Asuhan Keperawatan pada Tn. R dengan Gangguan Sistem Pencernaan: Sirosis Hepatis di Ruang Dahlia RSUD dr. Soeselo, Kabupaten Tegal
DOI:
https://doi.org/10.61132/protein.v3i4.1809Keywords:
Digestive disorder, fluid management, health education, liver cirrhosis, nursing careAbstract
Liver cirrhosis is a chronic disease characterized by progressive fibrosis, altered liver architecture, and the formation of regenerative nodules. Although it develops slowly, cirrhosis often leads to serious complications such as ascites, variceal bleeding, jaundice, and hepatic encephalopathy. According to the Global Burden of Disease Study 2019, cirrhosis is among the leading causes of death worldwide, with more than 1.4 million deaths annually. In Indonesia, the prevalence of cirrhosis is reported at 0.4% (Riskesdas, 2021) and shows an increasing trend over the years. This case study aims to describe the application of comprehensive nursing care in a patient diagnosed with liver cirrhosis using the nursing process approach. The research design was a case study conducted on Mr. R, who was admitted to Dahlia Ward at RSUD dr. Soeselo, Tegal. Data collection was carried out through interviews, observations, physical examinations, and medical record reviews. The results revealed that the main nursing problems identified were ineffective peripheral perfusion, ineffective breathing pattern, and knowledge deficit. Nursing interventions provided included positioning the patient in semi-fowler, monitoring vital signs, educating the patient about low-sodium diet and fluid restriction, and collaborating in the administration of diuretics and albumin. After three days of nursing care, the evaluation indicated clinical improvement, evidenced by reduced edema, decreased shortness of breath, and increased patient understanding of his disease and treatment plan. In conclusion, nursing care with a comprehensive process approach has a significant positive impact on the condition of patients with liver cirrhosis. Nurses play an essential role in assessment, planning, implementation, evaluation, and providing health education to prevent complications and improve patients’ quality of life.
Downloads
References
Adeliya, et al. (2023). Upaya penyelesaian masalah pola napas tidak efektif melalui tindakan pengaturan posisi semi fowler. Jurnal Ilmiah Keperawatan dan Kesehatan Alkautsar.
Amelia, et al. (2024). Asuhan keperawatan pada An. E dengan gangguan sistem muskuloskeletal: Post operasi open reduction internal fixation fraktur klavikula dextra di Ruang Mawar. Jurnal Umum Kesehatan, 2(4). https://doi.org/10.59841/jumkes.v2i4.1826
Bustan. (2023). Studi deskriptif pendokumentasian asuhan keperawatan jiwa oleh perawat di Rumah Sakit Jiwa Provinsi Sulawesi Tenggara. Jurnal Keperawatan, 6(3), 1–8.
Collins, et al. (2021). Pembuatan rancangan optimalisasi penulisan rekam medis menggunakan form SOAP. Jurnal Rekam Medis, 3(4), 1–10.
Darmawan, et al. (2023). Sirosis hepatis. Jurnal Ventilator, 1(4), 245–261. https://doi.org/10.59680/ventilator.v1i4.718
Dewi, et al. (2024). Hepatic cirrhosis. Jurnal Biologi Tropis. https://doi.org/10.29303/jbt.v24i1b.7801
Efmisa, et al. (2023). Penggunaan obat berpotensi hepatotoksik pada pasien sirosis hati: Suatu telaahan. Journal of Pharmaceutical and Sciences, 6(2), 766–771. https://doi.org/10.36490/journal-jps.com.v6i2.137
Fahrurozi. (2021). Diagnosa dalam proses keperawatan. Jurnal Ilmiah Kesehatan, 21(1), 14–19.
Hutagaol, & Tarigan, C. (2024). Pendekatan diagnosis sirosis hepatis: Laporan kasus. PREPOTIF Jurnal Kesehatan Masyarakat, 8(2), 3484–3493. https://doi.org/10.31004/prepotif.v8i2.30578
Karina, & Ginting. (2020). Perbandingan dalam mencapai tujuan awal. Jurnal Ilmu Kesehatan.
Kurniawati. (2020). Proses keperawatan. Universitas Nusantara PGRI Kediri, 1.
Lestari, et al. (2023). Profil pemeriksaan hematologi dan fungsi hati pada lansia dengan sirosis hepatis. Muhammadiyah Journal of Geriatric, 4(1), 65–72. https://doi.org/10.24853/mujg.4.1.65-72
Maharani, et al. (2023). Liver cirrhosis: Pathophysiology, diagnosis, and management. Jurnal Biologi Tropis, 23(1), 457–463. https://doi.org/10.29303/jbt.v23i1.5763
Maxelly. (2021). Hubungan kelengkapan anamnesa formulir gawat darurat dengan ketepatan kode ICD-10 sebab eksternal kasus kecelakaan di RS Panti Nirmala Malang. Jurnal Manajemen Informasi Kesehatan Indonesia, 9(2), 144. https://doi.org/10.33560/jmiki.v9i2.330
Muin. (2021). Sirosis hepatis dekompensata pada anak. Indonesian Journal of Clinical Pathology and Medical Laboratory, 18(1). https://doi.org/10.24293/ijcpml.v18i1.353
Musta. (2021). Pengelolaan ketidakefektifan perfusi jaringan perifer pada pasien post ORIF hari ke-3 atas indikasi fraktur femur dextra 1/3 distal di RSUD Ungaran. Indonesian Journal of Nursing Research, 3(2), 41. https://doi.org/10.35473/ijnr.v3i2.895
Natasya. (2022). Asuhan keperawatan pada PSMBA dengan sirosis hepatis. Studi Kasus, 1, 52–60.
Noviyani. (2023). Pendidikan kesehatan tentang diet. SENTRI: Jurnal Riset Ilmiah, 2(4), 1275–1289. https://doi.org/10.55681/sentri.v2i4.745
Pratiwi, et al. (2024). Gambaran faktor risiko terjadinya perdarahan pasca persalinan di RS Nur Hidayah Bantul. Jurnal Ilmu Kesehatan, 5(1), 1–13.
Prawiyogi. (2021). Penggunaan media Big Book untuk menumbuhkan minat membaca di sekolah dasar. Jurnal Basicedu, 5(1), 446–452. https://doi.org/10.31004/basicedu.v5i1.787
Rakhmawati. (2021). Pendidikan kesehatan kebersihan tangan berbasis audio visual di RSUD R. Syamsudin Sh Kota Sukabumi. Jurnal Kreativitas dan Inovasi (KREANOVA), 1(3), 129–133. https://doi.org/10.24034/kreanova.v1i3.5218
Rika Widianita. (2023). Cegah dan kenali kondisi hati (Cek Si Hati) sebagai upaya pendidikan kesehatan terkait sirosis hati kepada masyarakat. At-Tawassuth: Jurnal Ekonomi Islam, 8(1), 1–19.
Romdona. (2025). Teknik pengumpulan data. Jurnal Ilmu Sosial Ekonomi dan Politik, 3(1), 39–47. https://doi.org/10.61787/taceee75
Safitri. (2020). Implementasi keperawatan sebagai wujud dari perencanaan keperawatan guna meningkatkan status kesehatan klien. OSF Preprints. https://doi.org/10.31219/osf.io/8ucph
Safitri. (2021). Ketidakefektifan pemberian posisi semi fowler terhadap penurunan sesak nafas pada pasien asma di ruang rawat inap kelas III RSUD Dr. Moewardi Surakarta. Gaster, 8(2), 783–792.
Saskara, & Suryadarma. (2020). Laporan kasus: Sirosis hepatis. FK Universitas Udayana, 1–20.
Sasmita, P. (2023). Penanganan masalah keperawatan hipervolemia dan bersihan jalan napas tidak efektif pada pasien dengan sirosis hepatis: Studi kasus. Jurnal Assyifa’ Ilmu Kesehatan, 9(2), 20–28. https://doi.org/10.47134/phms.v2i1.65
Sawitri, & Sani. (2020). Asuhan keperawatan pada pasien sirosis hepatitis dalam pemenuhan kebutuhan rasa aman nyaman: Nyeri. Jurnal Universitas Kusuma Husada, 41(2), 84–93.
SDKI. (2017). Standar diagnosis keperawatan Indonesia (1st ed.). DPP PPNI.
Sihombing. (2023). Asuhan keperawatan pasien dengan sirosis hepatis dekompensata: Pendekatan model adaptasi Roy. Nursing Current: Jurnal Keperawatan, 11(1), 1. https://doi.org/10.19166/nc.v11i1.6785
SIKI. (2018). Standar intervensi keperawatan Indonesia. DPP PPNI.
Siregar. (2020). Proses keperawatan dalam memberikan asuhan keperawatan. Ilmu Keperawatan, 1. https://doi.org/10.31219/osf.io/8tngj
Sisy Rizkia. (2020). Pencegahan tetanus. British Medical Journal, 2(5474), 1333–1336.
SLKI, T. P. (2019). Standar luaran keperawatan Indonesia. DPP PPNI.
Surapati, & Gautama. (2022). Klasifikasi sistem pakar diagnosis penyakit anak menggunakan metode forward dan backward chaining (Studi kasus: Posyandu Kamal). Jurnal Pendidikan dan Konseling, 4(5), 979–991. https://doi.org/10.31326/sistek.v4i2.1354
Tandra. (2024). Hati-hati dengan hati. Gramedia Pustaka.
Tapper. (2020). Medically tailored meals for the management of symptomatic ascites: The Saltyfood pilot randomized clinical trial. Gastroenterology Report, 8(6), 453–456. https://doi.org/10.1093/gastro/goaa059
Thaha. (2020). Sirhosis hepatis. Jurnal Medical Profession (MedPro), 2(3), 166–175.
Zakiyya, & Irwandi. (2025). Case report: Pasien laki-laki usia 48 tahun dengan sirosis hepatis stadium dekompensata relatif hepatitis B. Jurnal Kesehatan dan Kedokteran, 1.
Zalukhu. (2020). Pengkajian dalam proses keperawatan sebagai penentu keberhasilan pemberian asuhan keperawatan. Jurnal Ilmu Pendidikan, 7(2), 809–820. https://doi.org/10.31219/osf.io/3amf7
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Protein : Jurnal Ilmu Keperawatan dan Kebidanan.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
