructive Pulmonary Disease (COPD) is a disease caused by abnormalities of the airways or alveoli caused by significant exposure to harmful particles or gases, host influences including abnormal lung development, this disease is common and can be prevented or treated. This nursing care analysis aims to report the results of pursed lips breathing intervention combined with diaphragmatic breathing in patients with chronic obstructive pulmonary disease in the Umar Bin Khattab 2 room, AL-IHSAN Hospital, Bandung. This report uses nursing care case analysis starting from assessment, diagnosis, intervention, implementation, to nursing evaluation. In addition, it also uses a pre-post test of a combination intervention on a patient, with the following case presentation: A 52-year-old male COPD patient who is known to have shortness of breath, shortness of breath is felt to increase during activities such as walking to the bathroom or lying down, shortness of breath decreases when resting sitting, tightness in the chest feels like being pressed by a heavy object, shortness of breath is felt to spread throughout the chest, shortness of breath scale 4 on a scale of 0-4, and shortness of breath is felt continuously, the shortness of breath is accompanied by a cough with phlegm and no appetite. The patient had been hospitalized twice before with the same complaint, namely shortness of breath, the client said he had a hereditary disease, namely asthma, the client said he had experienced an infectious disease such as tuberculosis in 2011-2012 but had finished treatment and now there was a relapse. This case report shows that PLB breathing exercises combined with DB twice a day for 3 days found that the client's oxygen saturation increased on the third day to 97%, the shortness of breath scale using the British medical research council shortness of breath scale on the third day the client's shortness of breath scale was on scale 2 (walking slower due to shortness of breath) and for the breathing frequency on the last day it was 20 x / minute, so that the problem of ineffective breathing patterns was resolved. Non-pharmacological therapy PLB and DB are effective therapies to improve the client's breathing pattern so the author combines the two therapies in the hope that it can help increase the client's oxygen saturation, reduce the scale of shortness of breath and the client's breathing frequency. This therapy is easy to do and the cost is very minimal, only consistency is needed in its implementation. After the therapy was carried out, there was an improvement in Mr. K.

Keywords: Chronic Obstructive Pulmonary Disease, Diaphragmatic Breathing, Pulmonary Tuberculosis, Pursed Lips Breathing

ABSTRAK

Penyakit paru obstruktif kronik (PPOK) merupakan penyakit yang disebabkan oleh kelainan saluran napas atau alveolus yang disebabkan akibat pajanan signifikan terhadap partikel atau gas berbahaya pengaruh pejamu termasuk perkembangan paru-paru abnormal, penyakit ini umum dan dapat dicegah atau diobati.  Analisa asuhan keperawatan ini bertujuan untuk melaporkan hasil intervensi pursed lips breathing kombinasi diafragmatic breathing pada pasien penyakit paru obstruktif kronis di ruang Umar Bin Khattab 2 RSUD AL-IHSAN Bandung.  Laporan ini menggunakan Analisa kasus asuhan keperawatan mulai dari pengkajian, diagnose, intervensi, implementasi, hingga evaluasi keperawatan. Selain itu, juga menggunakan pre post test intervensi kombinasi pada seorang pasien, dengan presentasi kasus berikut: Seorang pasien PPOK laki-laki berusia 52 tahun yang diketahui mengalami sesak nafas, sesak dirasakan meningkat saat beraktivitas seperti berjalan ke kamar mandi atau berbaring, sesak menurun saat istirahat duduk, sesak dibagian dada terasa seperti ditekan benda berat, sesak dirasakan menyebar di seluruh bagian dada, sekala sesak 4 dari skala 0-4, dan sesak terasa terus menerus, sesak yang dirasakan disertai batuk berdahak dan tidak nafsu makan. Pasien pernah masuk rumah sakit sebelumnya sebanyak dua kali dengan keluhan sama yaitu sesak, klien mengatakan memiliki penyakit keturunan yaitu asma, klien mengatakan pernah mengalami penyakit menular seperti TBC pada tahun 2011-2012 namun sudah selesai pengobatan dan sekarang terjadi kekambuhan. Laporan kasus ini menunjukkan, latihan napas PLB kombinasi DB 2 kali dalam sehari selama 3 hari didapatkan bahwa saturasi oksigen klien meningkat saat hari ke tiga 97 %, skala sesak menggunakan skala sesak British medical research council saat hari ke tiga skala sesak klien berada di skala 2 (berjalan lebih lambat karena sesak) dan untuk frekuensi napas saat hari terakhir yaitu 20 x/ menit, sehingga masalah pola napas tidak efektif teratasi.Terapi non farmakologi PLB dan DB merupakan terapi yang efektif untuk memperbaiki pola napas klien sehingga penulis mengkombinasikan kedua terapi tersebut dengan harapan dapat membantu meningkatkan saturasi oksigen klien, menurunkan skala sesak dan frekuensi napas klien. Terapi ini mudah dilakukan dan biaya sangat minim hanya di butuhkan konsistensi saja dalam pelaksanaannya. Setelah dilakukan terapi tersebut terdapat perbaikan yang terjadi pada Tn.K.

Kata Kunci: Diafragmatic Breathing, Penyakit Paru Obstruktif Kronis, Pursed Lips Breathing Tuberkulosis Paru