eliminasi bab
TRANSCRIPT
![Page 1: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/1.jpg)
Oleh :
Anang Satrianto, S.kep, Ns.
Prodi DIII Keperawatan
Sekolah Tinggi Ilmu Kesehatan
Banyuwangi
2010
![Page 2: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/2.jpg)
USUS BESAR/KOLON
FUNGSI :- Absorbsi air, garam, & glukosa
- Sekresi musin
- Defekasi
![Page 3: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/3.jpg)
•Refleks defekasi :Refleks intrinsik : lemah diperkuat oleh refleks ekstrinsik ( refleks parasimpatis )
![Page 4: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/4.jpg)
1. Refleks Intrinsik Diperantarai oleh sistem saraf enterik
setempat Faeces memasuki rektum peregangan dinding rektum sinyal2 aferen yg menyebar mel. plexus mienterikus glb. peristaltik pd kolon descenden, sigmoid dan rektum feces terdorong ke anus
sfingter ani direlaksasi oleh penghambat dari plexus mienterikus DEFEKASI
![Page 5: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/5.jpg)
2. Refleks Parasimpatis
• Melibatkan segmen sakral medula spinalis
• Feces pada rektum sinyal ini dihantarkan ke medula spinalis
![Page 6: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/6.jpg)
Medula Spinalis
• Kembali ke kolon desc, rektum, anus mell. saraf parasimpatis dlm nerfus pelvikus
• Memperkuat peristaltik
• Relaksasi sfingter ani interna
memperkuat reflek intrinsik
• Menimbulkan efek:- Nafas dalam - Penutupan glotis- Kontraksi otot ddg
perut
Mendorong isi faeces kebawah
Dasar pelvis terdorong ke bawah
DEFEKASI
![Page 7: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/7.jpg)
Faktor yg mempengaruhi eliminasi bowel
a. Tahap perkembangan :
Bayi : faeces tergantung pd makanan : ASI/PASI
Todller : latihan mengontrol defekasi ---- bowel training
Anak-anak, remaja, dewasa muda : pola defekasi bervariasi--- kuantitas, frekuensi
Dewasa tua : konstipasi krn penurunan aktivitas fisik, penurunan motilitas GI tract dan perubahan kebiasaan makan
![Page 8: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/8.jpg)
b. Pola defekasi sehari-hari:
Frekuensi, waktu, posisi dan tempat
c. Makanan dan cairan
d. Aktivitas
d. Gaya hidup
f. Faktor psikologi
![Page 9: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/9.jpg)
G. Faktor Patologi
h. Pengobatan
i. Pemeriksaan diagnostik
j. Pembedahan & anastesi
k. Posisi tubuh
l. Kehamilan
m. Nyeri
![Page 10: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/10.jpg)
1. Riwayat Keperawatan Pola eliminasi bowelPerubahan pola eliminasiPemakaian alat bantu yang mempermudah eliminasi bowel, misal: makanan, cairan, obat, huknahMasalah masalah yg berhubungan dg.eliminasiPenggunaan colostomy atau ileostomi
![Page 11: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/11.jpg)
2. Pemeriksaan Fisik
Abdomen Inspeksi : Permukaan abdomenAuskultasi : Bising ususPerkusi : Massa, cairan, gas, suara
timpaniPalpasi : Massa, organ-organ pada
abdomenAnus & RektumInspeksi dan palpasi : nodul, luka, massa, hemorhoid, polips
![Page 12: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/12.jpg)
Karakteristik faeces: volume, warna, bau, konsistensi, bentuk, komposisi
Tanda-tanda Ca –Colon:
Perubahan pola el. Bowel
Darah pd. Faeces
Nyeri abdominal/rektal
Perubahan karakteristik faeces
Perasaan incimplet emptying setelah BAB
![Page 13: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/13.jpg)
Pemeriksaan Diagnostik Sal. CernaPemeriksaan Diagnostik Sal. Cerna
EsophagogastroduodenosscopyColonoscopySigmoidoscopyBarium enema
![Page 14: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/14.jpg)
1. Bowel Elimination as the problema. Konstipasib. Impaksic. Flatulend. Diaree. Bowel inkontinensia
![Page 15: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/15.jpg)
2. Bowel elimination as the etiology
a.Altered Growth and Development related to parents misconceptions about bowel and bladder training
b.Altered Nutrition : less than body requirements related to loss of appetite from flatulence or impaction
c.Anxiety related to lack of voluntary control of fecal elimination and significant other’s response to ostomy
![Page 16: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/16.jpg)
d.Body image disturbance related to ostomy need to wear disposable adult briefts
e.Fluid volume deficit related to prolonged diarrhea
f. Impaired skin integrity related to prolonged diarrhea, fecal incontinenance
g. Ineffective individual coping related to inability to accept permanen ostomy
h. Knowledge Deficit: Bowel training, related to no previous experience
![Page 17: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/17.jpg)
i. Pain related to intestinal distention, prolonged constipations or impaction, fecal incontinence, hemorrhoids
j. Self – care deficit : Toileting, related to mobility deficit, weakness, confusing
k. Self-esteem disturbance related to need for assistance with toileting, fecal incontinence
l. Sexual disfunction related to perceived change in body image, lack of interest, loss of self-esteem
![Page 18: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/18.jpg)
Nursing Diagnosis for Common Problem
Problem Penyebab
Konstipasi 1. Asupan cairan kurang
2. Asupan serat kurang
3. Kebiasaan menahan defakasi
4. Imobilisasi
5. Obat penenang.anti parkinson
6. Penyakit organik ; hipokalemi
![Page 19: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/19.jpg)
Impaksi 1. Kelemahan
2. Tidak sadar
3. Kebingungan
Flatulen 1. Penurunan motalitas usus ( bedah abdomen, anestesi umum)
2 Imobilisasi
![Page 20: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/20.jpg)
Diare 1. Stress emosional
2. Infeksi usus
3. Alergi makanan
4. Obat-obatan
5. Intoleransi makanan
![Page 21: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/21.jpg)
Bowel
Inkontinensia
1. .Rusaknya spingter anus
2. Seringnya defekasi
3. Feces encer volume banyak
4. Stress
![Page 22: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/22.jpg)
Tujuan : Klien akan :
1. Memiliki pola defekasi yang normal
2. Menjelaskan hubungan antara eliminasi bowel dengan diet, intake cairan dan exercise
![Page 23: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/23.jpg)
1.Meningkatkan/mempertahankan kebiasaan BAB yang teratur.
- Waktu - Privacy - xercise- Posisi - Nutrisi
![Page 24: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/24.jpg)
2. Pendidikan kesehatan tentang :- Chatartics, laxatives and antidiarrhe- Mengurangi kembung- Mencegah makanan yg mengandung gas- Exercise- Rectal tube / darm buis
![Page 25: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/25.jpg)
Rectal tube
Gunakan tube no 22-34 French pd dewasa, anak-anak ukuran lebih kecilPosisi : miringBeri pelicin pd ujung tubeBuka tutup tubeMasukkan ke rektum/anus sepanjang 10 cm Diamkan selama 20 menit, bila kembung tidak berkurang, ulangi setiap 2-3 jamBeri pasien berbagai posisi, misal knee chest
![Page 26: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/26.jpg)
3. Pengosongan Kolon -- Enema / huknah- Rectal suppositoria- Oral intestinal lavage- Digital remove of stool -- Bowel training program- Perawatan colostomy
![Page 27: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/27.jpg)
4. Perawatan pada konstipasi5. Perawatan pada bowel
incontinence6. Perawatan pada diare
![Page 28: Eliminasi BAB](https://reader034.vdocuments.site/reader034/viewer/2022050706/5571f8bd49795991698dfdc1/html5/thumbnails/28.jpg)
THX U