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Group name:

Anisa nurul hikmah


Diah ayu prambadini
Nila nurfadillah
Astri merlin
Sri wulan
Yulia indrianisa
A. DEFINITION

Asthma is an intermittent, reversible obstructive


airway disease in which the trachea and brokhi
respond in a hyperactive manner to a particular
stimulus (Smeltzer & Bare, 2002).

Asthma is a disease characterized by increased


tracheal and bronchial responses to various stimuli
by manifestation of wide airway narrowing and its
degree of alteration, either spontaneously or as a
result of treatment (Muttaqin, 2008).
Respiratory organs

a. Nose
Nose or naso or nasal is the first air channel, has two holes (rice
cavity), separated by nasal septum (septum rice).

b. Faring
The pharynx is a place of intersection between the respiratory
path and the food path, located beneath the base of the skull,
behind the nasal cavity, and the front mouth of the neck bone.
c. Larynx
The larynx or larynx is the airway and acts as a sound
formation, located in front of the pharynx to the height of the
cervical vertebra and into the trachea below it.

d. Trachea
The trachea or windpipe is a continuation of the larynx
formed by 16 to 20 rings consisting of horse-shaped bones
resembling a horse's hoop (letter C) inside is covered by a fluffy
mucous membrane called a ciliated cell, only moving outward .
e. Bronkus
Bronchus or throat branch is a continuation of the trachea,
there are 2 pieces that exist at the height of vertebra thoracic
vertebrae IV and V, have a structure similar to trachea and coated
by the same set type.

f. Lungs
The lungs are a body tool consisting mostly of bubbles (bubbles of
air or alveoli). This gelembug alveoli consists of epithelial and
endothelial cells. If the surface area is covered approximately 90
m².
Respiratory process
Next...

Breathing (respiration) is an event of breathing oxygen-


enriched air from the outside and exhaling air containing lots
of carbon dioxide as residual oxidation out of the body. This
air sucking is called inspiration and exhaling is called
expiration. Thus, in the lungs an exchange of intermediate
oxygen is drawn and air enters the blood and CO2 is
removed from the blood by osmosis. Then CO2 is released
through the respiratory tract (respiratory tract) and enters the
body through the pulmonary venous capillaries and then
accumulates to the left portico of the heart (atrium sinistra)
to the aorta then to the whole body (tissues and cells), here
oxidation ( burning).
2. Respiratory system physiology
Oxygen in the body can be adjusted according to need.
Humans really need oxygen in their life, if not get oxygen for 4
minutes will cause damage to the brain that can not be repaired
lagidan can cause death. If the supply of oxygen diminishes will
cause chaos and mindcerebral anoxia.

a. Lung stroke
Lung breathing is the exchange of oxygen and carbon dioxide that
occur in the lungs. Breathing through the lungs or external
breathing, oxygen is taken through the mouth and nose when
breathing oxygen enters through the trachea to the alveoli
associated with blood in the pulmonary capillaries.
b. Cell respiration

Lung and tissue gas transport

The partial pressure difference between O2 and CO2 emphasizes


that the key of O2 flows from the alveoli into the tissue through the
blood, whereas CO2 flows from the tissues into the alveoli through
the blood vessels.
C. ETIOLOGY

To date the etiology of Bronchial Asthma is unknown. One thing


that stands out in people with asthma is the phenomenon of
bronchial hyperactivity. Bronchus asthma is very sensitive to
immunological stimulation and non immunology.

D. PATHOPHYSIOLOGY

An Asthma attack is the result of a reversible diffuse airway


obstruction. Obstruction is caused by the emergence of three
main reactions namely contraction of smooth muscles of the
respiratory tract, membrane swelling lining the bronchi, filling the
bronchi with thick mucus. In addition, the muscles of the bronchi
and mucosa glands swell, thick sputum, much produced and
alveoli become hyperinflation, with air trapped within the lung
tissue. The resulting antibody (IgE) then attacks the mast cells in
the lung.
A. CLINIC MANIFESTATIONS

The usual symptoms of Asthma Bronchial are cough, dyspnea,


and wheezing. Attacks often occur at night. Asthma usually
begins suddenly with a cough and a sense of tightness in the
chest, accompanied by slow breathing, wheezing. Expiration is
always more difficult and longer than inspiration, which
encourages patients to sit upright and use every accessory muscle
of respiration. A blocked airway causes dyspnea. Asthma attacks
can last from 30 minutes to several hours and may disappear
spontaneously.
Nursing care
Sample case:
Nn.D complained of chest pain. After the assessment, the client
said chest pain on the right and left sounds ronkhi accompanied by
cough with phlegm, and the client said he has a history of asthma,
allergic dust and cold, never treated with Nebulizer tools and clients
feel anxious because of shortness of breath

I. ASSESSMENT
1. Identity
a. Patient identity
Name : Ms. D
Age : 19 years
Islam
Female gender
Status : Student
Education : Strata 1
Tribe of Nations : Indonesia
Address : Kutabumi Rt 08/02, Tangerang
MRS Date : June 15, 2017
Assessment Date : June 17, 2017
Medical diagnosis : Bronchial asthma
Main complaints : Chest pain
b. Identity of Responsible Person
Name : Ny. K
Age : 60 years
Hub.dengan patient : Parents
Occupation : Prosperity
Address : Kutabumi Rt 08/02, Tangerang

2. Health Status
a. Current health status
1. The main complaint (when the MRS and current)
• When MRS : Patients complain of chest pain
• Current : Patients are short of breath and cough with
phlegm

2. Reasons for hospital admission and travel now:


Because Patients complain of chest pain right and left,
Patients complain of shortness of breath, and accompanied
by cough with phlegm
3. Efforts made to overcome them

• Self-made efforts
"The patient said it was done by taking Orsiprenaline (
Alupent) medicine from a pharmacy"
• Efforts made by others
"Patient says assisted with Nebulizer tool“

b. Past health status


1. Diseases that have been experienced:
"Patients say they have asthma. Patients also said that
they had never had a serious illness and had no trauma or
accident. Patients have allergies to cigarette smoke, dust and
cold. If Patients inhale cigarette smoke then Patients will
experience the flu and attack shortness of breath “
2. Have been treated:
"The patient said he had been treated previously,
treated with a Nebulizer tool"

3. Allergies:
"Patients say have dust and cold allergy"

4. Habit (smoking / coffee / alcohol etc):


"There is no"

c. Family disease history (depict genogram)


Patients say who suffer from the same disease as the
patient, the sister of the patient's father (the same patient's
uncle) has this asthma disease. While the family in the
mother of the patient no one suffers from asthma.
3. Pattern of basic needs (Data Bio-psycho-socio-cultural-
spiritual)
a. Pattern of Perception and Health Management

• Before illness :Patients said that in their daily life they do not
smoke and if they smell smoke the chest tightness, the
patient is not allergic to the type of drugs and food or
beverages but the patient there is dust and cold allergy, and
before the patient pain is very safe to dust and cold both
inside Outside the house, the patient always provides a mask
cover the nose and always use a protective coat because
patients understand the disease

• When sick :Patients say that if they get sick they will buy
Orsiprenaline (Alupent) medicine but the patient is always
more assisted by Nebulizer tool and the patient says if after
the patient gets sick avoided from cigarette smoke, dust or
dirt and cold temperatures that can lead to the exposure of
more serious diseases to patients
b. Pattern of Nutrition-Metabolic

• Before illness :
- Food intake: Patients say at the time before the usual
eating habits, good appetite, rice, vegetables and side
dishes. Frequency of eating 3x / day. Preferred foods are
ice, chocolate and fruit, because patients suffering from
asthma then the client has a taboo to eat in the form of
chocolate and ice food, foods containing preservatives are
limited.- Intake fluid: Patients 5-7 glasses a day, water

• When sick :
- Food intake : Patients say since sick appetite decreased
not even want to eat, eat only porridge only and can only
spend ½ portion of food only. How to eat it must be fed. So
his weight decreased- Intake fluid: Patient only drank 3-4
glass / day, water
c. Patterns of Activity and Exercise
1) Activity

• Before illness Patients say before the ill daily activity is


college, after college patients change clothes, eat and
sleep. At night the patient performs the task or study as
usual starting from 19:00 until 21:00 hours. And while the
student lecture take the time to travel with his friends

• When sick Patients say that when sick the daily activities
are disturbed, not as usual and not able to perform
activities because it is difficult to breathe. Patient's ability
decreases so much need help to carry out daily activities of
patient assisted by family member
2) Exercise
• Before illness Patients say that patients often do morning
exercises with family, such as cycling together. Every
weekend also patients are often invited to his family for
recreation
• When sick Patients say when sick can not exercise
because the condition of his body that does not allow
because of shortness of breath

d. Sleep Patterns and Rest


• Before illness Patients say sleeping night 7-8 hours, nap 1
hour, because patients do not feel shortness of breath no
problem
• When sick Patients say difficulty sleeping due to cough
that increases at night, patients say can not rest well,
patients often wake up at night, and patients sleep 2 hours
night, nap 3 hours
e. Pattern Elimination

1) CHAPTER
• Before illness: Patients say before CHAPTER normal as normal.
Usually CHAPTER 2-3 x / day, in the morning and evening, the
color of yellowish feces and consistency of its soft CHAPTER
• When sick: Patients say when the CHAPTER STD is still normal as
usual

2) BAK
• Before illness: Patients say before BAK illness is only 4-5x / day.
No difficulties experienced, clear urine color and typical urine
smell
• When sick: Patients say when the BAK disease is not normal
(decreased urine production) urine frequency 2-3x / day, yellow
color and typical urine smell
f. Pattern Roles and Responsibilities

• Before illnessPatients say good family relationships and


communicate well with family, patients can perform role as
the first child of Ny.K family and can act as good student on
campus and patient can very well be responsible

• When sickPatients say they can not perform their role as


the first child of their family due to chest pain and the
patient can not communicate well if experiencing shortness
of breath, and not only as the first child of his family but if the
patient is sick the patient can not act well as a student as
usual

g. Pattern of Coupling and Stress Tolerance

• Before illnessPatients say before the illness if there is a


problem always discussed with his family, patient behavior
and strategy discipline was used by the patient very well
and the absence of other drug use before the patient is ill.
• When sick : Patient when sick if there is a problem of patients
experiencing stress, causing chest pain relapse asthma patients and
the use of drugs Orsiprenalin (Alupent) or with tools Nebulizerh.

H. Cognitive Patterns and Perceptions

• Before illnessPatients assume no disturbance to the body, the


patient before the pain of understanding and adaptability with
around the patient is very good, the patient is very well understood
about his asthma disease, the patient also change his perception
from bad to good perception so it can be prevented to experience
(relapse) patient asthma

• When sickPatients say the perceptual pattern is disturbed but the


patient is very understanding about his asthma disease and the
patient assumes that the pain in his pain is the ordeal, the patient
receives the illness but the patient still tries to heal, hopes to recover
and can run his activity normally
i. Self Concept Patterns

• Before illnessBefore the illness of the patient can describe


the identity of his role in the family as well as on his campus
and self-concept in the patient that the patient should
always find out the knowledge of asthma suffered so that it
can be prevented by the knowledge or information already
obtained by the patient and the patient feel comfortable
when sick, and the patient implements in his daily life of his
knowledge or information

• When sickPatients say when the illness continues to run on


his self-concept and patient's self-esteem is good because
patients while ill continue to implement it from the
knowledge or information that patients get that asthma can
be cured by maintaining the condition by way of
knowledge or information that patients can be well
j. Sexual Reproduction Patterns

• Before illness Patients say not married, female patients,


menstrual phase of patients fluently and right on the date
of each month and patients understand the education of
maintaining health on reproduction

• When sick : Patients say not married, female patients and


menstrual phase of patients fluently and right on the date
of each month and patients understand the education of
maintaining health on reproduction k. Patterns of
Values and Confidence

• Before illness Patients always perform their duty as Muslims


(pray 5 time). The patient believes that his illness can be
cured by believing in God

• When sick : Patients perform prayers 3-4 times and always


pray to God about the pain he suffered
4. Physical Assessment
a.General situation : level of consciousness:
Composmetis / apatis / somnolen / sopor / koma

GCS: Verbal: 6 Psychomotor: 5 Eyes: 4 b.

Vital sign :
Nadi: 76x / min
Temperature: 35.8oC
TD: 100/60 mmHg
RR: 28x / min

Physical state :
1) The state of hair and head Inspection: simestris, no fall,
flat hair distribution, no lesions, oval head shape Palpation:
no lumps / swelling, bushy hair and strong / not fragile

2) Face Preparation Inspection: same color with other


body parts, not pale, simestris Palpation: no tenderness and
edema
3) Eye examination Inspection : left and right eye
symmetry, left eyeball symmetry right, isokor pupil

4) Ear Examination Inspection : symmetrical shape and


position, good skin integrity, same color with other skin, no
liquids Palpation: no tenderness in the ear

5) Nose Check Inspection : symmetrical nose shape,


there is still nasal hair, the use of the nostrils

6) Examination of the mouth and throat Inspection : no


enlarged tonsils, dry mouth mucosa, tongue is not dirty,
teeth are not caries, and the ceiling is clean.

7) Neck Examination Inspection : no jugular vein distention


Palpation: no enlargement of the thyroid gland
8) Examination of the Chest (lung, heart)
Auscultation : ronkhi sounds in both lungs
Palpation : when palpation tactile fremitus can feel
heavy vibration
Percussion : deaf, indicating a secret buildup
Inspection : ictus cordis, symmetrical chest, right and
left chest movements equal to breathing

9) Abdomen
Inspection : no stomach ascites, no lesions
Auscultation : Bowel sounds 12x / minute
Palpation : no tenderness in 4 quadrants
Percussion : sound of a tympanic sound

10) Upper extremities


Inspection : an infusion on the right hand and no toes,
no cyanosis
Muscle strength : still good (able to withstand the pressure
given)
11) Lower limb
Inspection : fingernails clean, no toes, no cyanosis
Muscle strength : still good (able to withstand the pressure
given)

12) Genetalia
- State of labia majora and minora: clean, no secret.
5. Analysis Data
A. Data Analysis Table
No Dx Syntom Etiologi Problem
00032 DS : Breath Road Ineffectiveness of
- The client says chest pain is Obstruction: Road Breath Clearing
right and left - Foreign body in the
airway
- Clients complain of - Restrained secretions
shortness of breath Physiological:
- Client says he has cough - Asthma
accompanied by phlegm - Allergic airway
- Clients say dust and cold
allergy
DO :
Vital sign :
TD: 100/60 mmHg
RR: 28x / min
- The client seemed to gasp
while breathing.
- Ronkhi breath
- The client appears to be
holding back pain
00002 DS: Less intake of Nutrition
- Clients say decreased eating imbalance: less
appetite than body needs
- Clients say eating out ½
servings

DO:
- BB / TB 43 kg / 155 cm
- Client seems weak - Eat
out ½ portion

00158 DS: Self-preparedness Readiness to


- Clients say want to improve coping
increase knowledge to
cope with stress
- Clients find out about
asthma
DO:
- Clients seem
anxious and
stressed
- The client appears
to indicate his
desire to increase
knowledge to cope
with stress
- Client seems to
improve itself to
environmental
changes
Nursing Diagnosis / Collaborative Issues by Priority

1. Ineffective airway clearance associated with Breathing Road


Obstruction: Foreign body in the airway, Stressed secretions and
Physiological: Asthma, Allergic airway
2. Nutrition imbalance: less than body needs associated with less
food intake
3. Readiness to improve coping associated
with Readiness
NOC:
After a 3x24 hour nursing action is expected the patient's airway
hygiene is resolved with indicators:
After a 3x24 hour nursing action is expected to meet the needs of
the patient's nutritional needs with indicators:
After a 3x24 hour nursing action is expected to increase the patient's koping
readiness with indicators:
1. NIC:
Ineffectiveness of Road Bleeding \
Road Breathing Management:

1. Perform chest physiotherapy, with deep breathing relaxation


Rational: to help the airway get better

2. Dispose of the secret by motivating the patient to cough or suck


lenders
Rational: to open and smoothen the patient's airway

3. Advise how to be able to perform an effective cough


Rational: In order for the patient to relieve the cough

4. Auscultation of breath sounds, note areas where ventilation is


decreased or absent and the presence of additional sound
Rational: To know the abnormal breath sounds in the patient

5. Position semi fowler


Rational: to ease the patient's shortness of breath
1. Respiratory Monitor:
1. Monitor additional breath sounds
Rational: To know the patient's additional breath sound

2. Monitor patient's coughing ability


Rational: To know the patient's coughing ability

3. Record the turnover, characteristics and duration of cough


Rational: to know the duration of cough

4. Monitor patient's respiratory secretions


Rational: to know the breathing of normal patients or not

5. Monitor patient's shortness of breath, including activities that


increase or worsen the shortness of breath
Rational: to know the symptoms of shortness of breath to
improve good breathing
1. Management of asthma pathway
1. Compare the current status with the previous status to detect
changes in respiratory status
Rational: to detect changes in respiratory status

2. Monitor the reaction of asthma


Rational: to monitor the reaction of asthma

Allergy management
1. Recognize known allergies (eg, drugs, food, insects,
environment) and unusual reactions
Rational: to avoid allergies that occur during asthma

2. Notify health providers and health workers about known


allergies
Rational: in order to avoid mistake of drug administration

3. Instruct the patient how to treat respiratory problems related to


exposure of the ingredients that make the allergy
Rational: so that patients avoid exposure that makes allergies
Nutrition Imbalance: Less than Body Needs
Nutrition management:

1. Determine the patient's nutritional status and ability [of patients]


to meet nutritional needs
Rational: Helps patients get nutrients as needed

2. Look for [any] food allergies that the patient has


Rational: In order to know the existence of food allergies that are
owned by the patient and can increase the appetite of patients by
meeting the nutritional needs

3. Determine the number of calories and types of nutrients needed


to meet nutritional requirements
Rational: To provide food intake to patients as often as possible
Weight gain help:
1. If necessary do a diagnostic check to determine the cause of
weight loss
Rational: To know the cause of weight loss

2. Monitor daily caloric intake


Rational: To monitor the patient's calorie intake

3. Support increased caloric intake


Rational: In order for the patient is motivated to improve calorie
intake

Preparedness Increase Koping


Increased Koping
1. Help the patient in checking the available resources to meet his
goals
Rational: to be helped to meet its objectives
2. Provide real-life information on diagnosis, treatment, and prognosis
Rational: to be able to know the real information

3. Find a way to understand the patient's perspective on stressful


situations
Rational: so that the patient does not feel stressed

Increased Self Efficacy


1. Examine barriers to changing behavior
Rational: to change the behavioral barriers to the patient

2. Provide information on the desired behavior


Rational: to let the patient know the desired behavior information

3. Help individuals to commit to action plans to change behavior


Rational: for patients to have a commitment and a goal to change
behavior

Counseling
1. Build a therapeutic relationship based on mutual trust and mutual
respect
Rational: to establish a relationship of mutual trust and mutual respect
2. Help the patient to find a problem or situation that causes distress
Rational: to calm and overcome situations that cause distress

3. Ask the patient to look for what they can / can not do related to
the events that occurred
Rational: to know to do related to perristiwa that happened

Muscle relaxation
1. Monitor the indicator of the absence of relaxed conditions, such
as movement, difficult breathing, difficulty breathing, speech, and
cough. Rational: to know the respiratory problems of the patient

2. Encourage the patient to breathe deeply and slowly and exhale


(release) tension
Rational: to provide relaxation

3. Develop a personalized relaxation pattern that keeps the patient


focused and comfortable
Rational: to make the patient feel comfortable
Increased self-awareness
1. Share your observations or thoughts about patient behavior or
responses
Rational: to know the behavior or response of the patient

2. Help the patient to identify the impact of the disease on self-


concept Rational: to know the impact of disease on self-concept

3. Help the patient to identify an anxious situation


Rational: to know the patient's anxiety situation

Anxiety reduction
1. Use a calm and convincing approach
Rational: to be patient calm and confident to the nurse

2. Identify when anxiety level changes occur


Rational: to know the development of changes in anxiety levels

3. Instruct the patient to use relaxation techniques


Rational: for patients to do relaxation techniques independently
Facilitation of learning
1. Provide information in an appropriate manner, such as from
[things] to the more complex [information], from the knowing first,
from concrete information to abstract information
Rational: so that patients can understand the information
appropriately

2. Make the difference between the material that is important to


know and the material you want to know
Rational: to realize the purpose of the difference between the
important material to know and the material to be known and to
know what material is important to know by the patient and what
material the patient wants to know

3. Immediate correction, if the patient misinterprets the information


Rational: to let the patient know the real information 4. Show the
behavior that supports the patient Rational: to make the patient
feel comfortable
Implementation:
Ineffectiveness of Road Bleeding
Road Breathing Management:
1. Perform chest physiotherapy, with deep breathing relaxation
Response results: patients are willing to do chest physiotherapy

2. Dispose of the secret by motivating the patient to cough or


suck lenders
Response results: the patient is able to issue a secret easily Advise
how to be able to perform effective cough Response results: the
patient is able to follow what the nurse

3. advises to do an effective cough


Response results: sounds ronkhi voice Positioning semi-fowler to
relieve shortness of breath

4. Consulting breath sounds, note down areas where ventilation is


decreased or absent and the presence of additional sounds
Response results: the patient feels comfortable and does not feel
short of breath
Respiratory Monitor:
1. Monitor patient's coughing ability
Response results: patients can secrete secretions

2. Note the characteristics and duration of cough


Response results: know the characteristics and duration of the
patient's cough

3. Monitor patient's respiratory secretions


Response results: the patient is willing to be monitored for
respiratory secretions

Management of asthma pathway


1. Compare the current status with the previous status to detect
changes in the respiratory status
Response results: facilitate patient documentation

2. Monitor asthma reactions


Response results: there is an extrinsic sign (allergic)
Allergy management
1. Recognize known allergies (eg, drugs, food, insects,
environment) and unusual reactions
Response results: avoid allergies that will occur

2. Notify health providers and health workers about known


allergies
Response results: avoid the occurrence of errors in drug
administration

3. Show the patient how to treat respiratory problems related


to exposure of the ingredients that make the allergy
Response results: the patient is spared from exposure that
makes the allergy

Nutrition imbalance: less than body needs


Nutrition management:
1. Determine the patient's nutritional status and ability [of
patients] to meet nutritional needs
Response result: patient's nutritional status and patient's ability
to meet nutritional needs can be resolved
2. Identify allergy or intolerance of the patient's food
Response results: there is an allergy in the patient

3. Determine the number of calories and types of nutrients


needed to meet nutritional requirements
Response results: the number of calories and types of nutrients
meets the nutritional requirements

Weight gain help:


1. If necessary do a diagnostic check to determine the cause
of weight loss
Response results: causes weight loss patients karna feel chest
pain
2. Monitor daily caloric intake
Response results: can meet the caloric intake
3. Supports increased caloric intake
Response results: patients are optimistic for increased caloric
intake

4. Instruct ways to increase your caloric intake


Response results: the patient follows the instructions already
given to increase the caloric intake

Readiness to Increase Koping


Increased Koping:

1. Assist the patient in checking the available resources to meet


his goals
Response results: the patient is assisted in checking the sources
to meet the objectives

2. Provide actual information on diagnosis, treatment, and


prognosis
Response results: patients get actual information
4. Support the patient to identify the strength and ability of self
Response of results: patients get support to identify self-strength
and ability

Increased Self Efficacy


1. Identify barriers to changing behavior
Response results: the patient experiences behavioral barriers

2. Provide information on the desired behavior


Response results: patients get information about behavior that
behavior

3. Assist individuals to commit to action plans to change


behavior
Response results: the patient is helped to commit to action
plans to change behavior
Counseling
1. Building a therapeutic relationship based on mutual trust and
mutual respect
Response result: patient more mutual trust and respect

2. Help the patient to identify the problem or situation that


causes distress
Response results: the patient helps to identify the problem or
situation that causes distress

3. Ask the patient to identify what they can / can not do with
the event
Response results: patients can do related to the events that
occur

Muscle relaxation
1. Monitor the indicator of the absence of relaxed conditions,
such as movement, difficulty breathing, difficult breath,
speech, and cough.
Response results: found no pegging problems, difficult
breathing
2. Instruct the patient to breathe deeply and slowly and exhale
[release] tension
Response results: the patient feels more relaxed after following
the instructions of the nurse

Increased self-awareness
1.Divide the observations or thoughts about the patient's
behavior or response
Response results: after the observation the patient feels better
than before

2.Helping the patient to identify the impact of the disease on


self-concept
Response results: patients are helped to identify the impact of
self-concept illness

3.Help the patient to identify anxious situation


Response results: patients feel helped to be more relaxed

Anxiety reduction
1.Using a calm and convincing approach
Response results: in order to reduce anxiety in patients
2.Identify in the event of anxiety level changes
Response results: know the occurrence of anxiety level changes

3.Meintruksikan patient to use relaxation techniques


Response results: patients can follow using relaxation techniques

Facilitation of learning

Provide information in a precise way, such as from [simple] things


to the [more] complex from the knowing [first], from concrete
information [to] abstract [information]
Response results: the patient can understand what is informed
appropriately
Make a difference between the material that is important to
know and the material you want to know
Response of results: knowing the difference which material is
important to know and which material you want to know
Immediate correction, if the patient misinterprets the information
Response of results: no errors in interpretation of information
obtained by the patient
Evaluation
S: Patients say right and left chest pain is decreased,
nausea at mealtime decreases, patients say anxiety
decreases
O: Shortness of breath of the patient has been visibly
reduced, the patient is seen to spend his food and
allergies appear diminished patients, the patient's anxiety
seemed overcome
A: Partial terasi problem
P: Continue the next intervention
1. Position a semi-fowler patient sleep if the patient feels
tight, advise the patient to limit his activity
2. Instruct the patient to eat less but as often as possible
3. Encourage the patient to improve behavior readiness
by increasing coping

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