Lapsus Bronkioltis Dan Pneumonia

8/19/2019 Lapsus Bronkioltis Dan Pneumonia

1/57

BRONKIOLITIS DANPNEUMONIA

Meriam Howard

10700249

DM Proo!i"##o Ke! A

LAPORAN KASUS ILMU KESEHATAN

ANAK

DOSEN PEMBIMBIN$dr% Dwi A#&'(i"a Ramada"i) S*%A


2/57

BRONKIOLITIS


3/57

DE+INISI

Pe",a-i( o'(r&-'i. a-ia( i"/ama'i a-&(*ada 'a!&ra" "a.a' -ei! ro"-io!&',a"# (er3adi *ada a"a- 2 (a5&"%


4/57

EPIDEMIOLO$I

I"'ide"'(er(i"##i*ada &'ia'e-i(ar 26&!a"

La-i6!a-i 8Perem*&a"

Prevalensi Kasus Bronkiolitis

2 (a5&"

8 2 (a5&"


5/57

ETIOLO$I

RS Re'*ira(or, S,",(ia! ir&'

Ade"o:ir&'

ir&' I"/&e";a

ir&' Parai"/&e";a

R5i"o:ir&'

Mi-o*!a'ma


6/57

PA

TOFI

SIO

LOG

I

BR

ONK

IOLITIS


7/57

KLASI+IKASI


8/57

DIA$NOSIS

Anamnesa


9/57

DIA$NOSA BANDIN$

A'ma ro"5ia!

P"e&mo"ia

A'*ira'i e"da a'i"#

Re/&-' #a'(roe'o*5a#ea!Si'(i-


10/57

KOMPLIKASI

$a"##&a" .&"#'i *ar& ,a"# me"e(a*

A'ma


11/57

PENATALAKSANAAN


12/57

Re'*ira(or, Di'(re'' A''e''me"( I"'(r&me"(RDAI


13/57

PEN=E$AHAN

Me"#5i"dari .a-(or *a*ara" a'a* ro-o-> *o!&'i &dara%

Mema(a'i *e"&!ara"%

Im&"o#!o&!i" I$

a-'i"a'i


14/57

PRO$NOSIS

Bera( ri"#a"",a *e",a-i(%

=e*a(",a *e"a"#a"a" 4? @ 72 3am%

Ada (ida-",a *e",a-i( awaa"%


15/57

PNEUMONIA


16/57

DE+INISI

S&a(& *erada"#a" *ar& ,a"# di'ea-a"o!e5 mi-roor#a"i'me a-(eri) :ir&')

3am&r) *ara'i(%


17/57

ETIOLO$I

Ba-(eri%

ir&'%

am&r%

Mi-o*!a'ma%

Pro(o;oa%

Ba5a" -imiae"da a'i"# ,a"#

(era'*ira'i%


18/57

PATO+ISIOLO$I


19/57

KLASI+IKASI

Berda'ar-a" -!i"i' da" e*idemio!o#i'C

P"e&mo"ia -om&"i(i omm&"i(,6a&ired *"e&mo"ia%

P"e&mo"ia "o'o-omia! 5o'*i(a!6ai&red *"e&mo"ia"o'oomia!*"e&mo"ia%

P"e&mo"ia a'*ira'i% P"e&mo"ia *ada *e"deri(a

Imm&"oom*romi'ed%


20/57

KLASI+IKASI

Berda'ar-a" a-(eri *e",eaC

P"e&mo"ia a-(eria!(i*i-a!%

P"e&mo"ia a(i*i-a!%

P"e&mo"ia :ir&'%

P"e&mo"ia 3am&r%


21/57

KLASI+IKASI

Berda'ar-a" *redi!e-'i i".e-'iC

P"e&mo"ia !oari'%

Bro"-o*"e&mo"ia%

P"e&mo"ia i"(er'(i'ia!%


22/57

DIA$NOSA BANDIN$

Pada a"a-

Bro"-io!i(i'

Pa,a5 3a"(&"#

A'*ira'i e"da a'i"# A'e' *ar&

Pada Ba,i

Me"i"#i(i'

I!e&'


23/57

DIA$NOSIS

A"am"e'a


24/57

PENATALAKSANAAN

A"(iio(i-

Pe"#oa(a" S&*or(i.


25/57

Pilihan Penggunaan Antibiotik paaPneumonia


26/57

KOMPLIKASI

E.&'i *!e&ra%

Em*iema%

A'e' Par&%

P"e&mo(ora-'%

$a#a! "a*a'%

Se*'i'


27/57

PRO$NOSIS

Pada &m&m",a ai-) (er#a"(&"# dari.a-(or *e"deri(a) a-(eri *e",ea da"*e"##&"aa" a"(iio(i- ,a"# (e*a( 'er(a

ade-&a(%


28/57

PEN=E$AHAN

Po!a 5id&* 'e&( (erma'&- (ida-mero-o-%

a-'i"a'i :a-'i" *"e&mo-o-a! da"

:a-'i" i"/&e";a%


29/57

LAPORAN KASUS


30/57

IDENTITAS PASIEN

Nama C A"% M+ e"i' Ke!ami" C La-i6!a-i Um&r C 14 &!a" A#ama C I'!am S&-& Ba"#'a C I"do"e'ia A!ama( C D&'&" Ked&"# Kemiri RT 01R 0 Ked&"#

A'em) o"oa'i5 Nama A,a5 C T"% S40 (5"Ta"i Nama I&C N,% MF4 (5"Era(eG Ta"##a! Ma'&-C 24 No:emer 201

Ta"##a! Ke!&arC F0 No:emer 201


31/57

ANAMNESA

Ke!&5a" U(ama C

Demam


32/57

ANAMNESA

Riwa,a( Pe",a-i( Se-ara"# C Demam 'e3a- F 5ari ,a"# !a!&) "ai- (&r&"% Se'a- "a*a' 'e3a- 2 5ari ,a"# !a!&% BAB -emari" 1G de"#a" -o"'i'(e"'i !&"a-% BAK !a"ar da" "orma!% M&"(a5 5ari i"i '&da5 FG i'i ma-a"a"%

Na.'& ma-a" er-&ra"# da" mi"&m a",a-% A"a- (ida- mi"&m ASI) '-r# PASI '&'& .orm&!a S$M

'o,a (e(a*i 'e3a- F 5ari ,a"# !a!& 5a",a 'edi-i(% Ke3a"# 6% Ba(&- erda5a- 'e3a- F 5ari ,a"# !a!& "am&" da5a-

(ida- i'a di-e!&ar-a"%

Pi!e- 'e3a- F 5ari ,a"# !a!&%


33/57

ANAMNESA

Riwa,a( Pe",a-i( Da5&!& C

MRS 2GC -e!&5a" 'e'a- > demam17101 > 11111 d#" dG i".e-'i

*ar&6*ar&% Riwa,a( Ke3a"# da" A'ma (ida- ada%


34/57

ANAMNESA

Riwa,a( Pe",a-i( Ke!&ar#a C

Tida- ada -e!&ar#a ,a"# 'a-i( 'e*er(i i"i%

Riwa,a( A'ma da" -e3a"# (ida- ada%

Tida- ada -e!&ar#a di r&ma5 ,a"#memi!i-i *e",a-i( a(&- !ama a(a& a(&-erdara5%


35/57

ANAMNESA

Riwa,a( So'ia! C

Di !i"#-&"#a" 'e-i(ar (ida- ada ,a"#'a-i( 'e*er(i i"i%

Tida- ada (e(a"##a di 'e-i(ar r&ma5,a"# memi!i-i *e",a-i( a(&- !ama a(a&a(&- erdara5%


36/57

ANAMNESA

Riwa,a( A!er#i da" Pe"#oa(a" C

Tida- ada a!er#i oa( da" ma-a"a"%

Tera-5ir -o"(ro! -e *o!i a"a- 'e(e!a5 MRS

(a"##a! 11111) a"a- da!am -o"di'iai-


37/57

ANAMNESA

Riwa,a( Im&"i'a'i C

Im&"i'a'i !e"#-a*

Riwa,a( Ke5ami!a" I& C

I& 5ami! 9 &!a" da" (ida- ada ma'a!a5'e!ama -e5ami!a"


38/57

ANAMNESA

Riwa,a( Ke!a5ira" C

La5ir "orma! di ida" de"#a" era(ada" !a5ir 2?00 #ram) a"a- *er(ama

Riwa,a( Per(&m&5a" da"Per-ema"#a" C

T&m&5 -ema"# a"a- ai- 'e*er(i a"a-'e&'ia",a


39/57

PEMERIKSAAN +ISIK

Keadaa" Um&m C Seda"#

Ke'adara" C =om*o' Me"(i'

A"(ro*ome(ri C

Bera( Bada" C 9 -#

Pa"3a"# Bada" C 72 m

Bera( Bada" Idea! C 9) -#

S(a(&' $i;i C BBU 9F)7J Norma!

BMI 94J 6 6'ore 62 SD'd 2 SD Norma!


40/57

PEMERIKSAAN +ISIK

Li"#-ar Ke*a!aC 4? m

Li"#-ar Le"#a" C 1? m

i(a! Si#" C

Nadi C 10 Gme"i(

Per"a*a'a" C 72 Gme"i(

S&5& C F9)2o=


41/57

PEMERIKSAAN +ISIK

Ke*a!a C

aid C 666

P=H

Hi*eremi .ari"# 6

To"'i! C T1T1

Mo"i!ia'i' 6

Le5er C

Peme'ara" K$B 6

Ma''a 6


42/57

PEMERIKSAAN +ISIK

T5oraG C Sime(ri' -a"a"-iri

Re(ra-'i I=S

P&!mo C S&ara "a*a' *ar& -a"a" -iri :e'i-&!er

R5o"-i

5ee;i"# =or C

S1S2 (&"##a!

M&rm&r 6) $a!!o* 6


43/57

PEMERIKSAAN +ISIK

Adome" C

Soe/

Bi'i"# &'&' "orma!

T&r#or -&!i( &-&* Me(eori'm&' 6

N,eri (e-a" 6

He*a(ome#a!i 6 S*!e"ome#a!i 6


44/57

PEMERIKSAAN +ISIK

$e"i(a!ia C d"

E-'(remi(a' C

A-ra! 5a"#a( 'em&a

=RT 2 de(i- Oedema 6

S(a(&' Ne&ro!o#i C d"


45/57

ASSESMENT

Dia#"o'i'C

O'% +eri' da" D,*'"e& e S&'*e-Bro"-io!i(i' da" P"e&mo"ia

Dia#"o'a Ba"di"# C

Bro"-i(i'

TB Par&


46/57

PLANNIN$

Dia#"o'i'C

Laora(ori&m C

$DA

DL

=RP

Radio!o#iC +o(o T5ora-'


47/57

PLANNIN$

Tera*iC

O2 "a'a! F!*m

I".% D 14 NS 900 24 3am

I"3e-'i =e.(riaGo"e 2 G 40m#

I"3e-'i Ra"i(idi"e 2 G 9m# I"3e-'i Parae(amo! F G 100m# Ne&! Sa!&(amo! am*&! P 2 Ka!ori 1%0?0 Ka!5ari

PASI 1%?005ari 12 G 10 Roora"(ia Dro* 1 G 0) Bedre'( Kom*re' air ia'a i!a *a"a'

HASIL LABORATORIUM 24


48/57

HASIL LABORATORIUM 2461161 !enis Pemeriksaan "asil Nilai Normal

$DA 9 200 m#d!

=RP Ti(er 9 Ne#a(i.

"b #$%& L '#()#*% P '#+)#,g-l

".T (# L '/$)&$% P '(&)/01

Leukosit #*2($$ /2$$$)##2$$$-3mm

Tromo'i( 2?9%000 10%000640%000mm

Eri(ro'i( )0 L C4)6)) P CF6 3(mm

Eo'i"o

Ba'o

Ne&(ro

Lim.o'i( 2 164 J


49/57

2 No:emer 201 @ F0 No:emer

201

SOAP

Tanggal 25 November 2015 26 November 2015 27 November 2015


50/57

S Demam(+),Sesak(+) ) BAB(-) 2 har !ll)

BA"(+)) #akan (-), $AS% se&k') Ba'k

ber&ahak (+) har !ll

Demam kmrn sore *, komres

'rn) Sesak (+)) BAB (-) * har !ll,

BA" (+), #akan (-), $AS% se&k') Ba'k

ber&ahak (+) 5 har !ll

Demam kmrn sore *,0 komres

'rn) Sesak (+)) BAB 1. ag

konss'ens lnak ) BA" (+), #akan (-),

$AS% ///, Ba'k ber&ahak (+) 6 har !ll

" lemah, "es 3omos men's

T *7,0o4) Na& 12 .men'

70 .men'

a3& ---+) $4 (+)

Sme'rs kanan kr, e'raks (++)

Sara na8as veskler, 9hee:ng ++,

honk ++;

" lemah) "es 3omos men's

T *7,*o4) Na& 12 .men'

70 .men'

a3& ---+) $4 (+)



honk ++;


51/57

S Demam (-), Sesak (+) s&ah berkrang,

BAB 1. &gn konss'ens lnak, BA"

(+), #akan (-), $AS% ///, Ba'k

ber&ahak (+) 7 har !ll

Demam (-), Sesak (-), BAB (+), BA"

(+), #akan (+) se&k', $AS% ///,

Ba'k (+) berkrang

Demam (-), Sesak (-), BAB (+), BA"

(+), #akan (+), $AS% ///, Ba'k (+)

=arang;

" lemah, "es 3omos men'sT *6,7o4, Na& 10 .men',

65 .men'

a3& ---+) $4 (-)



honk ++

" 3k, "es 3omos men'sT *6,o4, Na& 10 .men',

55 .men'

a3& ----) $4 (-)

Sme'rs kanan kr, e'raks (--)


honk --

" lemah"esa&aran 3omos men's

'al sgn

T *6,7o4

Na& 10 .men'

0 .men'

a3& ----) $4 (-)

Sme'rs kanan kr, e'raks (--)

Sara na8as veskler, 9hee:ng-

-,honk --

A Bronkol's + $nemona Bronkol's + $nemona Bronkol's + $nemona

$ 6 2 nasal *lm

6 %n8; D5 1 NS 00332=am

6 %n=eks 4e8'ra.one 2.50mg6 Nebl Salb'amol > aml + $?

233

6 "alor 1;00 "3alhar

6 $AS% 1;[email protected]

6 oboran'a Dro 1.0,533

6


52/57

ANALISA KASUS


53/57

A"am"e'a

Demam) 'e'a-) a(&-) *i!e-) da" "a.'&ma-a" *a'ie" er-&ra"# 5a! i"i 'e'&aide"#a" #e3a!a -!i"i' dari ro"-io!i(i' da"

*"e&mo"ia dima"a *ada *e"deri(aro"-io!i(i' da" *"e&mo"ia a-a" da*a(dida5&!&i de"#a" #e3a!a ISPA 'e*er(i a(&-da" *i!e- -em&dia" 'e'a- da" demam

,a"# "ai- (&r&" da" #e3a!a a"ore-'ia%


54/57

Pemeri-'aa" +i'i-

Per"a*a'a" &*i"# 5id&"#) re(ra-'ii"(ero'(a!i') (erde"#ar ada",a w5ee;i"#da" ro"-i) ,a"# me"a"da-a" *a'ie" i"i

me"#a!ami -e'&!i(a" er"a*a' da"mer&*a-a" 'a!a5 'a(& #e3a!a ro"-io!i(i'da" *"e&mo"ia 'e5i"##a me!e"#-a*idia#"o'a ro"-io!i(i' da" *"e&mo"ia%


55/57

Pemeri-'aa" Pe"&"3a"#

DL C Le&-o'i(o'i' 1?%F00mm

+o(o T5ora-' C

Ada",a (erda*a( #amara" -o"'o!ida'i

,a"# (er'ear (er&(ama *ada a*eG*&!mo 'i"i'(ra ,a"# me"a"da-a"ada",a i".e-'i *ada *ar& *a'ie"


56/57

Pe"a(a!a-'a"aa" Ka'&'

Pemeria" O2 Tera*i aira" da" -a!ori

Pemeria" ASIPASI ,a"# &-&*

Pemeria" a"(iio(i-

Pemeria" a"(i*ire(i-

Ne&!ai;er 6a#o"i' Sa!&(amo!

Roora"(ia


57/57

DOSEN PEMBIMBIN$Cdr% Dwi A#&'(i"a Ramada"i)S*%A

S4F IL45 K6S6"ATAN ANAK

RS57 7R24O" SAL6" PROBOLINGGO

FAK5LTAS K67OKT6RAN

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Lapsus Bronkioltis Dan Pneumonia