PowerPoint Presentation

Pembimbing :dr. Tomy Yuner Sirait, Sp.AAnimated spinning picture(Intermediate)

Tip: Some shape effects on this slide are created with the Combine Shapes commands. To access this command, you must add it to the Quick Access Toolbar, located above the File tab. To customize the Quick Access Toolbar, do the following:Click the arrow next to the Quick Access Toolbar, and then under Customize Quick Access Toolbar click More Commands.In the PowerPoint Options dialog box, in the Choose commands from list, select All Commands. In the list of commands, click Combine Shapes, and then click Add.

To reproduce the shape effect on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.Also on the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Oval (first row).On the slide, drag to draw an oval.Select the oval. Under Drawing Tools, on the Format tab, in the Size group, enter 6 in the Height box and 6 in the Width box.Also on the Format shape, in the Shape Styles group, click Shape Outline, and then click No Outline.On the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Pie (second row).On the slide, drag to draw a pie.Select the pie. Drag the yellow diamond adjustment handle to create a wedge shape. Under Drawing Tools, on the Format tab, in the Size group, enter 5.7 in the Height box and 5.7 in the Width box.Press and hold CTRL, select the oval, and then select the pie. On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide.Click Align Center.Click Align Middle.Press and hold CTRL, and then select the oval and then the pie shape. On the Quick Access Toolbar, click Combine Shapes, and then click Shape Subtract.Select the new shape. Under Drawing Tools, on the Format tab, in the Shape Style group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane, in the Fill pane, click Picture or texture fill, and then click the button next to Texture and click Recycled Paper (third row). Also in the Format Shape dialog box, click Picture Color in the left pane, in the Picture Color pane, under Recolor, click the button next to Presets, and then click Grayscale (first row). Also in the Format Shape dialog box, click Picture Corrections in the left pane, in the Picture Corrections pane, under Brightness and Contrast, in the Contrast box, enter 20%. Also in the Format Shape dialog box, click Shadow in the left pane, in the Shadow pane, click the Presets button, and then under Outer, click Offset Diagonal Bottom Left.Also in the Shadow pane, in the Blur box, enter 10 pt.

To reproduce the picture effects on this slide, do the following:On the Insert tab, in the Images group, click Picture. In the Insert Picture dialog box, select a picture and then click Insert.Select the picture. Under Picture Tools, on the Format tab, in the Size group, click the Size and Position dialog box launcher. In the Format Picture dialog box, resize or crop the image so that the height is set to 5.8 and the width is set to 5.8. To crop the picture, click Crop in the left pane, and in the right pane, under Crop position, enter values into the Height, Width, Left, and Top boxes. To resize the picture, click Size in the left pane, and in the right pane, under Size and rotate, enter values into the Height and Width boxes. Under Picture Tools, on the Format tab, in the Size group, click the down arrow under Crop, and then click Crop to Shape. Under Basic Shapes, click Oval (first row, first option from the left).Also under Picture Tools, on the Format tab, in the Arrange group, click Send Backward.

To reproduce the other shapes on this slide, do the following:Also on the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Oval (first row). On the slide, drag to draw an oval.Select the oval. Under Drawings Tools, on the Format tab, in the Size group, enter 0.17 in the Height box and 0.17 in the Width box. Also on the Format tab, in the Shape Styles group, click Shape Fill, and then under Theme Colors, click Black, Text 1, Lighter 25% (fourth row). Also on the Format tab, in the Shape Styles group, click Shape Outline, and then click No Line. On the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Donut.On the slide, drag to draw a donut.Select the donut. Under Drawing Tools, on the Format tab in the Size group, enter 0.25 in the Height box and 0.25 in the Width box.Also on the Format tab, in the Shape Styles group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane, in the Fill pane, click Gradient fill, and then click the button next to Preset colors and click Silver (fifth row). Also in the Format Shape dialog box, click Line Color in the left pane, in the Line Color pane, click No line.Also in the Format Shape dialog box, click 3-D Format in the left pane, in the 3-D Format pane, under Bevel, click the button next to Top, and then click Circle (first row).Press and hold CTRL, and then select the freeform shape, the picture, the small circle, and the donut. On the Home tab, in the Drawing group, click Arrange, point to Align, and the do the following:Click Align to Slide.Click Align Center.Click Align Middle.Also on the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Oval.On the slide, drag to draw an oval.Select the oval. Under Drawing Tools, on the Format tab, in the Size group, enter 0.65 in the Height box and 0.65 in the Width box. Also on the Format tab, in the Shape Styles group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane, in the Fill pane, click Picture or texture fill, and then click the button next to Texture and then click Recycled Paper (fourth row). Select the freeform shape. On the Home tab, in the Clipboard group, click Format Painter, and then click the new oval. Position this circle over the top edge of the freeform shape. On the Home tab, in the Drawing group, click Arrange, and then do the following:Under Order Objects, click Send to Back.Point to Align, and then click Align Center.

To reproduce the animation effects on this slide, do the following:Select the picture. On the Animations tab, in the Advanced Animation group, click Add Animation, and then under Emphasis Effects, click Spin.Also on the Animations tab, in the Animation group, click the Show Additional Effects Options dialog box launcher. In the Spin dialog box, on the Effect tab, do the following:In the Smooth start box, enter 5 sec.In the Smooth end box, enter 5 sec.Also in the Spin dialog box, click the Timing tab, and then do the following:In the Start list, select With Previous.In the Duration box, enter 20 sec.Select the small oval at the top edge of the freeform shape. On the Animations tab, in the Advanced Animation group, click Add Animation, under Motion Paths, click Shapes.On the slide, drag the bottom, left, and right sides of the motion path so that it matches the inside edge of the freeform shape.Also on the Animations tab, in the Animation group, click the Show Additional Effects Options dialog box launcher. In the Circle dialog box, on the Effect tab, do the following:In the Smooth start box, enter 5 sec.In the Smooth end box, enter 5 sec.Also in the Spin dialog box, click the Timing tab, and then do the following:In the Start list, select With Previous.In the Duration box, enter 20 sec.

To reproduce the background effects on this slide, do the following:On the Design tab, in the Background group, click Background Styles, and then click Style 9.

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STATUS PASIENIDENTITAS PASIENNama: An. YUmur: 3 bulanBerat Badan: 6,1 kgJenis Kelamin: PerempuanAgama: IslamAlamat: Cibitung-BekasiMasuk RS: 01 November 2014 pukul 10:10 WIBAyahNama: Tn.BUmur: 32 tahunPekerjaan : WiraswastaPendidikan: SMAIbuNama: Ny. SUmur : 30 tahunPekerjaan: Ibu Rumah TanggaPendidikan: SMAIDENTITAS ORANG TUA Animated picture pans in window with fade-in captions(Advanced)

Tip: For best results, select a high-resolution, vertically oriented picture, where the picture height is larger than the slide height. The picture in the example above is 15 high and 10 wide. (Normal slide dimensions are 7.5 high and 10 wide.)

To reproduce the picture effects on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank. On the Insert tab, in the Images group, click Picture. In the Insert Picture dialog box, select a picture, and then click Insert.Select the picture. Under Picture Tools, on the Format tab, in the Size group, click the Size and Position dialog box launcher. In the Format Picture dialog box, resize or crop the image so that the height is set to 15 and the width is set to 10. To crop the picture, click Crop in the left pane, and in the right pane, under Crop position, enter values into the Height, Width, Left, and Top boxes. To resize the picture, click Size in the left pane, and in the right pane, under Size and rotate, enter values into the Height and Width boxes.On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide.Click Align Top.Click Align Center. The remainder of picture will extend beyond the bottom edge of the slide area. You may need to zoom out to view your slide. To zoom out, on the View tab, in the Zoom group, click Zoom. In the Zoom dialog box, select 33%.

To reproduce the shape effects on this slide, do the following:On the Home tab, in the Drawing group, click Shapes, and then under Rectangles click Rounded Rectangle (second option from the left). On the slide, drag to draw a rounded rectangle.Select the rounded rectangle. Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 2.5.In the Shape Width box, enter 8.Also on the Format tab, in the Shape Styles group, do the following:Click the arrow next to Shape Fill, and then click No Fill.Click the arrow next to Shape Outline, and then under Theme Colors click White, Background 1 (first row, first option from the left).Also on the Format tab, in the bottom right corner of the Shape Styles group, click the Format Shape dialog box launcher. In the Format Shape dialog box, in the left pane, click Line Style. In the Line Style pane, in the Width box, enter 12.5 pt.Also in the Format Shape dialog box, in the left pane, click 3-D Format, and then do the following in the 3-D Format pane:Under Bevel, click the button next to Top, and then under Bevel click Circle (first row, first option from the left).Under Surface, click the button next to Material, and then under Standard click Warm Matte (second option from the left). Click the button next to Lighting, and then under Cool click Freezing (second option from the left).On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide.Click Align Middle.Click Align Center.On the Home tab, in the Drawing group, click Shapes, and then under Rectangles click Rectangle (first option from the left). On the slide, drag to draw a rectangle.Select the rectangle. Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 2.51.In the Shape Width box, enter 10.Also on the Format tab, in the Shape Styles group, click the arrow next to Shape Outline, and then click No Outline.Also on the Format tab, in the Shape Styles group, click the arrow next to Shape Fill, point to Gradient, and then click More Gradients. In the Format Shape dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Linear.Click the button next to Direction, and then click Linear Down (first row, second option from the left). Under Gradient stops, click Add gradient stops or Remove gradient stops until two stops appear in the slider.Also under Gradient stops, customize the gradient stops as follows:Select the first stop from the left in the slider, and then do the following: In the Position box, enter 0%.Click the button next to Color, and then under Theme Colors click Black, Text 1 (first row, second option from the left).In the Transparency box, enter 0%. Select the second stop from the left in the slider, and then do the following: In the Position box, enter 100%.Click the button next to Color, and then under Theme Colors click Black, Text 1, Lighter 25% (fourth row, second option from the left).In the Transparency box, enter 0%. On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide. Click Align Top. Click Align Center.Select the rectangle. On the Home tab, in the Clipboard group, click the arrow next to Copy, and then click Duplicate.On the Home tab, in the Drawing group, click Arrange, point to Rotate, and then click Flip Vertical.Also on the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide. Click Align Bottom. Click Align Center.Also on the Home tab, in the Drawing group, click Shapes, and then under Rectangles click Rectangle (first option from the left). On the slide, drag to draw a rectangle.Select the rectangle. Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 2.55.In the Shape Width box, enter 1.06.Under Drawing Tools, on the Format tab, in the bottom right corner of the Shape Styles group, click the Format Shape dialog box launcher. In the Format Shape dialog box, in the left pane, click Line Color. In the Line Color pane, select No line.Also in the Format Shape dialog box, in the left pane, click Fill. In the Fill pane, select Solid fill, click the button next to Color, and then under Theme Colors click Black, Text 1, Lighter 25% (fourth row, second option from the left).On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following: Click Align to Slide.Click Align Right. Click Align Middle.Select the rectangle. On the Home tab, in the Clipboard group, click the arrow next to Copy, and then click Duplicate.Select the duplicate rectangle. On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide.Click Align Left.Click Align Middle.On the Home tab, in the Editing group, click Select, and then click Selection Pane. In the Selection and Visibility pane, select the rounded rectangle.On the Home tab, in the Drawing group, click Arrange, and then click Bring to Front.In the Selection and Visibility pane, press and hold CTRL, and then select the rounded rectangle and four rectangles. On the Home tab, in the Drawing group, click Arrange, and then click Group.

To reproduce the text effects on this slide, do the following:On the Insert tab, in the Text group, click Text Box. On the slide, drag to draw a text box.Type the text you want to appear in the text box, and then select the text. Format the text in the textbox using the following steps:On the Home tab, in the Font group, choose the Calibri font and a font size of 26.Click the arrow next to Font Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).In the Paragraph group, click Align Text Left.Drag the text box to the lower left part of the rounded rectangle.

To reproduce the animation effects for the picture on this slide, do the following:On the slide, select the picture.On the Animations tab, in the Advanced Animation group, click Add Animation, and then, under Entrance, click Fade.Also on the Animations tab, in the Timing group, in the Start list, select With Previous.Also on the Animations tab, in the Timing group, in the Duration box, type 2.On the Animations tab, in the Advanced Animation group, click Add Animation, and then click More Motion Paths.In the Add Motion Paths dialog box, under Lines and Curves, click Up.Also on the Animations tab, in the Timing group, in the Start list, select With Previous.Also on the Animations tab, in the Timing group, in the Duration box, type 20.On the slide, select the Up motion path, and then do the following: Press and hold SHIFT, and then drag the end point (red arrow) of the motion path to the top edge of the slide.Press and hold Shift, and then drag the starting point (green arrow) of the motion path to the bottom edge of the slide.

To reproduce the animation effects for the text on this slide, do the following:On the slide, select the text box.On the Animations tab, in the Advanced Animation group, click Add Animation, and then, under Entrance, click Fade.Also on the Animations tab, in the Timing group, in the Start list, select With Previous.Also on the Animations tab, in the Timing group, in the Duration box, type .5.Also on the Animations tab, in the Timing group, in the Delay box, type 3.0.Also on the Animations tab, in the Advanced Animation group, click Add Animation, and then, under Exit, click Fade.Also on the Animations tab, in the Timing group, in the Start list, select With Previous.Also on the Animations tab, in the Timing group, in the Duration box, type .5.Also on the Animations tab, in the Timing group, in the Delay box, type 8.0.On the slide, select the text box. On the Home tab, in the Clipboard group, click the arrow next to Copy, and then click Duplicate.On the slide, click in the second text box and edit the text.On the Animations tab, in the Advanced Animation group, click Animation Pane.In the Animation Pane, do the following:Select the entrance animation on the second text box. Click the arrow to the right of the effect, and then click Timing. In the Fade dialog box, on the Timing tab, in the Delay box, enter 8.5, and then click OK.Select the exit animation on the second text box. Click the arrow to the right of the effect, and then click Timing. In the Fade dialog box, on the Timing tab, in the Delay box, enter 13.0, and then click OK.On the slide, select the second text box. On the Home tab, in the Clipboard group, click the arrow next to Copy, and then click Duplicate.On the slide, click in the third text box and edit the text. In the Animation Pane, do the following:Select the entrance animation on the third text box. Click the arrow to the right of the effect, and then click Timing. In the Fade dialog box, on the Timing tab, in the Delay box, enter 13.5, and then click OK.Select the exit animation on the third text box. Click the arrow to the right of the effect, and then click Timing. In the Fade dialog box, on the Timing tab, in the Delay box, enter 19.5, and then click OK.On the slide, press and hold CTRL, and then select the three text boxes. On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align Selected Objects.Click Align Middle.Click Align Center.

To reproduce the animation effects for the shapes on this slide, do the following:On the slide, select the rounded rectangle and the group of shapes that form the background of the slide. On the Animations tab, in the Advanced Animation group, click Add Animation, and then click More Emphasis Effects. In the Add Emphasis Effect dialog box, under Basic, click Grow/Shrink.Also on the Animations tab, in the Timing group, in the Start list, select After Previous.Also on the Animations tab, in the Timing group, in the Duration box, type 2.On the Animations tab, in the Animation group, click Effect Options, and then click Horizontal.On the Animations tab, in the Advanced Animation group, click Add Animation, and then click More Exit Effects. In the Add Emphasis Effect dialog box, under Basic, click Fade.Also on the Animations tab, in the Timing group, in the Start list, select With Previous.Also on the Animations tab, in the Timing group, in the Duration box, type 1.

ANAMNESISKeluhan UtamaBAB cair 7x sehari

Keluhan TambahanDemam, lemas dan nampak sesakRIWAYAT PENYAKIT SEKARANGRiwayat Penyakit DahuluPasien tidak memiliki riwayat penyakit seperti ini sebelumnya.Riwayat alergi susu sapi dan makanan disangkal.Riwayat Penyakit KeluargaTidak ada anggota keluarga yang mengalami keluhan yang sama saat ini.

RIWAYAT MAKANAN 0 15 hari: ASIMulai usia 15 hari: PASI ( bubur susu, biskuit)Kesan: Kualitas dan kuantitas makanan cukup

RIWAYAT IMUNISASI DASAR

Imunisasi dilakukan di PuskesmasUsia 0 bulan : Hep.B, Polio 0Usia 1 bulan: BCG dan Hep.BUsia 2-3 bulan: Polio I dan DPT I

Pemeriksaan fisikKeadaan umum: Tampak sakit beratKesadaran : Somnolen

Tanda Vital Nadi : 170 x/menitFrekuensi napas: 66 x/menitSuhu: 38.9 0CStatus Gizi:Antropometri: BB : 6,1 kg PB: 63 cm BB/U : p85 TB/U : p90 BB/PB : 6,1/5,8 = 105,1%

Kepala : ubun-ubun besar cekungMata : Mata cekung (+/+) Air mata (-/-)Hidung : Nafas cuping hidung (+)Mulut : Bibir kering, mukosa mulut keringLeher : KGB tidak teraba membesarToraks : Retraksi epigastrium (+)Abdomen Inspeksi : Abdomen datarPalpasi: Supel, nyeri tekan (-), hepar dan lien tidak t teraba membesar, turgor kembali sangat lambatPerkusi: Tympani di seluruh kuadran abdomenAuskultasi: Bising usus (+) meningkat Ekstremitas : Akral hangat, oedem (-), sianosis (-)Pemeriksaan hematologi.9Pemeriksaan Analisa Gas Darah (AGD)Ph: 7,4(n: 7,35-7,45)PCO2: 17,1(n: 35-45 mmHg)PO2: 100(n: 75-100 mmHg)HCO3: 10,7(n: 21-25 mmol/L)Total CO2: 11.2(n:21-27 mmol/L)Base Excess: -14,3(n: -2,5 - +2,5 mmol/L)Saturasi O2: 97,9(n: 95-98 %)Standard HCO3: 15,2(n:22-24 mmol/L)Standard Base Excess: -11,6PENATALAKSANAANIVFD Asering 30cc/kgbb = 1 jam pertama70 cc/kgbb= 5 jam berikutnyaRanitidin 2x15 mgParasetamol drip 125 cc/24 jamCefotaxime 2x150 mgProbiotik 1x1 schZink syrup 1x1 cth

PemantauanNilai kembali derajat dehidrasiObservasi tanda-tanda vital

PROGNOSIS Ad vitam : Dubia ad malamAd fungtionam: Dubia ad BonamAd sanationam: Dubia ad Bonam

ANALISA KASUSPada pasien BAB cair sebanyak 7x sudah 2 hari, ampas (+) disertai demam 1 hari sebelum masuk RS.

Pemeriksaan fisik : nampak lemah, malas minum, ububn-ububn besar cekung, mata cekung, air mata (-), mukosa kering, turgor kembali sangat lambat, peristatltik meningkat, akral angat diagnosis diare cair akut dengan dehidrasi berat.Diare pada anak tidak boleh diberikan obat antidiare TIDAK DIBERIKAN ANTIDIARE PADA PASIEN.RENCANA TERAPI C SUDAH DILAKUKANPemberian antibiotik leukositosis.pemberian regimen bikarbonat pada pasien ini dirasakan kurang tepat karena diagnosis asidosis metabolik sebagai komplikasi diare pada pasien ini masih belum dapat ditegakkan. Ph: 7,4(n: 7,35-7,45)PCO2: 17,1(n: 35-45 mmHg)PO2: 100(n: 75-100 mmHg)HCO3: 10,7(n: 21-25 mmol/L)Total CO2: 11.2(n:21-27 mmol/L)Base Excess: -14,3(n: -2,5 - +2,5 mmol/L)Saturasi O2: 97,9(n: 95-98 %)Standard HCO3: 15,2(n:22-24 mmol/L)Standard Base Excess: -11,6

TINJAUAN PUSTAKAAnimated picture pans in window with fade-in captions(Advanced)

Tip: For best results, select a high-resolution, vertically oriented picture, where the picture height is larger than the slide height. The picture in the example above is 15 high and 10 wide. (Normal slide dimensions are 7.5 high and 10 wide.)

To reproduce the picture effects on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank. On the Insert tab, in the Images group, click Picture. In the Insert Picture dialog box, select a picture, and then click Insert.Select the picture. Under Picture Tools, on the Format tab, in the Size group, click the Size and Position dialog box launcher. In the Format Picture dialog box, resize or crop the image so that the height is set to 15 and the width is set to 10. To crop the picture, click Crop in the left pane, and in the right pane, under Crop position, enter values into the Height, Width, Left, and Top boxes. To resize the picture, click Size in the left pane, and in the right pane, under Size and rotate, enter values into the Height and Width boxes.On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide.Click Align Top.Click Align Center. The remainder of picture will extend beyond the bottom edge of the slide area. You may need to zoom out to view your slide. To zoom out, on the View tab, in the Zoom group, click Zoom. In the Zoom dialog box, select 33%.

To reproduce the shape effects on this slide, do the following:On the Home tab, in the Drawing group, click Shapes, and then under Rectangles click Rounded Rectangle (second option from the left). On the slide, drag to draw a rounded rectangle.Select the rounded rectangle. Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 2.5.In the Shape Width box, enter 8.Also on the Format tab, in the Shape Styles group, do the following:Click the arrow next to Shape Fill, and then click No Fill.Click the arrow next to Shape Outline, and then under Theme Colors click White, Background 1 (first row, first option from the left).Also on the Format tab, in the bottom right corner of the Shape Styles group, click the Format Shape dialog box launcher. In the Format Shape dialog box, in the left pane, click Line Style. In the Line Style pane, in the Width box, enter 12.5 pt.Also in the Format Shape dialog box, in the left pane, click 3-D Format, and then do the following in the 3-D Format pane:Under Bevel, click the button next to Top, and then under Bevel click Circle (first row, first option from the left).Under Surface, click the button next to Material, and then under Standard click Warm Matte (second option from the left). Click the button next to Lighting, and then under Cool click Freezing (second option from the left).On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide.Click Align Middle.Click Align Center.On the Home tab, in the Drawing group, click Shapes, and then under Rectangles click Rectangle (first option from the left). On the slide, drag to draw a rectangle.Select the rectangle. Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 2.51.In the Shape Width box, enter 10.Also on the Format tab, in the Shape Styles group, click the arrow next to Shape Outline, and then click No Outline.Also on the Format tab, in the Shape Styles group, click the arrow next to Shape Fill, point to Gradient, and then click More Gradients. In the Format Shape dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Linear.Click the button next to Direction, and then click Linear Down (first row, second option from the left). Under Gradient stops, click Add gradient stops or Remove gradient stops until two stops appear in the slider.Also under Gradient stops, customize the gradient stops as follows:Select the first stop from the left in the slider, and then do the following: In the Position box, enter 0%.Click the button next to Color, and then under Theme Colors click Black, Text 1 (first row, second option from the left).In the Transparency box, enter 0%. Select the second stop from the left in the slider, and then do the following: In the Position box, enter 100%.Click the button next to Color, and then under Theme Colors click Black, Text 1, Lighter 25% (fourth row, second option from the left).In the Transparency box, enter 0%. On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide. Click Align Top. Click Align Center.Select the rectangle. On the Home tab, in the Clipboard group, click the arrow next to Copy, and then click Duplicate.On the Home tab, in the Drawing group, click Arrange, point to Rotate, and then click Flip Vertical.Also on the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide. Click Align Bottom. Click Align Center.Also on the Home tab, in the Drawing group, click Shapes, and then under Rectangles click Rectangle (first option from the left). On the slide, drag to draw a rectangle.Select the rectangle. Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 2.55.In the Shape Width box, enter 1.06.Under Drawing Tools, on the Format tab, in the bottom right corner of the Shape Styles group, click the Format Shape dialog box launcher. In the Format Shape dialog box, in the left pane, click Line Color. In the Line Color pane, select No line.Also in the Format Shape dialog box, in the left pane, click Fill. In the Fill pane, select Solid fill, click the button next to Color, and then under Theme Colors click Black, Text 1, Lighter 25% (fourth row, second option from the left).On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following: Click Align to Slide.Click Align Right. Click Align Middle.Select the rectangle. On the Home tab, in the Clipboard group, click the arrow next to Copy, and then click Duplicate.Select the duplicate rectangle. On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide.Click Align Left.Click Align Middle.On the Home tab, in the Editing group, click Select, and then click Selection Pane. In the Selection and Visibility pane, select the rounded rectangle.On the Home tab, in the Drawing group, click Arrange, and then click Bring to Front.In the Selection and Visibility pane, press and hold CTRL, and then select the rounded rectangle and four rectangles. On the Home tab, in the Drawing group, click Arrange, and then click Group.

To reproduce the text effects on this slide, do the following:On the Insert tab, in the Text group, click Text Box. On the slide, drag to draw a text box.Type the text you want to appear in the text box, and then select the text. Format the text in the textbox using the following steps:On the Home tab, in the Font group, choose the Calibri font and a font size of 26.Click the arrow next to Font Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).In the Paragraph group, click Align Text Left.Drag the text box to the lower left part of the rounded rectangle.

To reproduce the animation effects for the picture on this slide, do the following:On the slide, select the picture.On the Animations tab, in the Advanced Animation group, click Add Animation, and then, under Entrance, click Fade.Also on the Animations tab, in the Timing group, in the Start list, select With Previous.Also on the Animations tab, in the Timing group, in the Duration box, type 2.On the Animations tab, in the Advanced Animation group, click Add Animation, and then click More Motion Paths.In the Add Motion Paths dialog box, under Lines and Curves, click Up.Also on the Animations tab, in the Timing group, in the Start list, select With Previous.Also on the Animations tab, in the Timing group, in the Duration box, type 20.On the slide, select the Up motion path, and then do the following: Press and hold SHIFT, and then drag the end point (red arrow) of the motion path to the top edge of the slide.Press and hold Shift, and then drag the starting point (green arrow) of the motion path to the bottom edge of the slide.

To reproduce the animation effects for the text on this slide, do the following:On the slide, select the text box.On the Animations tab, in the Advanced Animation group, click Add Animation, and then, under Entrance, click Fade.Also on the Animations tab, in the Timing group, in the Start list, select With Previous.Also on the Animations tab, in the Timing group, in the Duration box, type .5.Also on the Animations tab, in the Timing group, in the Delay box, type 3.0.Also on the Animations tab, in the Advanced Animation group, click Add Animation, and then, under Exit, click Fade.Also on the Animations tab, in the Timing group, in the Start list, select With Previous.Also on the Animations tab, in the Timing group, in the Duration box, type .5.Also on the Animations tab, in the Timing group, in the Delay box, type 8.0.On the slide, select the text box. On the Home tab, in the Clipboard group, click the arrow next to Copy, and then click Duplicate.On the slide, click in the second text box and edit the text.On the Animations tab, in the Advanced Animation group, click Animation Pane.In the Animation Pane, do the following:Select the entrance animation on the second text box. Click the arrow to the right of the effect, and then click Timing. In the Fade dialog box, on the Timing tab, in the Delay box, enter 8.5, and then click OK.Select the exit animation on the second text box. Click the arrow to the right of the effect, and then click Timing. In the Fade dialog box, on the Timing tab, in the Delay box, enter 13.0, and then click OK.On the slide, select the second text box. On the Home tab, in the Clipboard group, click the arrow next to Copy, and then click Duplicate.On the slide, click in the third text box and edit the text. In the Animation Pane, do the following:Select the entrance animation on the third text box. Click the arrow to the right of the effect, and then click Timing. In the Fade dialog box, on the Timing tab, in the Delay box, enter 13.5, and then click OK.Select the exit animation on the third text box. Click the arrow to the right of the effect, and then click Timing. In the Fade dialog box, on the Timing tab, in the Delay box, enter 19.5, and then click OK.On the slide, press and hold CTRL, and then select the three text boxes. On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align Selected Objects.Click Align Middle.Click Align Center.

To reproduce the animation effects for the shapes on this slide, do the following:On the slide, select the rounded rectangle and the group of shapes that form the background of the slide. On the Animations tab, in the Advanced Animation group, click Add Animation, and then click More Emphasis Effects. In the Add Emphasis Effect dialog box, under Basic, click Grow/Shrink.Also on the Animations tab, in the Timing group, in the Start list, select After Previous.Also on the Animations tab, in the Timing group, in the Duration box, type 2.On the Animations tab, in the Animation group, click Effect Options, and then click Horizontal.On the Animations tab, in the Advanced Animation group, click Add Animation, and then click More Exit Effects. In the Add Emphasis Effect dialog box, under Basic, click Fade.Also on the Animations tab, in the Timing group, in the Start list, select With Previous.Also on the Animations tab, in the Timing group, in the Duration box, type 1.

SUATU PENYAKIT YANG DITANDAI :

BAB yang tidak normal atau bentuk tinja yang encer dengan frekuensi lebih banyak dari biasanya.Penyebab Kematian Umur 0-12 bulan

Riskesdas 2007 Menurut WHO (2005) diare dapat diklasifikasikan menjadi : Diare akut, yaitu diare yang berlangsung kurang dari 14 hari.Disentri, yaitu diare yang disertai dengan darah.Diare persisten, yaitu diare yang berlangsung lebih dari 14 hari.Diare yang disertai dengan malnutrisi berat ETIOLOGIDiare cair akut20%-80% anak di dunia rotavirusPenelitian di 6 rumah sakit (Indonesia) 55% kasus diare akut pada balita rotavirus

DisentriWHO sebagian besar ShigellaPenelitian di 6 rumah sakit (Indonesia) Shigella, Salmonella, Campylobacter jejuni, Escherichia coli (E. coli) dan Entamoeba histolyticaPATOFISIOLOGI

Diare Gangguan absorpsi dan sekresi cairan serta elektrolit

Normal usus halus mengabsorbsi Na+, Cl-, HCO3-.

ABNORMAL : jumlah cairan melebihi kemampuan kolon dalam mengabsorpsi.PATOFISIOLOGI (cont)Virus dapat secara langsung merusak vili usus halus mengurangi luas permukaan usus halus dan mempengaruhi mekanisme enzimatik.malabsorbsi dan motilitas abnormal dari usus selama infeksi rotavirus PATOFISIOLOGI (cont)Bakteri mengakibatkan diare melalui beberapa mekanisme yang berbeda. MANIFESTASI KLINISDIAGNOSADIDASARKAN PADA KEADAANDiare cair akutDiare lebih dari 3 kali sehari berlangsung kurang dari 14 hariTidak mengandung darahKoleraDiare air cucian beras yang sering dan banyak dan cepat menimbulkan dehidrasi berat, atauDehidrasi dengan dehidrasi berat selma terjadi KLB kolera, atauDehidrasi dengan hasil kultur tinja positif untuk V.cholerae O1 atau O139DisentriDiare berdarah (terlihat atau dilaporkan)Diare persistenDiare berlangsung selama 14 hari atau lebihDiare dengan gizi burukDiare jenis apapun yang disertai tanda gizi burukDiare terkait antibiotik (Antibiotic Associated Diarrhea)Mendapat pengobatan antibiotik oral spektrum luasInvaginasiDominan darah dan lendir dalam tinjaMassa intraabdominal (abdominal mass)Tangisan keras dan kepucatan pada bayiDIAGNOSISTentukan Persistensinya lebih dari14 hari?

Etiologi ada darah?

Derajat DehidrasiAsupan peroral ?frekuensi miksi/urin ?Frekuensi serta volume tinja dan muntah ?Pernah periksa / mengkonsumsi obat tertentu ?

Lihat: Kead. Umum MataAir mataMulut dan lidahRasa haus

Periksa Turgor kulitHasil pemeriksaan

Terapi Baik, sadar Normal Ada Basah Minum biasa tidak haus

Kembali cepatTanpa dehidrasi

Rencana terapi A* Gelisah, rewel Cekung Tidak ada Kering * Haus, ingin minum banyak

* Kembali lambatD. Ringan/sedang1 tanda * (+) 1 atau lebih tanda lain Rencana terapi B* Lesu, lunglai, tak sadarSangat cekung & kering Tidak ada Sangat kering * Malas minum atau tidak bisa minum

* Kembali sgt lambatDehidrasi berat1 tanda * (+) 1 atau lebih tanda lainRencana terapi CPenilaian A BCHubungan Derajat Dehidrasi Dengan Perkiraan Jumlah Cairan yang HilangPengukuranKekurangan Cairan (%) Berat BadanKekurangan Cairan dalam ml/Kg Berat BadanTidak Dehidrasi10%>100 ml/kgLima Lintas Tatalaksana 29TATALAKSANA DIARE (2)Penanganan dehidrasi:Ask,look, and feel tanda-tanda dehidrasiKondisi anak & pemeriksaan fisis: mata, air mata, mulut & lidah. Apakah tampak kehausan, skin pinchAnterior fontanelle, arms & legs, pulse, breathingTentukan derajat dehidrasi (Berat, ringan sedang atau tanpa dehidrasi)Pilih rencana pengobatan:C: Severe dehydration (loss of >10% of Body Weight)B: Some dehydration (loss of 5-10% of BW)A: No signs of dehydration (loss of 5 tahundewasaTotal ORS300 ml600 ml1200 ml2400 ml RENCANA TERAPI C

UmurIst treatment30 ml/KG BB dlm2nd treatment 70 ml/KG BB dlmInfant < 12 bln1 jam5 jamAnak > 12 bln - 1 jam 2 - 3 jam

YALima Lintas Tatalaksana 42Dukungan NutrisiTetap diteruskan sesuai umur anak menu sama pada anak sehatASI tetap diteruskan frekuensi lebih sering dari biasanyaTujuan mencegah gizi burukAdanya perbaikan nafsu makan fase kesembuhan43Suplementasi zincPemberian zincMengurangi lama dan beratnya diareMencegah berulangnya diare selama 2-3 bulanMengembalikan nafsu makan anak

Dosis zinc untuk anak Anak di bawah umur 6 bulan : 10 mg(1/2 tablet) per hari Anak di atas umur 6 bulan : 20 mg (1 tablet) per hari

Diberikan selama 10-14 hari berturut-turut meskipun anak sudah sembuh dari diare

44Indikasi :diare berdarah (disentri) dan kolera

Disentri Beri antibiotik selama 5 hari yang masih sensitif terhadap shigella menurut pola setempatAntibiotik Selektif45WHO Golongan Quinolon seperti Ciprofloxacin dengan dosis 30-50 mg/kgBB/hari dibagi dalam 3 dosis selama 5 hari

Pantau setelah 2 hari pengobatan : demam, diare berkurang, darah dalam feses, peningkatan nafsu makanMembaik HENTIKAN ANTIBIOTOKTidak membaik hentikan pemberian antibiotik sebelumnya dan berikan antibiotik yang sensitif terhadap shigella berdasarkan areaJika kedua jenis antibiotika tersebut di atas tidak memberikan perbaikan maka amati kembali adanya penyulit atau penyebab selain disentri

46pasien rawat jalan dianjurkan pemberian sefalosporin generasi ketiga seperti sefiksim 5 mg/kgBB/hari per oral

KontrolTidak membaik atau bertambah berat muncul tanda-tanda komplikasi (panas tinggi, kejang, penurunan kesadaran, tidak mau makan dan menjadi lemah)47TATALAKSANA DIARE DI RUMAHBeri minum lebih banyak dari biasanyaBeri makan lebih seringBawa/rujuk ke petugas kesehatan bila keadaan tidak membaik48KOMPLIKASI LAINDiare Air Dehidrasi Kalium Hipokalemia Natrium Hiponatremia Bikarbonat Asidosis Nutrien Hipoglikemia49- selesai-TERIMA KASIH Chart14224976435

prosentaseDiare; 42%Pneumonia; 24%Meningitis/Ensefalitis; 9%Kel Sal Pencernaan; 7%Kel Jantung Kongenital & hidrosefalus; 6%Sepsis; 4%Tetanus; 3%Lain-lain (malnutrisi,TB, Campak); 5%

Sheet1DiarePneumoniaMeningitis/EnsefalitisKel Sal PencernaanKel Jantung Kongenital & hidrosefalusSepsisTetanusLain-lain (malnutrisi, TB, Campak)prosentase4224976435