I.02074 Perawatan Emboli Paru

Definisi : Mengidentifikasi dan mengelola pasien yang mengalami oklusi sirkulasi pulmonal

Tindakan

Observasi

  1. Monitor perubahan status respirasi dan kardiovaskuler (mis. mengi, hemoptisis, dispnea, takipnea, takikardia, sinkop)
  2. Monitor nyeri dada, bahu, punggung atau nyeri pleura(mis. intensitas, lokasi, radiasi, durasi, dan faktor yang memperberat dan mengurangi)
  3. Monitor gejala oksigenisasi jaringan yang tidak adekuat (mis. pucat, sianosis, CRT melambat)
  4. Monitor bunyi napas tambahan
  5. Monitor analisa gas darah
  6. Monitor tanda dan gejala gagal napas (mis. Pao2 rendah, PaCO2 meningkat, kelelahan otot, pernapasan)
  7. Monitor efek samping antikoagulan

Terapeutik

  1. Pasangkan kaus kaki elastis, jika perlu
  2. Pasangkan kaus kaki kompresi pneumatik intermiten, jika perlu
  3. Lepaskan kaus kaki elastis atau kompresi pneumatik intermiten selama 15-20 menit setiap 8 jam
  4. Hindari akses intravena antekubiti
  5. Lakukan rentang gerak aktif atau pasif
  6. Ubah posisi setiap 2 jam

Edukasi

  1. Jelaskan mekanisme terjadinya emboli paru
  2. Anjurkan teknik napas dalam
  3. Ajarkan pentingnya antikoagulan selama 3 bulan
  4. Ajarkan pencegahan tromboemboli berulang
  5. Anjurkan menggerakkan kaki fleksi dan ekstensi 10 kali setiap jam, jika perlu

Kolaborasi

  1. Kolaborasi pemberian terapi trombolitik (mis. treptokinase, urokinase, aktivase)
  2. Kolaborasi pemberian antikoagulan dosis rendah dan atau anti-platelet dosis tinggi (mis. Heparin, clopidogrel, warfarin, aspirin, dipiridamol, dekstran)
  3. Kolaborasi pemeriksaan diagnostik untuk menepis gejala penyakit yang serupa (mis. infark miokard akut, perikarditis, diseksi aorta, pneumonia, pneumotoraks, ulkus peptikum, ruptur, gastritis)

Daftar Pustaka

PPNI (2018). Standar Intervensi Keperawatan Indonesia.

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