geriatric + pneumonia
TRANSCRIPT
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CASE REPORTPNEUMONIA DAN GERIATRIC IMPAIRMENT
GEORGE RADEN MAS SAID
1061050186
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Identitas
Tanggal masuk RS : 14-10-2015
Nama : Tn. S
Usia : ! ta"#n Alamat : $%. SMA 14 RT 004&004
Ci%i%itan
Pekerjaan : Tida' (e'e)*a
Status + Meni'a" Agama : Is%a,
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e%#"an Uta,a
Sesa' Naas / ! "a)i SMRS
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Riaat Pena'it
e%#a)a Pasien ,ena'# tida' ada 'e%#a)a an
,ena%a,i "a% an se)#3a denan 3asien.Riaat 3ena'it *ant#n 3ena'it "ati
,a#3#n 3ena'it 3a)# 3ada 'e%#a)a disan'a%%e" 3asien.
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Riaat Pe)i%a'# dan
e(iasaan P)i(adi Pasien tida' ,e,i%i'i 'e(iasaan ,e)''.
Pasien (e)(a)in %a,a di te,3at tid#).
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Pe,e)i'saan :isi'
esada)an + C,3s ,entis
eadaan U,#, + Ta,3a' Sa'it Sedan
TD + 1!0&80 ,,; Nadi + 80
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e3a%a dan =e"e)
N),"e3a%i
G7 tida' te)a(a ,e,(esa)
Mata + Cn*#nti>a ane,is -&-
S'%e)a i'te)i' -&-
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A(d,en
Ins3e'si + Pe)#t ta,3a' data)
A#s'#%tasi + 7isin #s#s 9 4
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E
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Tata%a'sana IGD
P) )aat ina3 O2 N !-4 %3,
Ce' ;2 T= GDS EG
I?:D + III NS 0B =&24 *a,
Diet %#na' DM 1!
M,& +
Cet)ia
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=a()at)i#, 14 10
2015 9Pemeriksaan asil Normal
emoglobin !"#$ 14-16 )&d%
%eukosit !'5-10 )i(#%
ematokrit 3(#3 40-48
Trombosit 2!6 150-400 )i(#%
Natrium !"$ 1!6-145 ,,%&=
)alium 41 !5-51 ,,%&=
*lorida +3 BB-111 ,,%&=
,S 11B F200 ,&d%
S,.T 10 10-!4 #&=
S,PT B B-4! #&=
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=a()at)i#, 15 10
20159Pemeriksaa
nasil Normal
/TA 0 neati Neati
/TA 00 neati Neati
/TA 000 Pendin Neati
Ureum !8 15-45 ,&d%
*reatinin 06 00 110 ,&d%
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:t T")a<
:t T")a<
Psisi AP
Sin#s & Dia)a,a 'i)i (ai' $ant#n ,e,(esa)
Pa)# + (e)a' 3a)a'a)dia% & 3e)se%#(#nan3e)i'a)dia% 'anan
T#%an dan soft tissue tida' te)da3at 'e%ainan
esan + a)di,ea%i dan Pne#,nia de
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Diansa A'"i)
Diansa #ta,a + Pne#,nia
Diansa se'#nde)
Sind), Ge)iat)i
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PENDA;U=UAN
Pne#,nia ,eni,(#%'an an'a 'esa'itan antini denan e*a%a-e*a%a (at#' de,a, dansesa' naas
Tia i)i '"as '%asi' e*a%a 3ne#,nia (at#'sesa' naas dan de,a, te)(se)>asi 3ada!0 3asien %ansia.
Di3e)(#)#' denan adana i,3ai),ent da)isind), e)iat)i 3ada 3asien
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Ge)iat)i
Di'ata'an 3asien e)iat)i a3a(i%a + ete)(atasan #nsi t#(#" an (e)"#(#nan denan
,a'in ,enin'atna #sia
Adana a'#,#%asi da)i 3ena'it-3ena'it deene)ati
=an*#t #sia sea)a 3si'ssia% an dinata'an ')isis(i%a +
ete)ant#nan 3ada )an %ain
Menis%asi di)i ata# ,ena)i' di)i da)i 'eiatan
'e,asa)a'atan 'a)ena (e)(aai se(a(.
;a%-"a% an da3at ,eni,(#%'an an#an'esei,(anan ",estasis9 an 3))esi.
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7atasan %an*#t #sia ,en#)#t @;O
1. Midd%e ae 45-5B t"9
2. E%de)% 60-0 t"9 !. O%d&%ansia 5-B0 t"9
4. ?e) O%d&sanat t#a B0 t"9
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14 IMPAIRMENTS 14 I9
0mmobilit1
0nstabilit1
0ncontinence
0mpairments o2 cognitie
0mpaction
0mpairments o2 4ision#
earing# skin integrit1#taste
0n2ection
0solation 0nanition 0mpecunit1 0atrogenesis 0nsomnia 0mpotence
0mmunode5cienc1
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Schematic !0NT6RA*T0N, 0M6NS0.NS .7 ,6R0ATR0*ASS6SSM6NT
8aid / Reuben9
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ANAMNESIS
Da)i e%#a)a ata# Caretaker
Identitas
Pena'it an dide)ita se'a)an
e%#"an #ta,a
e%#"an ta,(a"an
@a't# dan %a,a tia3 'e%#"an #)#tanna
Pena'it da"#%#
Ana,nesis 'e(iasaan Ana,nesis %in'#nan 'eadaan )#,a" tina%9
Reie obat-obatan an di'ns#,si PENTING
Pe)#(a"an 3e)i%a'#
PENGAA$IAN STATUS :UNGSIONA=
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PENGAA$IAN STATUS :UNGSIONA=
!; A% 8Actiit1 ail1 %iing9/arthel 8/A09 :
)omponen +
/A/# /A)# membersihkan diri# penggunaan tolilet# makan#
berpindah tempat# mobilisasi# berpakaian# naik turun tangga#mandi
"; 0A% 80nstrumen Actiit1 o2
%iing9 80A%9 : )omponen :
telepon# belanja# persiapan makanan# peraatan rumah#mencuci baju# transport# pengobatan# manajemen keuangan
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PENGA$IAN :UNGSI OGNITI:MEMORI dan DEMENSIA
MMS68Mini Mental State
6
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MMSE
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PENAPISAN DEPRESI
,S8,6R0ATR0*
6PR6SS0.NS*A%69
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Pneumonia
Pne#n,ia ada%a" 3e)adanan 3a)en'i,3a)# dista% da)i ()n'i%#s te),ina%is an,ena'#3 ()n'i%#s )es3i)at)i#s dan
a%>e%i an dise(a('an %e",i'))anis,e(a'te)i.>i)#s*a,#)3)ta9
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Insidensi
Se'ita) 80 da)i se%#)#" 'as#s (a)# 3)a'te'#,#, (e)"#(#nan denan ine'si sa%#)anna3as an te)*adi di ,asa)a'at 3ne#,nia
',#nitas&P9 ata# di da%a, )#,a" sa'it3ne#,nia ns',ia%&PN9.
7e)dasa)'an #,#) 3ne#,nia da3at,ene)an sia3a sa*a.
Pada (e)(aai #sia 3ene(a(na end)#n(e)(eda-(eda dan da3at ,en*adi 3ed,anda%a, ,e,(e)i'an te)a3i.
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O)an t#a %e(i" )entan %e" 'a)ena +
Siste, i,#nitas ,e%e,a"
Pena'it ')ni' an %ain Tanda-tanda 3ne#,nia tida' *e%as & '"as '"#s#s an#an
,e,)i de,entia ',#ni'asi s#'a) H t"& te)%a,(at
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6P06M0.%.,0
AS : - pen1ebab kematian ke 40
- (&&;&&& orang diraat =th
- "$ > (&? kehilangan 2ungsi tubuh
independen
)eluhan pneumonia pada orang tua @ orang muda
0nsiden meningkat :
- sesuai usia
- pada panti-panti peraatan
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7A)T.R R6S0).
- I,,#ns#3)esi- Usia 0
- As3i)asi
- Gan#an ,ene%an
- #a%itas "id#3 (#)#'
- Disa(i%itas
- 7e)(a)in %a,a
- Usia %an*#t
- Gan#an ,ene%an
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6T0.%.,0
Pe,e)i'saan s3#t#,Medan $a'a)ta S#)a(aa Ma%an Ma'asa)9
.Pne#,niae 45.18
S.Pne#,niae 14.04
S.?i)idans B.21
S.A#)e#s B
Ps. Ae)#insa 8.56
7 ;e,%iti' .8B
Ente)(ate) 5.26
Pse#d,nas S33 0B
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iagnosis
Ana,nesis + Ge*a%a %ini' +
- 7at#' 3)d#'ti
- De,a, ,enii%
- Sesa' Naas
- Ma%aise '#)an nas# ,a'an %e,as9
Pe,e)i'saan :isi' +
- :)e,it#s >a% ,enin'at
- 3e)'#si Red#3 3ada %'asi inJ%t)at&3e)se%#(#nan
- 7)n'ia%
- Rn'"i
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iagnosis
Pe,e)i'saan 3en#n*an + =a()at)i#, +
- =e'sitsis =e#'sit 10.000&K=9
- =ED ,enin'at
- Eti%i + '#%t#) da"a' da)a" se)%i
- AGD
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Ga,(a)an Radi%is
Pe)se%#(#nan ",en ata# in",en ses#aidenan %(#s ata# se,ent 3a)# sea)a anant,is.
Silhouette sign 9 + (e),anaat #nt#' ,enent#'an%eta' %esi 3a)# (atas %esi denan *ant#n "i%an(e)a)ti %esi te)se(#t (e)da,3inan denan *ant#nata# di %(#s ,edi#s 'anan.
7i%a te)*adina 3ada %(#s ine)i) ,a'a sin#s
3")enista%is an 3a%in a'"i) te)'ena. Pada ,asa )es%#si se)in ta,3a' Air Bronchogram
Sign te)3e)an'a3na #da)a 3ada ()n'#s 'a)enatiadana 3e)t#'a)an #da)a 3ada a%>e%#s9.
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Pne#,nia
P il i j t
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Penilaian erajat)eparahanP.RT 8Pneumonia Patient .utcome Research
Team9)arakteristik Points7aktor emogra5
Usia : %aki-laki Umur 8th9
Perempuan Umur 8th-!&9
Peraatan di rumah !&Pen1akit pen1erta :
)eganasan 3&
Pen1akit hati "&
*7 !&
*4 !&
,injal !&
P il i j t
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Penilaian erajat)eparahanP.RT 8Pneumonia Patient .utcome ResearchTeam9)arakteristik Points
7isik :
Perubahan mental "&
RR B 3&
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PDPI 200!9 )ite)ia
Raat Ina3 S') PORT 0
F 0 denan +
RR !0
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/R0T0S T.RA*0*
S.*06TH 8/TS9C n#sin ,enta% test s)e 89U #)ea ,,%&=9
R RR !0
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Pencegahan P%a "id#3 se"at )'' Q9
?a'sinasi
- Pne#,''a% + 2! se)ti3e
- In#ena A 7
U,#,- Uni>e)sa% 3)ea#tin H #i tanan
- ,enea" 'nta' denan 3ende)ita %ain
- ;ati-"ati te)"ada3 ,ate)ia% an
te)'nta,inasi da"a'
- Mas'e) + (at#' (e)sin
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Penata%a'sanaan
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esi,3#%an
Pada Ge)iat)i e*a%a dan tanda an dia'i(at'an %e" 3ne#,nia (isa sa,a ata#(e)(eda denan 3ende)ita 3ne#,ni denan
#,#) an (e)(eda. ;asi% 3e,e)i'saan 3en#n*an ,en*adi sa%a"
sat# sa)ana #nt#' ,endiansa adana3ne#,nia 3ada e)iat)i
I,3ai),ent 3ada 3asien e)iat)i ,ena,(a"
)esi' te)*adina 3ne#,ni 3ada e)iat)i ata#da3at *#a ,ena,a)'anna.