pemeriksaan diagnostik 2

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Pemeriksaan DiagnostikMuhammad Nur Hasan, S.Kep., Ns

TIU/TIKMendefinisikan istilah yang berhubungan dengan prosedur diagnostik Mendeskripsikan tujuan dan langkah-langkah langkahprosedur diagnostik Mengidentifikasi data yang dikaji dan dibutuhkan untuk prosedur diagnostik Mengidentifikasi pendidikan kesehatan yang dibutuhkan klien untuk melakukan pemeriksaan diagnostik tertentu Mengidentifikasi persiapan pasien untuk pemeriksaan diagnostik tertentu Mengidentifikasi peran perawat pada pemeriksaan diagnostik tertentu Menggambarkan panduan untuk evaluasi dan mencatat tanggung jawab klien untuk prosedur diagnostik tertentu

Pemeriksaan Diagnostik (Impuls Elektrik) Elektrokardiografi Elektroensephalografi Elektromiografi

Elektrokardiografiuntuk mendeteksi impuls jantung Dilakukan pada pasien dengan gangguan pada jantung Gelombang P, QRS, T Alat



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Mencatat aktivitas listrik pada otak Persiapan Pasien Ruangan yang gelap Pada saat klien tidur (pemeriksaan 1-2 jam) Klien tidak distimulan dengan kopi, depresan, dan alkohol Hygiene pada daerah kepala Dilakukan pada pasien trauma/injuri otak (ex. (ex. Cedera kepala, stroke)

Pemeriksaan Diagnostik (Inspeksi Visual/endoskopi)Thorakoskopi, pemeriksaan pleura, rongga pleura, mediastinum dan perikardium (bagian(bagian-bagian paru-paru dan jantung). paru Proktoskopi (sigmoidoskopi dan proktosigmoidoskopi), untuk memeriksa rektum dan kolon sigmoid. Laringoskopi, untuk memeriksa laring (salah satu bagian saluran napas). Laparoskopi, untuk melihat lambung, hati, dan organ-organ lain di dalam rongga organperut.


untuk melihat dinding dalam esofagus, lambung, dan usus halus. Sistoskopi, untuk melihat saluran kencing, kandung kencing dan prostat. Kolposkopi, untuk memeriksa vagina dan mulut rahim. Kolonoskopi, untuk memeriksa usus besar. Bronkhoskopi, untuk melihat trachea dan cabang-cabang bronkhus cabang(bagian dari saluran napas)

Laryngoscopy or bronc oscopyProsedur

Jelaskan prosedur tindakan Jelaskan bahwa akan dilakukan anestesi lokal (injeksi akan menimbulkan nyeri) Jelaskan tes akan dilakukan selama 30-60 30menit Kaji TTV, sputum, dan karakter repirasi Anjurkan klien tidak memakai gigi palsu, kalung, anting, dan pin Lakukan oral hygiene Cek ulang klien tidak alergi terhadap medikasi Atur analgesik, sedativa, dan antianxiety, medikasi untuk dry secretion


Selama prosedur Asistensi dokter Monitor nadi dan respirasi Beri support pada klien

Post PresedurMonitor TTV setiap 30 menit Monitor cairan sampai terdapat tanda gag reflex Posisikan lateral Inspeksi sputum Observasi klien terhadap tanda adanya dyspnea, stridor, nafas pendek Administrasikan anestesi jika dibutuhkan Menghubungi petugas kesehatan jika ada kesulitan bernafas dan darah pada sputum

Esop agoscopy, gastroscopy, duodenoscopy Jelaskan

pada klien perasaan tidak nyaman pada lambung Administrasikan oral simethicone sebelum tes (mengurangi udara pada daerah lambung) Jika atropine diberikan maka lakukan monitor pada Heart rate

Post Prosedur Inspeksi

emesis Jika kesulitan menelan persistent, nyeri, demam, vomitus, dan black stool untuk menghubungi dokter/ perawat

CystoscopyKaji TTV, frekuensi urunaria, disuria, jumlah, dan konsistensinya Administrasikan enema jika diorderkan Puasa selama 6-8 jam atau hanya cairan 6IV

ProsedurMonitor VS, urinaria, bandingkan dengan data dasar Posisi lateral Inspeksi adanya darah dalam urin Laporkan keadekuatan urin selama 8 jam Peningkatan cairan untuk mengurangi iritasi pada jaringan urin Administrasikan analgesik Laporkan jika ada kesulitan BAK persisten, darah segar, nyeri, dan panas

Anoscopy, proctoscopy, sigmoidoscopy, colonoscopy

Kaji TTV dan konsistensi feces Yakinkan preexamination diet yang tepat dan intake cairan Administrasikan laxative Administrasikan enema Ensure the voids before the examination Administer sedativa Explain That the client will experience the sensation of having to move bowels due to the pressure of instrument That the client may experience some abdominal cramping when air is introduced to distend the bowel

Post Prosedure Support

kneeknee-chest position Monitor pulse and respiration Label spesimen Support klien emotionally Inspect the stool for blood Allow the client to rest Provide fluids and food

Examinations Involving Removal of Body Fluids and Tissue Lumbal

Puncture Abdominal paracentesis Thoracocentesis Pericardial aspiration Bone Morrow Biopsy Liver Biopsy

Lumbal Puncture (LP, Spinal Tap) Insertion

of a needle into the subarachnoid of spinal canal withdraw cerebrospinal fluid (CSF) For diagnostic or therapeutic reasons The site is ussually between the third and fourth lumbar vertebrae For the infant or small child is ussually lower

Nursing Intervention

Vitals sign Pertinent health status (e.g. level of consciousness and neurologic status) Determine drug allergies, particularly to local anesthetics and skin antiseptics Explain: prosedure, when, where, who, and how long Have the client empty the bladder and bowel to prevent unnecessary discomfort Position the client laterally with the head bent toward the chest, the knees flexed onto abdoment, and the back at edge of the bed or examining table.

Lanjutan Support

the position Encourage the client to breathe normally and relax, excessive muscle tension, coughing, or change in breathing can increase CSF pressure

Post Prosedurethe client to a dorsal recumbent position Assist VS Ensure that CSF spesiments are corectly labeled Record the prosedure include the date and time, the name of the physician, the color, character, and amount of CSF Assist

Abdominal Paracentesisparacentesis is the removal of fluid from the peritonela cavity In some disease; cirrhosis of the disease; liver Normally the fluid about 1500 ml Abdominal

Abdominal paracentesisMerupakan pemeriksaan tamba an yang sangat berguna untuk menentukan adanya perdara an dalam rongga peritoneum. Lebi dari 100.000 eritrosit/mm dalam larutan NaCl yangkeluar dari rongga peritoneum setela dimasukkan 100--200 ml larutan 100--200 NaCl 0.9% selama 5 menit, merupakan indikasi untuk laparatomi

Nursing Intervention VS

the procedure to client Support the sitting position Support clint verbally A major concern is hypovolemic shock Expain

Post Prosedurethe pulse rate, skin color, and blood presure Observe hypovolemic shock (pallor, dyspnea, diaphoresis, and a drop in blood pressure Documentation Asses

Thoracocentesis Thoracocentesis

is the withdrawal of fluid or air from the pleural cavity For diagnostic and therapeutic purpose In injury of thorax

Nursing InterventionAsses vital sign, respiratory depth, complaints of chest pain, breath sounds, dyspnea, type and frequency of cough, character and amount of sputum Support sitting position with arms above the head VS The clients cough, sputum, respiration depth, breath sounds, and chest pain

Bone Marrow Biopsibone marrow biopsy is the removal of a spesimen of bone marraw for study in a laboratory For abnormal blood cell development and detect anemia, leukemia, and other disease of the blood The sites are sternum, the posterior superior iliac crestA

Nursing Intervention Observe

the VS, bleeding from the site (hematoma)

Liver Biopsyliver biopsy is a short prosedure, generally performed at clients bedside The site of insertion is either between two of the right lower ribs Facilitate diagnosis of liver disease and to gain information about changes in liver tissueA

Nursing ProsedureAsses vital sign Determine any drug allergies Determine prothrombine time and platelet count (administered vit K, IM) Administer sedativa Support a supine position Post prosedure Assist the client to a rihgt side-lying sideposition for several hours

HighHigh-Tech Studies Roentgenography Nuclear

Medicine (Radioisotop) Computed Tomography (CT Scan) Ultrasonography (Ultrasound)

Roentgen ray (x rays)X rays are part of the spectrum of electromagnetic radiation Contracst materials are introduced into the body in four way to view spesific organs Orraly Intravenously Subarachnoid space for the spine and the ventricles of the brain Through a nasotracheal tube or bronchoscope for the bronchial tree

LanjutanGastrointestinal tract: tract: pharynx and esophagus, upper gastrointestinal tract (barium swallow), and lower gastrointestinal tract (barium enema) Gallbladder (cholecystography) and bile ducts (cholangiography) Urynary tract (IVP or IVU) Musculoskeletal system Central nervous system (myelography) Vascular System (angiography) Mammograpphy/xerography

Nuclear Medicine (Radioisotop)A basic principle is the body constituents are dynamic, not static Isotopes enter into the same chemical reactions and metabolic prossess Radioactive substances for spesific body tissue are introduced orally or intravenously Example, radioactive iodine given to measure the function of the thyroid gland

LanjutanOrally or intravenous 1-48 hours, isotope is assimilated by the organ The scanning prosedure, during which the client must remain still Scintillation scanning assess the function of organ or detect a tumor Include thyroid, heart, brain, lung, liver, spleen, bone marrow, bones, and kidney

Computed Tomography (CT Scan) Painless,

non invasive x-ray xprosedure Pasien diberi kontras iodine IV, proses scanning 1 jam Observasi raksi alergi terhadap kontras Post tindakan: puasa 4-6 jam agar 4tidak muntah

Ultrasonographydensities or tissue Mengetahui ukuran, konsistensi struktur internal Menu