Analisis Asuhan Keperawatan pada Pasien Terpasang Canul Trakeostomi dengan Masalah Keperawatan Bersihan Jalan Napas Tidak Efektif dengan Intervensi Fisioterapi Dada di Ruang Mawar RSD dr. Soebandi Jember: Studi Kasus

https://doi.org/10.22146/jkkk.82213

Tanwirotul Afidah(1*), Murtaqib Murtaqib(2), Suheriyono Suheriyono(3)

(1) Program Studi Profesi Ners, Fakultas Keperawatan, Universitas Jember
(2) Program Studi Ilmu Keperawatan, Fakultas Keperawatan, Universitas Jember
(3) RSD dr. Soebandi Jember
(*) Corresponding Author

Abstract


Background: Maxillofacial fracture is a fracture that refers to the facial skeletal, dentoalveolar bone and related parts within the head and neck area due to external trauma. Severe fractures in the facial bones hinder client’s airway. Tracheostomy is one of the procedures for persistent airway obstruction.
Objective: To analyze nursing care for clients with tracheostomy for indications of maxillofacial fracture with nursing problems in ineffective airway clearance using chest clapping physiotherapy interventions in the Mawar Room, RSD dr. Soebandi Jember.
Case report: The client was admitted to the Hospital due to motorcycle accident. During the assessment the client complained of coughing, tightness, and sleeplessness. After a canul tracheostomy was attached to the client, there were several symptoms, ie.: the client coughed quite frequently, unable to cough effectively, there was a dry ronchi, had difficulty in speaking, and the client's breathing pattern changed. In conclusion, the main nursing problem was ineffective airway clearance.
Outcome: The results of the analysis after chest physiotherapy 3 times for 3 days showed the expected result of chest physiotherapy action, which was the sputum was removed and cleared from the airway. Therefore, oxygen diffusion was optimal, the client's oxygen saturation increased within the normal range, coughing decreased, and insomnia complaints were reduced.
Conclusion: Chest physiotherapy can help remove the client's sputum, thus reduces sputum and ronchi sound, tightness marked with respiration rate (RR) within the normal range, and coughing in clients with nursing problem ineffective airway clearance attached canul tracheostomy.

ABSTRAK

Latar belakang: Fraktur maksilofasial merupakan fraktur yang mengacu pada skeletal wajah, tulang dentoalveolar dan bagian-bagian yang terkait dalam daerah kepala dan leher karena trauma eksternal. Fraktur pada tulang wajah yang parah menyebabkan pasien tidak dapat mempertahankan jalan napasnya. Trakeostomi merupakan salah satu prosedur untuk obstruksi jalan napas persisten.
Tujuan: Untuk menganalisis asuhan keperawatan pada pasien yang terpasang trakeostomi atas indikasi fraktur maksilofasial dengan masalah keperawatan bersihan jalan napas tidak efektif menggunakan intervensi fisioterapi dada clapping di Ruang Mawar RSD dr. Soebandi Jember.
Laporan kasus: Pasien masuk ke Rumah Sakit karena kecelakaan sepeda motor. Saat dilakukan pengkajian, pasien mengeluh batuk, sesak napas, dan tidak bisa tidur. Terdapat beberapa gejala pada pasien setelah terpasang canul trakeostomi, antara lain batuk cukup sering, tidak mampu melakukan batuk efektif, terdapat ronchi kering, sulit berbicara, dan pola napas pasien berubah, sehingga memiliki masalah keperawatan utama bersihan jalan napas tidak efektif. 
Hasil: Hasil analisis setelah dilakukan fisioterapi dada 3 kali selama 3 hari, menunjukkan pencapaian tindakan fisioterapi dada, yaitu dapat mengeluarkan dan membersihkan sputum dari saluran napas, sehingga difusi oksigen optimal, saturasi oksigen pasien meningkat dalam rentang normal, batuk berkurang, dan keluhan susah tidur berkurang.
Simpulan: Fisioterapi dada dapat membantu mengeluarkan sputum pasien, sehingga sputum dan suara ronchi dapat berkurang, sesak napas berkurang ditandai dengan respiration rate (RR) dalam rentang normal, dan batuk dapat berkurang pada pasien dengan masalah keperawatan bersihan jalan napas tidak efektif yang terpasang canul trakeostomi.

 


Keywords


bersihan jalan napas tidak efektif; fraktur maksilofasial; fisioterapi dada; trakeostomi

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DOI: https://doi.org/10.22146/jkkk.82213

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