t5_pencernaan_parenteral nutrition bu yuni
TRANSCRIPT
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 1/32
Yuni Sufyanti A, S.Kp,M.Kes Yuni Sufyanti A, S.Kp,M.Kes
21/03/161
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 2/32
PRE TESTPRE TEST
Perbedaan TPN dan PPNPerbedaan TPN dan PPN
Komplikasi Parenteral nutritionKomplikasi Parenteral nutrition
Intervensi Keperawatan pada parenteral nutritionIntervensi Keperawatan pada parenteral nutrition
21/03/162
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 3/32
DEFINISIDEFINISI
SSuatu bentuk pemberian nutrisi yang diberikanuatu bentuk pemberian nutrisi yang diberikanlangsung melalui pembuluh darah tanpa melaluilangsung melalui pembuluh darah tanpa melalui
saluran penernaansaluran penernaan
21/03/163
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 4/32
K!ASIFIKASIK!ASIFIKASI
".". #$N%#entral $arenteral Nutriti&n#$N%#entral $arenteral Nutriti&n
'hen feeding is infused in t& a large'hen feeding is infused in t& a large
diameter (ein suh as the S)# anddiameter (ein suh as the S)# andsubla(ian (einssubla(ian (eins *$N *$N
+.+. $$N $eripheral $arenteral Nutriti&n-$$N $eripheral $arenteral Nutriti&n-
hen smaller perifer is used suh as thehen smaller perifer is used suh as the(ein in f&rearm(ein in f&rearm hyperalimentasi, entralhyperalimentasi, entral(en&us nutriti&n, periferal (en&us nutriti&n(en&us nutriti&n, periferal (en&us nutriti&n
21/03/164
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 5/32
K/M$/NEN $NK/M$/NEN $N
$N admi0ture are pr&teins, arb&hydrates, fats,$N admi0ture are pr&teins, arb&hydrates, fats,eletr&lytes,eletr&lytes, (itamins, trae minerals, and(itamins, trae minerals, andsterile atersterile ater
21/03/165
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 6/32
*121AN *121AN
Menyediakan nutrisi bagi tubuh melaluiMenyediakan nutrisi bagi tubuh melaluiintra(ena,karena tidak memungkinkannyaintra(ena,karena tidak memungkinkannyasaluran erna untuk melakukan pr&sessaluran erna untuk melakukan pr&sespenernaan makanan.penernaan makanan.
*$N digunakan pada pasien dengan luka bakar *$N digunakan pada pasien dengan luka bakaryang berat,panreatitis,in3ammat&ry b&elyang berat,panreatitis,in3ammat&ry b&elsyndr&me,in3ammat&ry b&elsyndr&me,in3ammat&ry b&eldisease,ulerati(e &litis,aute renaldisease,ulerati(e &litis,aute renal
failure,hepati failure,ardiafailure,hepati failure,ardiadisease,pembedahan dan aner.disease,pembedahan dan aner.
Menegah lemak subutan dan &t&t digunakanMenegah lemak subutan dan &t&t digunakan&leh tubuh untuk melakukan katab&lisme&leh tubuh untuk melakukan katab&lisme
energyenergy 21/03/166
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 7/32
DASA4 FISI/!/5IDASA4 FISI/!/5I Kebutuhan nutrisi tidak tercukupiKebutuhan nutrisi tidak tercukupi Kekurangan kalori danKekurangan kalori dan
nitrogennitrogen
Apabila terjadi defisiensi nutrisiApabila terjadi defisiensi nutrisi proses glukoneogenesis proses glukoneogenesisakan berlangsung dalam tubuh untuk mengubah proteinakan berlangsung dalam tubuh untuk mengubah protein
menjadi karbohidrat.menjadi karbohidrat. Kebutuhan kalori Kurang lebih 1500 kalori/hari,diperlukanKebutuhan kalori Kurang lebih 1500 kalori/hari,diperlukan
oleh rata-rata dewasa untuk mencegah protein dalam tubuholeh rata-rata dewasa untuk mencegah protein dalam tubuhuntuk digunakan.untuk digunakan.
21/03/16
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 8/32
DASA4 FISI/!/5IDASA4 FISI/!/5I
Kebutuhan kalori menigkat terjadi pada pasien denganKebutuhan kalori menigkat terjadi pada pasien dengan penakit hipermetabolisme,fe!er,injur,membutuhkan kalori penakit hipermetabolisme,fe!er,injur,membutuhkan kalorisampai dengan 10.000 kalori/hari.sampai dengan 10.000 kalori/hari.
"roses ini menediakan kalori ang dibutuhkan dalam"roses ini menediakan kalori ang dibutuhkan dalam
konsentrasi ang langsung ke dalam sstem intra!ena angkonsentrasi ang langsung ke dalam sstem intra!ena angsecara cepat terdilusi menjadi nutrisi ang tepat sesuaisecara cepat terdilusi menjadi nutrisi ang tepat sesuaitoleransi tubuh.toleransi tubuh.
21/03/16!
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 9/32
PN is indicated in the followingPN is indicated in the following
situations:situations:
#he patient#he patient$$s intake is insufficient to maintain ans intake is insufficient to maintain ananabolicanabolic state %eg, se!ere burns, malnutrition, shortstate %eg, se!ere burns, malnutrition, short
bowel sndrome, bowel sndrome, A&'(, sepsis, cancer).A&'(, sepsis, cancer).
#he patient#he patient$$s abilit to ingest food orall or b tube iss abilit to ingest food orall or b tube isimpairedimpaired %eg, paraltic ileus, *rohn%eg, paraltic ileus, *rohn$$s disease withs disease withobstruction,obstruction, postradiation enteritis, se!ere postradiation enteritis, se!erehperemesis gra!idarum inhperemesis gra!idarum in pregnanc). pregnanc).
#he patient is not interested in or is unwilling to#he patient is not interested in or is unwilling toingest ade+uateingest ade+uate nutrients %eg, anoreia ner!osa,nutrients %eg, anoreia ner!osa,
postoperati!e elderl postoperati!e elderl patients). patients).
21/03/16"
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 10/32
PN is indicated in the following situations:PN is indicated in the following situations:
#he underling medical condition precludes being fed#he underling medical condition precludes being fed
orall or b tube %eg, acute pancreatitis, highorall or b tube %eg, acute pancreatitis, high
enterocutaneousenterocutaneous
fistula).fistula).
"reoperati!e and postoperati!e nutritional needs are"reoperati!e and postoperati!e nutritional needs are
prolonged prolonged %eg, etensi!e bowel surger).%eg, etensi!e bowel surger).
21/03/1610
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 11/32
K/M$!IKASIK/M$!IKASI
*ehnial &mpliati&n *ehnial &mpliati&n
6 malp&sisi kateter6 malp&sisi kateter
6 subla(ian arteri punture6 subla(ian arteri punture
6 ar&tid arteri punture6 ar&tid arteri punture
6 air emb&lisme6 air emb&lisme
6 tr&mb&sis6 tr&mb&sis
Septi &mpliati&nSepti &mpliati&n
6 ateter related sepsis6 ateter related sepsis
6 sepsis tr&mb&sis6 sepsis tr&mb&sis
21/03/1611
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 12/32
K/M$!IKASIK/M$!IKASI
Metab&li &mpliati&nMetab&li &mpliati&n
6 hyperglikemi6 hyperglikemi
6 hyp&kalsemi6 hyp&kalsemi
6 hyperkalemi6 hyperkalemi
6 hyperf&spatemia6 hyperf&spatemia
21/03/1612
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 13/32
M&nit&ring *$NM&nit&ring *$N
M&nit&r intake &utputM&nit&r intake &utput
1rynari gluk&se elektr&lit1rynari gluk&se elektr&lit
71N #a, $, Mg71N #a, $, Mg
Alkaline ph&spateAlkaline ph&spate
AlbuminAlbumin
*rygilserid *rygilserid
$realbumin$realbumin
869 hari pertama869 hari pertama tergantung stabilitas pasientergantung stabilitas pasien
21/03/1613
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 14/32
AS1:AN KE$E4A'A*ANAS1:AN KE$E4A'A*AN
$ADA $ASIEN DEN5AN$ADA $ASIEN DEN5AN
$A4EN*E4A! N1*4I*I/N$A4EN*E4A! N1*4I*I/N
21/03/1614
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 15/32
$EN5KA2IAN$EN5KA2IAN
IIdentifying patients h& may bedentifying patients h& may beandidatesandidates f&r $Nf&r $N Kehilangan 77 yangKehilangan 77 yang
signi;kan signi;kan "<= &r"<= &r m&re &f usual eight-,m&re &f usual eight-,
a derease in &ral f&&d intake f&r m&rea derease in &ral f&&d intake f&r m&re than " eekthan " eek
any signi;ant sign &f pr&tein l&ss serumany signi;ant sign &f pr&tein l&ss serum
albuminle(els less than 8.+ g%d! >8+ g%!?albuminle(els less than 8.+ g%d! >8+ g%!?
21/03/1615
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 16/32
$EN5KA2IAN$EN5KA2IAN
musle astingmusle asting
dereased tissuedereased tissue healinghealing
abn&rmal urea nitr&gen e0reti&nabn&rmal urea nitr&gen e0reti&n
$ersistent$ersistent (&miting and diarrhea(&miting and diarrhea
Mengka@i status hidrasi pasien, intake kal&ri,Mengka@i status hidrasi pasien, intake kal&ri,dan nilai elektr&litdan nilai elektr&lit
21/03/1616
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 17/32
NURSING DIAGNOSNURSING DIAGNOSIISS
7ased &n the assessment data, the ma@&r nursing7ased &n the assessment data, the ma@&r nursingdiagn&ses maydiagn&ses may inlude the f&ll&inginlude the f&ll&ing
Imbalaned nutriti&n, less than b&dy reBuirements,Imbalaned nutriti&n, less than b&dy reBuirements,relatedrelated t& inadeBuate &ral intake &f nutrientst& inadeBuate &ral intake &f nutrients
4isk f&r infeti&n related t& &ntaminati&n &f the4isk f&r infeti&n related t& &ntaminati&n &f theentralentral atheter site &r infusi&n lineatheter site &r infusi&n line
4isk f&r e0ess &r de;ient 3uid (&lume related t&4isk f&r e0ess &r de;ient 3uid (&lume related t&alteredaltered infusi&n rateinfusi&n rate
4isk f&r imm&bility related t& fear that the atheter4isk f&r imm&bility related t& fear that the atheterill be&meill be&me disl&dged &r &ludeddisl&dged &r &luded
4isk f&r ineCeti(e therapeuti regimen4isk f&r ineCeti(e therapeuti regimenmanagement relatedmanagement related t& kn&ledge de;it ab&utt& kn&ledge de;it ab&uth&me $N therapyh&me $N therapy
21/03/161
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 18/32
COLLAORATI!E PROLE"S#COLLAORATI!E PROLE"S#
POTENTIAL CO"PLICATIONSPOTENTIAL CO"PLICATIONS
21/03/161!
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 19/32
Co$%lications of Pa&ente&al Nut&itionCo$%lications of Pa&ente&al Nut&ition
#ompli#ation#ompli#ation #ause#ause nursin$ a#tions and #ollaborativenursin$ a#tions and #ollaborativeinterventionsinterventions
PneumotorakPneumotorak Improper #at%eterpla#ementImproper #at%eterpla#ement
and inadvertent pun#ture o& and inadvertent pun#ture o&
t%e pleurat%e pleura
Pla#e patient in 'owler Pla#e patient in 'owler (s position)(s position)
*&&er reassuran#e)*&&er reassuran#e)
+onitor vital si$ns)+onitor vital si$ns)
Prepare &or t%ora#entesis or #%est tubePrepare &or t%ora#entesis or #%est tubeinsertion)insertion)
,ir embolism ,ir embolism 1)1) -is#onne#ted tubin$-is#onne#ted tubin$
2)2) .ap missin$ &rom.ap missin$ &rom
portport3)3) lo#ked se$ment o&lo#ked se$ment o&
vas#ular vas#ular
sstemsstem
1)1) Tape all tubin$ #onne#tion sites se#urel)Tape all tubin$ #onne#tion sites se#urel)
epla#e tubin$ immediatel and noti&epla#e tubin$ immediatel and noti&
p%si#ian)p%si#ian)2)2) epla#e #ap and noti& p%si#ian)epla#e #ap and noti& p%si#ian)
3)3) Turn patient on le&t side and pla#e in t%eTurn patient on le&t side and pla#e in t%e%eadlow position)%eadlow position)
Noti& p%si#ian)Noti& p%si#ian)
.lotted #at%eter line.lotted #at%eter line Inadeuate/in&reuentInadeuate/in&reuent%eparin &lus%es%eparin &lus%es
-isruption o& in&usion-isruption o& in&usion
,dminister %eparin &lus% in unused lines ,dminister %eparin &lus% in unused linestwi#e a da)twi#e a da)
+onitor in&usion rate %ourl and inspe#t t%e+onitor in&usion rate %ourl and inspe#t t%einte$rit o& t%einte$rit o& t%e line)line)
21/03/161"
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 20/32
Co$%lications of Pa&ente&al Nut&itionCo$%lications of Pa&ente&al Nut&ition
komplikasikomplikasi penebabpenebab nursin$ a#tions and #ollaborativenursin$ a#tions and #ollaborativeinterventionsinterventions
.at%eter displa#ement.at%eter displa#ement andand#ontamination#ontamination
#essive movement possibl#essive movement possibl
wit% a nonse#ured #at%eter wit% a nonse#ured #at%eter
7eparation o& tubin$ and7eparation o& tubin$ and
#ontamination#ontamination
7top t%e in&usion and noti& t%e p%si#ian)7top t%e in&usion and noti& t%e p%si#ian)
Tape all tubin$ #onne#tion sites)Tape all tubin$ #onne#tion sites)
,void interruptin$ t%e main line or ,void interruptin$ t%e main line orpi$$ba#kin$ ot%er pi$$ba#kin$ ot%er
lines)lines)
7epsis7epsis 7eparation o& dressin$s7eparation o& dressin$s.ontaminated solution.ontaminated solution
In&e#tion at insertion site o&In&e#tion at insertion site o&#at%eter #at%eter
ein&or#e or #%an$e dressin$ ui#klein&or#e or #%an$e dressin$ ui#klusin$ asepti# te#%niue)usin$ asepti# te#%niue)
-is#ard) Noti& p%arma#ist)-is#ard) Noti& p%arma#ist)
Noti& p%si#ian) +onitor vital si$ns everNoti& p%si#ian) +onitor vital si$ns ever
4 %ours)4 %ours)
.at%eter site is #%an$ed ever 4 weeks.at%eter site is #%an$ed ever 4 weeks
8per$l#emia8per$l#emia 9lu#ose intoleran#e9lu#ose intoleran#e +onitor $lu#ose levels :blood and urine;)+onitor $lu#ose levels :blood and urine;)+onitor urine output)+onitor urine output)
*bserve &or stupor #on&usion let%ar$)*bserve &or stupor #on&usion let%ar$)
Noti& p%si#ian< t%e addition o& insulin toNoti& p%si#ian< t%e addition o& insulin tot%e PN solutiont%e PN solution
ma be pres#ribed)ma be pres#ribed)
21/03/1620
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 21/32
Co$%lications of Pa&ente&al Nut&itionCo$%lications of Pa&ente&al Nut&ition
komplikasikomplikasi penebabpenebab nursin$ a#tions andnursin$ a#tions and#ollaborative interventions#ollaborative interventions
'luid overload'luid overload 'luid in&usin$ rapidl'luid in&usin$ rapidl -e#rease in&usion rate use-e#rease in&usion rate usein&usion pump) +onitor vitalin&usion pump) +onitor vitalsi$ns) Noti& p%si#ian) Treatsi$ns) Noti& p%si#ian) Treatrespirator distress b sittin$respirator distress b sittin$patient upri$%t andpatient upri$%t andadministerin$ o$en asadministerin$ o$en asneeded i& pres#ribed)needed i& pres#ribed)
ebound %po$l#emiaebound %po$l#emia 'eedin$s stopped too abruptl'eedin$s stopped too abruptl +onitor &or smptoms+onitor &or smptoms:weakness tremors:weakness tremorsdiap%oresisdiap%oresis
%eada#%e %un$er and%eada#%e %un$er and
appre%ension;< noti& p%si#ian)appre%ension;< noti& p%si#ian)9raduall wean patient &rom9raduall wean patient &romPN)PN)
21/03/1621
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 22/32
Planning and GoalsPlanning and Goals
*he ma@&r g&als f&r the patient may inlude *he ma@&r g&als f&r the patient may inlude
&ptimal le(el &f nutriti&n,&ptimal le(el &f nutriti&n,
absene &f infeti&n, adeBuate 3uid (&lume,absene &f infeti&n, adeBuate 3uid (&lume,&ptimal le(el&ptimal le(el &f ati(ity ithin indi(idual&f ati(ity ithin indi(idual
limitati&ns-, kn&ledge &f and skilllimitati&ns-, kn&ledge &f and skill in self6in self6
are, and pre(enti&n &f &mpliati&ns.are, and pre(enti&n &f &mpliati&ns.
21/03/1622
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 23/32
Nu&sing Inte&'entionsNu&sing Inte&'entions
MAIN*AININ5 /$*IMA! N1*4I*I/NMAIN*AININ5 /$*IMA! N1*4I*I/N
$4E)EN*IN5 INFE#*I/N$4E)EN*IN5 INFE#*I/N
MAIN*AININ5 F!1ID 7A!AN#EMAIN*AININ5 F!1ID 7A!AN#E
EN#/14A5IN5 A#*I)I*YEN#/14A5IN5 A#*I)I*Y
21/03/1623
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 24/32
MEM$E4*A:ANKAN N1*4ISI YAN5 /$*IMA!MEM$E4*A:ANKAN N1*4ISI YAN5 /$*IMA!
M&nit&r 77M&nit&r 77
M&nit&r intake dan &utput dan keseimbanganM&nit&r intake dan &utput dan keseimbangan
airanairan
#atat $N s&luti&n yang diberikan &leh tim medis,#atat $N s&luti&n yang diberikan &leh tim medis,
dan atat t&leransi dari pasiendan atat t&leransi dari pasien
21/03/1624
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 25/32
Menegah InfeksiMenegah Infeksi
Kandungan gluk&sa yang tinggiKandungan gluk&sa yang tinggi sumbersumber
media pertumbuhan bakteri @amurmedia pertumbuhan bakteri @amur
Sumber utama mikr&&rganismeSumber utama mikr&&rganisme ateterateter
*utup tempat penusukan dengan kasa steril, *utup tempat penusukan dengan kasa steril,
dan &bser(asi adanya keb&&ran, katererdan &bser(asi adanya keb&&ran, katerer
yang kusut, dan reaksi kulityang kusut, dan reaksi kulit
21/03/1625
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 26/32
Mempertahankan keseimbangan airnMempertahankan keseimbangan airn
$emberian $N dengan infuse pump$emberian $N dengan infuse pumpMempertahankan keepatan yang akurat dariMempertahankan keepatan yang akurat daripemberianpemberian
2ika terlalu epat 2ika terlalu epat :yper&sm&lar diuresis e0ess:yper&sm&lar diuresis e0ess
gula -gula -
Ke@ang, k&ma, meninggalKe@ang, k&ma, meninggal 2ika terlalu lambat 2ika terlalu lambat $asien tidak mendapatkan$asien tidak mendapatkan
keuntungan yang maksimal untuk mendapatkankeuntungan yang maksimal untuk mendapatkankal&ri dan nitr&genkal&ri dan nitr&gen
M&nit&r intake &utput setiap @amM&nit&r intake &utput setiap @am
Ka@i adanya dehidrasiKa@i adanya dehidrasi
M&nitir 7l&&d 5luk&seM&nitir 7l&&d 5luk&se hyperglikemi menyebbakanhyperglikemi menyebbakandiuresis dan kehilangan airan yang berlebihdiuresis dan kehilangan airan yang berlebih
21/03/1626
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 27/32
En&uraging ati(ityEn&uraging ati(ity
2ika seara ;sik pasien mampu 2ika seara ;sik pasien mampu an@urkanan@urkan
untuk berakti(itas dan ambulasiuntuk berakti(itas dan ambulasi
$ada pemasingan ateter subla(ian (ein$ada pemasingan ateter subla(ian (ein pasien bebas untuk bergerak danpasien bebas untuk bergerak dan
mempertahankan t&nus &t&t yang baikmempertahankan t&nus &t&t yang baik
An@urkan untuk terapi &kupasiAn@urkan untuk terapi &kupasi
21/03/162
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 28/32
$4/M/*IN5 :/ME AND$4/M/*IN5 :/ME AND
#/MM1NI*Y67ASED #A4E#/MM1NI*Y67ASED #A4E
Tea#%in$ Patients 7el&.areTea#%in$ Patients 7el&.are
.ontinuin$ .are.ontinuin$ .are
21/03/162!
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 29/32
E)A!1ASIE)A!1ASI
pe#ted patient out#omes ma in#lude t%epe#ted patient out#omes ma in#lude t%e&ollowin$=&ollowin$=
1) ,ttains or maintains nutritional balan#e1) ,ttains or maintains nutritional balan#e
2) 'ree o& in&e#tion at t%e #at%eter site2) 'ree o& in&e#tion at t%e #at%eter site
a) Is a&ebrilea) Is a&ebrile
b) 8as no purulent draina$e &rom t%e #at%eterb) 8as no purulent draina$e &rom t%e #at%eterinsertion siteinsertion site
#) 8as inta#t I> line#) 8as inta#t I> line
3) Is %drated as eviden#ed b $ood skin tur$or 3) Is %drated as eviden#ed b $ood skin tur$or
21/03/162"
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 30/32
E)A!1ASIE)A!1ASI
G. Ahie(es an &ptimal le(el &f ati(ity, ithinG. Ahie(es an &ptimal le(el &f ati(ity, ithinlimitati&nslimitati&ns
H. Dem&nstrates skill in managing $N regimenH. Dem&nstrates skill in managing $N regimen
. $re(ents &mpliati&ns. $re(ents &mpliati&ns
a. Maintains pr&per atheter and eBuipmenta. Maintains pr&per atheter and eBuipmentfunti&nfunti&n
b. :as n& sympt&ms &f sepsisb. :as n& sympt&ms &f sepsis
. Maintains metab&li balane ithin. Maintains metab&li balane ithinn&rmaln&rmal limitslimits
d. Sh&s impr&(ed and stabiliJed nutriti&nald. Sh&s impr&(ed and stabiliJed nutriti&nalstatusstatus
21/03/1630
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 31/32
7e a 5&&d Nurse.7e a 5&&d Nurse.
21/03/1631
7/26/2019 T5_pencernaan_Parenteral Nutrition Bu Yuni
http://slidepdf.com/reader/full/t5pencernaanparenteral-nutrition-bu-yuni 32/32
POST TESTPOST TEST
Perbedaan TPN dan PPNPerbedaan TPN dan PPN
Komplikasi Parenteral nutritionKomplikasi Parenteral nutrition
Intervensi Keperawatan pada parenteral nutritionIntervensi Keperawatan pada parenteral nutrition
21/03/1632