CHAPTER II

SOME DISEASE IN HUMANS

1. SCHIZOPHRENIA
a. Definition
Schizophrenia is a disorder of psychological / psychiatric disorder caused by a
chemical in the brain, which in turn interfere with the function of systemic and brain
nerve impulses. These conditions lead to a malfunction in the brain and to process
information from the senses, so that the resulting projections should not be.
b. Cause
Experts have not found the cause of schizophrenia. Suspected environmental
factors and genetics play a role in the formation of this condition.
c. Signs and symptoms
Closed-social behavior and changes in sleep patterns be early symptoms of
schizophrenia. Because the disease usually begins to develop in adolescence, these
symptoms only considered as a change young people's behavior.
d. Treatment of schizophrenia
Usually schizophrenia treated with antipsychotic drugs and therapy as a form of
psychological treatment. In addition, the treatment of schizophrenia also be supported
with the support and attention from those closest to the patient. Which includes
proper treatment of schizophrenia include recognizing signs of an acute episode,
medication as prescribed, and openness to others about this condition. By combining
various methods of treatment, people with schizophrenia can be slowly recovering, a
normal life and prevent recurrence of the disease.
2. TRYPOPHOBIA
a. Definition
Phobia is the fear experienced by a person against an object that raises real impact
b. Cause
Until now unknown causes of phobias are quite strange. Some people believe that
Trypophobia has experienced since childhood. Most likely what happened was a
traumatic experience when entering the early stages of life. Because of its origin is
unknown until this moment there is no kind of test or diagnosis to check this phobia.
c. Symptoms trypophobia
Someone who experienced trypophobia will feel uneasy and even to experience
itching all over his body when he saw an object that there are many holes on a surface
such as a sponge, bone marrow, lotus seed and others. In general, patients will

undergo two possible trypophobia the bold look then melupakanya but some are
feeling dizzy and eneg after seeing this tersebut.Berikut hole reactions experienced by
a person who had a phobia like trypophobia:
o Panic and experiencing excessive fear when dealing with the source of his fear.
o Experiencing anxiety and would have an impact on an organ that is not
functioning optimally.
o Removing sweat, heart berdegub fast, frantic, ceas and even difficulty breathing.
o In people with children will continue to tantrums and crying.
d. Treatment trypophobia
Basically not all phobias require treatment. Only if the impact on daily life it is
advisable to do therapy to overcome fear of the patient. because Trypophobia not
known with certainty the cause then treatment can be done is by way of consultation
neurolinguistic, cognitive behavioral, and consulting a psychologist. Therapy by
means of hypnotherapy, behavior therapy and counseling have been proven effective
for treating people with phobias. This is because the majority of phobias occur due to
emotional problems.
RESPIRATORY SYSTEM DISEASES
1. BRONCHIAL ASTHMA
a. Definition
Bronchial asthma is a disease of the airways characterized by increased reactivity
(hyperactivity) trachea and bronchi to various stimuli with manifestations such as
airway constriction was thorough (Leksana, et al, 2005).
b. Cause: allergic reactions to dust, smoke, cleaning products, odors, cold air, ispa, and
stress.
c. Signs and symptoms
o Cold with rhinorrea with: irritability, cough, tachypnea, wheezing
o respiratory distress during or immediately after meals
o mucosal gland hyperplasia
o The narrowing of the airway
o Lack of flexibility static lung
o Lack of muscle fibers
o Lack of collateral ventilation
d. Nursing diagnosis and intervention
a) The airway is not effectively connected with bronchospasm, increased production
of secretions, decreased energy, sticky secretions
Intervesinya:
o Provide sleep half-sitting position

o
o
o
o
o
b)

Protect the environment from pollution / substances - allergens.

Increase fluid intake.
Teach cough technique effectively.
Perform chest physiotherapy
Collaboration: bronchodilators
The pattern of breath efektifberhubungan with decreased lung expansion,

o
o
o
o
o
o
o

increased breathing work

Intervention:
Monitor breathing, note the presence of abnormal breath sounds
Note the ratio of inspiration: expiration
Monitor the dyspnea, restlessness, muscle use breathing apparatus
Position the patient so that it can support or improve lung expansion
Maintain a minimum pollution
Teach purse lip breathing technique
Perform chest physiotherapy

2. PULMONARY TUBERCULOSIS "

a. Definition
Tuberculosis is a contagious infectious disease caused by mycobacterium tuberculosis
yan, an acid-resistant aerobic bacillus transmitted through the air (airborne). In almost
all cases of infectious tuberculosis bacteria obtained through inhalation of particles
that are small (about 1-5 mm).
b. Etiology
The cause of the disease is pulmonary tuberculosis germs (bacteria) that can only be
seen with miroskop, the mycobacterium tuberculosis. Microbakteri are aerobic
bacteria, shaped stones that form spores.
c. Clinical symptoms
Tuberculosis can be divided into two groups, namely respiratory symptoms and
systemic symptoms.
a) Respiratory symptoms
o Coughing more than 3 weeks
o coughing up blood
o Chest pain
b) Systemic symptoms
o Fever
o Other systemic symptoms: malaise, night sweats, anorexia and weight loss
d. The diagnoses and interventions nursing
1. Ineffective airway clearance related to accumulation of purulent secretions in
the airway.
Intervention

o assess respiratory function, examples of breath sounds, speed and rhythm.

o give patients semi-Fowler position or high Fowler effectively assist the
patient to cough and deep breathing exercises.
o maintain fluid intake at least 2500 ml / day, unless contraindicated
o collaboration for the administration of drugs according to indications,
mucolytics medicine
2. Kurangn nutritional changes of body requirements related to the production of
sputum, anorexia
o record the patient's nutritional status, record of skin turgor, body weight
o
o
o
o

and degree of underweight, ability / inability to swallow, nausea-history.

supervised input or expenditure and weight periodically
provide oral care before and after the act of breathing.
encourage eating little and often with food TKTP
Collaboration with the nutritionist to determine the composition of the
diet.
SYSTEM CARDIOVASCULAR DISEASE

1. HYPERTENSION
a. Definition
High blood pressure or hypertension is a condition a person's blood pressure is at
levels above normal. And the consequences of this situation is the emergence of
diseases that interfere with the patient's body. In hypertensive disease is a health
problem and need of prevention. (Sudjaswandi: 2002 h 17)
b. Cause
o high levels of salt in your food
o Lack of exercise
o Being overweight
o family health history with high blood pressure
o Smoking
o Too much consuming liquor
o Stress
o The risk of high blood pressure increases with age
c. Signs and symptoms
Between Signs and symptoms are dizziness or headaches, anxiety, red face, neck stiff,
irritability, ear berdenggung, insomnia, shortness of breath, fatigue, dizzy eyes, and
nosebleeds.
d. Nursing Diagnosis and intervention

1. Cardiac output, decrease, high risk of b / d increase in afterload, vasokontruksi,

miorkadia ischemia, hypertrophy b / d is not applicable for signs and symptoms that
define the actual diagnosis.
Intervention

o Monitor TD
o Note the presence of
o Aukultasi tone of the heart and breath sounds
o Provide a quiet, comfortable, less

activity

environment

fray

o Collaboration with physicians in therapy

2. Pain (acute), headache b / d increase in vascular pressure selebral d / d to report about
the throbbing pain that is located on the suboccipital Rhegium. Happens when you
wake up and disappear spontaneously after some time.
Intervention :
o Assess the patient's response to activity
o Encourage activity
o Instruct the patient to energy saving techniques
2. STROKE
a. Definition
According to WHO, stroke is the presence of clinical signs are growing rapidly as a
result of brain dysfunction focal (or global) with symptoms lasting for 24 hours or
more causing death without any other apparent cause other than vascular. (Arif
Muttaqin, 2008)
b. Cause
Under some circumstances this can lead to stroke, among others:
Cerebral Thrombosis.
Thrombosis occurs in blood vessel occlusion leading to ischemia in Dapa brain
tissue causing edema and congestion in sekitarnya.Hal This can occur because of
a decrease in sympathetic activity and a drop in blood pressure that can cause

cerebral ischemia
Embolism
Cerebral embolism is a blockage of a brain blood vessel by a blood clot, fat and
air. In general, emboli originating from the heart of the thrombus in the detached

and cerebral arteries clog the system.

Haemorhagi
Including intracranial hemorrhage

or

intracerebral

hemorrhage

in

the

subarachnoid space or into the brain tissue itself. This bleeding can occur due to
atherosclerosis and hypertension. Due to rupture of cerebral blood vessels causing

leakage of blood into the brain parenchyma may lead to suppression,

displacement and separation of adjacent brain tissue, so that the brain will swell,
depressed brain tissue, resulting in cerebral infarction, edema, and possible brain

herniation.
General hypoksia: severe hypertension, pulmonary Cardiac Arrest, Cardiac output

falls due to arrhythmia

Local Hypoxia: cerebral artery spasm accompanied by subarachnoid hemorrhage,
brain artery vasoconstriction with migraine headaches.

c. Signs and symptoms

o Loss / decrease in motor skills.
o Loss / decrease in communication skills.
o Impaired perception.
o Damage to cognitive function and psychological effects.
o Dysfunction: 12 cranial nerves, sensory abilities, muscle reflexes, bladder.
d. Nursing Diagnosis and Nursing Plan
1. Changes perpusi brain tissue associated with intracerebral hemorrhage, brain
occlusion, vasospasm, and cerebral edema.
Intervention

Provide an explanation to the client's family about the cause of the increase in

NO and akibatnaya.
Lay the Client f (bed rest) in total with the supine position without a pillow.
Monitor the patient's signs vital.Bantu to membtasi vomiting, coughing,

encourage clients inhale when moving or turning off the bed.

Teach client to avoid excessive coughing and straining.
2. Ineffective airway clearance related to the accumulation of secretions, cough
decreased ability, decreased physical mobility secondary, and altered level of
consciousness.
Intervention :
o Assess the state of the airway,
o Perform suctioned if necessary d.
o Teach clients effective cough.
o Perform postural drainage percussion / penepukan.
o Collaboration: the 100% oxygen.
DISEASE IN SYSTEM DIGESTION
1. GASTROENTERITIS
a. Definition

Gastroenteritis or diarrhea is defined as bowel movements that are not normal or

watery stool form with frequency more than usual (Mansjoer Arief et al, 1999)
b. Etiology
Causes of diarrhea can be divided into several factors, namely:
a) Factors infection
Internal infection is an infection of the digestive tract which is a major cause
of diarrhea include:
Bacterial Infections: vibrio E.coli Salmonella, Shigella, Campyio bacter,

Aeromonas
Infection: Enteriviru (echo virus, coxsacle, poliomyelitis), Adenovirus,

Astrovirus, etc.
Parenteral infection is an infection outside the digestive tract of food such

as acute otitis media (AOM), Bronco pneumonia, and so on.

b) Factors malabsorption
carbohydrate malabsorption
malabsorption Lema
c) Factors Food
The food is not clean, stale, toxic and allergic to food.
c. Clinical manifestation
Patients often experience vomiting, abdominal pain due to diarrhea due to
infection and cause the patient to feel thirst, dry tongue, reduced skin turgor due
to lack of fluids.
d. Diagnosis and nursing interventions
1. Disorders of fluid balance b / d output overload
Intervention
Monitor a sign of lack of fluids
Observe / record the output of fluid intake
Encourage clients to drink
Explain to the mother sign dehydrated
Provide appropriate therapeutic advice: infusion rl 15 MDGs
2. Impaired sense of comfort (pain) bd Hiperperistaltik
Thorough pain, disability intensity (with skala0-10).
Encourage clients to avoid the allergen
Make a warm compress on the stomach area
Collaboration
Give the drug as an indication
Oral steroids, IV, and inhalation
Analgesics: 3x1 amp novalgin injection (500mg / ml)
Antacids and ulcers: 3x1 amp ulsikur injection (200mg / 2ml)
2. GASTRITIS
a. Definition

Gastritis is an inflammation localized or spread on the gastric mucosa that

develops when the mucosal protective mechanism is filled with bacteria or
irritants. (J. Reves, 1999)
b. Etiology
bacterial infections.
The use of pain medication continuously
Excessive alcohol use
The use of cocaine
Physical Stress
Autoimmune Disorders
c. Signs and symptoms
In most Patients, Appear and symptoms can be pain or pain in the upper abdomen,
nausea, vomiting, and loss of appetite. And in the case of a fairly severe gastritis,
the which is due to erosion and bleeding in the stomach lining. The symptoms can
include red or black stools and vomiting blood.
d. Diagnosis and nursing interventions
1. Changes comfort; Acute pain associated with gastric mucosal irritation.
Intervention:
Satisfy Patients in the first 6 hours.
Provide soft foods little by little and give a warm drink.
Identify and limit foods that cause discomfort.
Observation of pain, note the location, duration, intensity, (scale 0-10), as
2.

well as changes in the characteristics of pain.

Compliance nutrition less than body requirements related to anorexia.
Intervention:
Create programs daily nutritional requirements and minimum B standard.
Provide oral care before and after meals.
Monitor physical activity and record the activity level.
Avoid foods that cause gas.
Provide food with good ventilation, pleasant surroundings,with situations
that are not in a hurry.

SYSTEM DISEASES IN SEX

1. CANCER UTERUS
a. Definition

Cervical cancer is a malignant tumor of the endometrium (lining of the uterus).

This cancer seringmenyerang women over the age of 50 years, but in its
development is now seringmenyerang woman underneath a result of an unhealthy
lifestyle. This cancer can spread (metastases) quickly and surely. These cancer
cells can spread locally (cervical region only) maupunmenyebar to other body
parts such as the cervical canal, fallopian tubes, ovaries, the area around the
uterus, lymph system or other parts of the body through the blood vessels.
b. Etiology
The cause was unknown, but the disease appears to involve an increase in
estrogen levels. One function is normal estrogen stimulates uterine epithelial
pembentukanlapisan. A large number of estrogen are injected to animals in
laboratory experiments kanker.Wanita cause endometrial hyperplasia and cancer
of the uterus seems to have certain risk factors. (a risk factor is something that
will increase the likelihood of someone to menderitasuatu disease).
c. Clinical manifestation
abnormal uterine bleeding
abnormalc menstrual cycles.
vaginal bleeding or spotting in women after menopaused.
Bleeding very long, heavy and often (in women aged over 40 years)
Lower abdominal pain or pelvic cramping
white watery discharge or clear (in postmenopausal women)
Pain or difficulty in urination
Pain during sexual intercourse.
d. Diagnoses and nursing interventions
1. Pain (acute) b / d of ulcers and erosions in the lining of endothelial, epithelial
inflammation of the cervix
Intervention
location and duration of pain, assess uterine contractions, and abdominal
tenderness hemiragic
2. Assess the client's pain intensity with pain scale
3. Assess psychological stress / partner and emotional responses to events
o Provide an environment that is comfortable, quiet and activity to divert pain,
Bantu kliendalam using relaxation methods and explain procedures
4. Activity intolerance bd weakness due to abdominal pain.
Intervention
o Assess the client's response to the activities, note the frequency of the pulse of more

than 20 beats per minute above the break frequency; TD tangible improvement during /
after activity; dyspnea or chest pain; excessive fatigue and weakness; diaphoresis;
dizziness or fainting
o Instruct the client about the technical use of energy.
o Give the quiet neighborhood and during the period of uninterrupted rest, push the
recess before eating
o Increase activities gradually
2. Gonorrhea
a. Definition
Gonorrhea or gonorrhea is a sexually transmitted disease caused by Neisseria gonorrhoeae that
infects the inner lining of the urethra, cervix, rectum, throat, and the white part of the eye
(conjunctiva). Gonorrhea can spread through the bloodstream to other parts of the body,
especially the skin and joints. In women, gonorrhea can spread to the genital tract and infect the
membranes inside the hip causing hip pain and disorders reproduksi.Namun gonorrhea disease
can also be transmitted through kissing or close body contact. Certain pathogens are easily
transmitted can be transmitted through food, blood transfusion, syringes for use.
b. Etiology
The exact cause of gonorrhea is Neisseria gonorrhoeae bacteria / gonokok that are pathogenic.
Germs are included in the group known as Neisseria and there are four species, namely N.
gonorrhoeae and N. meningitidis are pathogenic and cattarrhalis N. and N. sicca pharyngis that
are commensal. The fourth species is difficult to distinguish unless the fermentation test
c. Clinical manifestation
ai) In men
o gonorrhea shoots a very short period, the men generally varies between 2-5 days, sometimes sometimes longer because the treatment itself but the dose is not sufficient or very vague
symptoms that go unnoticed.
o Symptoms begin as discomfort in the urethra followed by pain when urinating
o Dysuria that arise suddenly, a sense of urination accompanied with mucoid discharge from the

urethra
o urinary retention due to inflammation of the prostate
o Discharge of pus from the penis or sometimes slightly contain blood.
o The bacteria enter the urethra cause urethritis in men.
o Subjective complaints of itching, hot when urinating located on the tip of the penis or the distal
part of the urethra, feeling pain during erection.
c) In women
o The initial symptoms typically occur within 7-21 days after infection
o Patients often do not feel the symptoms for weeks or months (asymptomatic)
o If symptoms develop, usually mild. However, some patients showed severe
symptoms such as urgency to urinate
o Pain when urinating
o The release of fluid from the vagina
o Fever
d. Nursing Diagnosis and Intervention
1. Impaired sense of comfort when urinating pain associated with inflammatory reaction in the
urethra
Intervention
o Observe nonverbal signs of pain, such as facial expressions restless, crying. R /: Knowing the
level of pain felt by Patients
o Observations pain scale. R /: Knowing the scale of the pain felt by the patient
o Observation vital signs. R /: the progress of the disease
o Teach clients and extraction of relaxation techniques to reduce pain. R /: With relaxation
techniques and extraction can reduce pain
o Provide a comfortable and calm environment. R /: clients will feel comfortable and quiet
o Collaboration with the medical team for giving analgesic therapy. R /: Carry out an
independent function and analgesics can reduce pain

5. The increase in body temperature associated with reaction disease (an inflammatory
reaction
o Observation of the client's body temperature every two hours.
o Observations pulse, blood pressure and respiration rate clients.
o Explain to the client and the client's family to compress clients on major arteries areas
for example in the axilla and neck.
o Explain to the client in order to compress using warm water, should not use cold water.
o Increase fluids and nutrients inktake clients.
o Collaboration with other medical teams in the delivery of antipyretic drugs.
DISEASE IN urinary system
1. prostate hypertrophy
b. Definition
Hypertrophic prostate is a gland hyperplasia of the periurethral prostate tissue that is then urged
that are native to peripheral and become hoop surgery. (Jong, Wim de, 1998).
c. Cause
With increasing age there will be change in the balance of estrogen testosterone, because
testosterone production decreases and the conversion of testosterone to estrogen in peripheral
adipose tissue. Because prostate enlargement process occurs slowly then the effect of the changes
also occur gradually.
In the early stages after the enlargement of the prostate, bladder neck and resistance in the
prostate increases, and detrusor becomes thicker. Thickening phase is called phase compensation
detrusor muscle wall. If the situation continues then the detrusor becomes tired and eventually
suffered decompensation and no longer able to contract resulting in urinary retention.
d. Signs and symptoms
o Loss of power radiating during micturition (no tub lampias)
o The difficulty in emptying the bladder.
o Pain when initiating micturition

o The presence of urine mixed with blood (hematuria)

e. Diagnosis and nursing interventions
1.

Impaired

sense

of

comfort:

pain

associated

with

muscle

spasm

spincter

Intervention
o Assess pain, note the location, intensity (scale 0-10)
o Monitor and record the existence of pain, location, duration and trigger factors as well as pain
relief.
o Observe non-verbal signs of pain (anxiety, forehead wrinkle, increased blood pressure and
pulse)
o Give warm water compress on the abdomen, especially the lower abdomen.
o Advise patients to avoid stimulants (coffee, tea, smoking, abdominal tension
e. Lack of knowledge: about TUR-P associated with less information
Intervention

o Give an explanation to avoid strenuous activity for 3-4 weeks.

o Give an explanation to prevent straining BAB time for 4-6 weeks; and wearing a stool
lubricant to laxative as needed.
o Revenue fluid at least 2500-3000 ml / day.
o Advise for further treatment to the doctor.
o Empty the bladder when the bladder is full.
2. ACUTE RENAL FAILURE
e. Definition
Acute renal failure is a clinical syndrome in which the kidneys are no longer secrete waste
products of metabolism. Usually due to kidney hiperfusi this syndrome commonly result in
azotemia (uremia), namely the accumulation of nitrogen waste products in the blood and urine
output aliguria where less than 400 ml / 24 hours (Tambayong, 2000).
f. Diagnosis and nursing intervention
1.

Deficit

Intervention

fluid

volume

associated

with

diuresis

phase

of

acute

renal

failure.

o Monitoring of fluid status (turgor skin, mucous membranes, urine output)

o Assess the state of edema
o Control intake and output per 24 hours.
o Weigh weight per day.
2. Ineffective breathing breathing pattern associated with a decrease in pH in the cerebrospinal
ciaran, leakage of fluid, pulmonary congestion secondary effects of changes in alveolar capillary
membrane and interstitial fluid retention of pulmonary edema in response to metabolic acidosis.
Intervention:
o Assess the factors causing metabolic acidosis.
o Monitor tight TTV.
o Rest the client with Fowler position.
o Measure intake and output.
Diseases of the musculoskeletal system
1. OSTEOPOROSIS
g. Definition
Osteoporosis is a disorder in which there is a decrease in total bone mass. There are changes in
the normal homeostasis of bone turnover, bone resorption speeds greater than the speed of bone
formation resulting in a decrease in total bone mass. Bone progressively become porous, brittle
and easily broken, the bone becomes easy with stress fracture that will not have an impact on
normal bone. (Brunner & Suddarth, 2000).
Etiology
Below are some of the causes of osteoporosis are:
1) Postmenopausal Osteoporosis
Occurs due to lack of estrogen (the main female hormone), which helps regulate the
transport of calcium into the bones in women. Usually symptoms occur in women aged

between 51-75 years, but could begin to appear faster or slower. Not all women have the
same risk of developing postmenopausal osteoporosis, white women and the eastern
regions

more

easily

suffer

from

this

disease

than

black

women.

2) Senile Osteoporosis
Perhaps as a result of calcium deficiency related to age and the imbalance between the
rate of bone destruction and formation of new bone. Senile means that this condition only
occurs in the elderly. This disease usually occurs at the age of 70 and 2 times more often
in women. Women often suffer from senile and postmenopausal osteoporosis
Secondary osteoporosis
Experienced less than 5% of patients with osteoporosis, caused by another medical condition or
by drugs. This disease can be caused by chronic renal failure and hormonal disorders (especially
thyroid, parathyroid and adrenal) and drugs (eg corticosteroids, barbiturates, anti-seizure and
excessive thyroid hormone). Excessive alcohol consumption and smoking can worsen this
condition.
4) idiopathic juvenile osteoporosis
Osteoporosis is a kind of unknown cause. It occurs in children and young adults who have
hormone levels and the function of normal, normal vitamin levels and has no obvious cause of
bone fragility.
Clinical manifestations Osteoporosis
Symptoms most often and most worrisome to osteoporosis are:
o Bone pain, especially in the spine increased the intensity of their attacks at night.
o severe pain and localized to the affected vertebra reply
o Pain is reduced during breaks in bed
o mild pain on waking and and will increase due to activity
o bone deformity. May occur in the vertebrae and traumatic causes angular kyphosis spinal cord
that can cause stress that can occur paraparesis.

j. Diagnosis and nursing interventions

1. Pain associated with secondary effects of vertebral fractures
Intervention
Monitor or review the level / pain scale (1-10), the intensity and nature of pain
P: Provocate = Factor Triggers
Q: Quality = Quality
R: Region = Location
S: Severe = Severity
T: Time = Duration
o Adjust the position of the patient as comfortable as possible
o Teach clients and their families pain management
o Collaboration in providing analgesic
2. Barriers to physical mobility associated with dysfunction secondary to skeletal changes
(kyphosis) or a new fracture
Intervention
o Teach the client to perform physical exercises gradually
o Teach client about the importance of physical exercise
o Encourage clients to avoid flexion exercises, bowing with a sudden and heavy lifting
o Collaboration in drug delivery

DISLOCATION
a. Definition

Dislocation is a compression release bone tissue of the joints unity. This dislocation can only
component of bones are shifted or the release of all components of bone from where it should be
(from the bowl joints). A person who can not shut their mouths back after opening its mouth is
because apart from its jaw joints. In other words: the jaw joint has been dislocated.
b. Etiology
a) Sports Injuries
Sports usually cause dislocation is football and hockey, and sports are at risk of falling
for example: fall due to skiing, gymnastics, volleyball. Basketball players and football
players most often experience dislocation of the hands and fingers due to inadvertently
catch the ball from other players.
b) Trauma that is not related to sport
Heavy impact on the joints while motorcycle accidents usually cause dislocation
c) Dropped
o Falling off a ladder or fell while dancing on slippery floor
o Unknown
o Factors predisposing (setting position)
o As a result of the growth disorder since birth.
o Trauma from accidents.
o Trauma due to orthopedic surgery (the science of bone mempelajarin
o There was an infection around the joints.
c. Clinical manifestation
Pain is great .Pasien arm supporting it by hand next to it and reluctant to accept any
checks frontline shoulder lateral image may be uneven and, if the patient is not too
muscular a palpable bulge just below the clavicle.
o Pain
o Changes in the contour of the joint
o Changes in limb length
o Loss of normal mobility
o Changes in bone dislocated axis
o deformity
o stiffness
o Diagnose and nursing interventions
d. Diagnosis and nursing interventions
1. Impaired sense of comfort pain associated with tissue discontinuitas
Intervention:
o Assess pain scale

o Provide a relaxed position in patients

o Teach distraction techniques and relaxation
o Provide a comfortable environment, and entertainment activities
o Collaboration of analgesics
2. Impaired physical mobility associated with deformity and pain during mobilization
o Assess the level of mobilization of the patient
o Provide training ROM
o Encourage the use of a tool if diperlukan
o Monitor muscle tone
o Assist the patient to immobilize both the nurse and the family
DAFTAR PUSTAKA
Baughman, Diane C. (2000). Keperawatan Medikal-Bedah ; Buku Saku untuk Brunner dan
Suddarth, EGC, Jakarta.
Crowin, Elizabeth J. (2002). Patofisiologi. Jakarta: EGC.
Doenges, Marilyn E. (2000). Rencana Asuhan Keperawatan Edisi 3. Jakarta: EGC.
Mansjoer, Arief. (1999). Kapita Selekta Kedokteran, Edisi 3, Media Aesculapius; Jakarta
Smeltzer, Suzanne C. (2002). Keperawatan Medikal Bedah Vol. 1. Jakarta: EGC.
Dorgoes, 2001, Rencana Asuhan Keperawatan, BBC, Jakarta
Http//askep, blogspot/2008/02/askep hipertensi, sabtu, 28 November, jam 11:19