cbd asymptomatic bacteriuria wendhy

7/26/2019 CBD Asymptomatic Bacteriuria Wendhy

1/27

ASYMPTOMATICBACTERIURIA

CASE BASED

DISCUSSION

When to Treat ?Why Not To Treat ?

Wendhy Pramana


2/27

Identitas Pasien

Nama : Ny. Dalilah

Penii!an : SD

Pe!er"aan : Tia! Be!er"a Um#r : $% tah#n

Alamat : Yo&ya!arta

Pem'iayaan : ()N non PBI Ini!a*i : Dia&no*i* an tera+i


3/27

Wanita, $% tah#n en&an !el#han #tama m#al an m#ntah Se"a! - min& *e'el#m ma*#! r#mah *a!it OS men&el#h

m#al /0, m#ntah /0, nyeri #l# hati 10, 'aan lema* /0,emam 10, *e*a! na2a* 10, 'at#! 10, '#an& air !e3il 4ol#me5 $%% 336hari, BA) +ana* 10, BA) anyan&1 anyan&en 10,

*erin& BA) 10,Nyeri 'a&ian +er#t 'a7ah 10, Nyeri +in&&an&10, ri7ayat !a!i 'en&!a! 10, BAB hitam 10, m#n3#l 'er3a!!e'ir#an i +aha !iri OS +eri!*a !e U8D RSUP Dr.Sar"ito.

Ri7ayat hi+erten*i 10, Dia'ete* mellit#* 10,ri7ayat 'at#&in"al 10, min#m o'at1o'atan 10

Dari +emeri!*aan 9*i! ia+at!an: TD -%6;% mm6 mnt, re*+ira*i % >6mnt, *#h# @,. )on"#n&ti4a +#3at/0, i3t#* 3ori* tera'a i SIC I MCS, e!imo*i* +aha !iri/0, +#r+#ra 10, RT : tia! tera'a ma**a, 2e*e* /0, lenir10, arah 10,

RESUME


4/27

Darah rutinHb 5,2

AL 6,61

AT 66

AE 1,56

Hmt 14,9

S 72,6

L 16,3

M 7,9

E 3,0

B 0,2

MCV 95,5

MCH 33,3

Retik 0,9

Inek! "etik 0,29#

Perdarahan

$$T 17,4

% 13,5A$TT 34,0

% 29,5

I&R 1,32

Hati

Hb!A' &(n "e)kti*

+T 20+$T 19

Elektrolit (prepost HD)

&) 135

13-% 6,223,2-

C. 10699

Ginjal(prepost HD)B/& 11546

C"e) 13,965,71

Urine

H 5,0

B 1,010

$"(t 1

+.

Bi.

/"( &%et

&it

E"it 2

LE 3

Seimen

E"it 21Lek( 255-

Se. eite. -,1

B)kte"i) 715,2

%"i!t). 6,1

e)!t 0,0

PENUN(AN8


5/27

Sin#* Rythm, heart rate $ !ali6menit, normoa>i*


6/27

E>+erti*e -6%@6%-0: $.m( t)k t)m)k ke.)in)n

Be!)" 8(" n("m).

Ro. Thora!*


7/27

Chroni3 )iney Di*ea*e *ta&e e3 *#*+&lomer#lone2riti* !roni* en&an *inrom#remi!#m an hi+er!alemia +o*t


8/27


9/27

MASALAH PENGKAJIAN PLAN OFCARE

RENCANADIAGNOSTIK

TERAPI

S!s"e#

In$e#si

Sa%!ran

Kemih

asimt&mati#

In$e#si sa%!ran #emih 'ISK(

ada%ah #eadaan adanya in$e#si

'ada "er#em)an*)ia#an

)a#teri( da%am sa%!ran #emih+

me%i"!ti in$e#si di "aren#im

*in,a% sam"ai in$e#si di

#and!n* #emih den*an ,!m%ah

)a#teri!ria yan* )erma#na-

.a#teri!ria )erma#na ada%ah

)i%a ditem!#an "ada )ia#an

!rin "ert!m)!han )a#teri

se,!m%ah / 011-111 "er m% !rin

se*ar-

Fa#t&r risi#&2 #er!sa#an ata!

#e%ainan anat&mi sa%!ran #emih

)er!"a &)str!#si interna% &%eh

,arin*an "ar!t+ "emasan*an

#ateter yan* %ama+ enda"an

&)at intrat!)!%ar+ re3!#s+

hi"ertensi+ #ehami%an-

Men*etah!i

#!man

"enye)a)

in$e#si

Mem)eri#an

anti)i&ti#

em"iri#

M&nit&rin*

Ed!#asi

Pemeri#saan #!%t!r

sensiti:itas !rin

In,- Ce$tria;&n 0 *r


19/27

RESISTENSI

)e"aian re*i*ten*i 'a!teri ter#* menin&!at

tia! *e"alan en&an+enem#an anti'ioti! 'ar# Pen&o'atan *ema!in *#lit ila!#!an


20/27

RESIS

TENSI


21/27

RESISTENSI

Re*i*ten*i anti'itioti! K Penin&!atan mortalita*


22/27

RESIS

TENSI


23/27

C. DEICIE

Re*i*ten*i anti'itioti! K Penin&!atan mortalita*


24/27

C.DE

ICIE


25/27

C. DEICIE

Pre*enta*e !e"aian in2e!*i C.eL3ile +aa +a*ien i

R#mah Sa!it #*ia H tah#n


26/27

C.DE

ICIE

A)TOR1A)TOR RISI)O INE)SICLOSTRIDUM DEFFICILE

E!*+o*#r anti'ioti!

Da+atan C.eL3ile

U*ia lan"#t

Imm#noe9*ien*i

Naso-Gastric Tube

Pen&naan o'at *#+re*i a*am lam'#n

PPI0

Fa#t&r Risi#& tama


27/27

TERIMA KASIHMOHON ASPAN

cbd asymptomatic bacteriuria wendhy

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