I. PENDAHULUAN
A. LATAR BELAKANG
Infeksi virus hepatitis B yang oleh masyarakat awam dikenal sebagai penyakit
kuningmasih merupakan masalah kesehatan serius sampai saat ini. Infeksi yang terjadi
dapat bersifat sementara (transient), yaitu pada hepatitis B akut. Ini terutama dijumpai
pada penderita dewasa dengan kompetensi imunitas yang baik. Umumnya penderita
hepatitis akut pada orang dewasa akan sembuh secara sempurna ( > 90%). Hanya
sebagian kecil yang menetap (permanent) dan menjadi kronik (5 10%).
Sebaliknya jika infeksi terjadi pada masa bayi dan anak-anak, sebagian besar akan
menjadi kronik (pengidap > 90%). Ini disebabkan karena sistem imunologi bayi belum
sempurna dan bersifat toleran terhadap virus. Sebagian dari pengidap ini akan
berkembang menjadi sirosis hati bahkan karsinoma hepatoseluler primer. Terdapat suatu
fenomena, di mana makin tinggi prevalensi infeksi hepatitis B di suatu tempat, maka
infeksi pada bayi dan anak-anak makin banyak dijumpai.
Diperlukan asuhan keperawatan yang komprehensif dan peripurna agar hepatitis dapat
sembuh dan yang lebih penting lagi adalah agar pasien mengetahui perawatan dan
pencegahannya di rumah. Dengan perawatan yang sesuai diharapkan hepatitis tidak
menjadi penyakit yang mematikan.
B. TUJUAN
Tujuan pembuatan Laporan Pendahuluan ini adalah :
1. Mengetahui tentang penyakit hepatitis
2. Mengetahui masalah keperawatan yang muncul pada kasus hepatitis.
3. Mengetahui proses keperawatan yang diberikan kepada pasien hepatitis.
II. KONSEP TEORI
A. PENGERTIAN
Hepatitis adalah peradangan dari sel-sel liver yang meluas/ menyebar , hepatitis virus
merupakan jenis yang paling dominan . Luka pada organ liver dengan peradangan bisa
berkembang setelah pembukaan untuk sejumlah farmakologi dan bahan kimia dari
inhalasi , ingesti , atau pemberian obat secara parenteral ( IV ) . Toxin dan Drug induced
Hepatitis merupakan hasil dari pembukaan atau terbukanya hepatotoxin , seperti : industri
toxins , alkohol dan pengobatan yang digunakan dalam terapi medik.
Hepatitis kemungkinan terjadi sebagai infeksi sekunder selama perjalanan infeksi dengan
virus-virus lainnya , seperti :
Cytomegaloviru
Virus Epstein-Barr
Virus Herpes simplex
Virus Varicella-zoster
Klien biasanya sembuh secara total dari hepatitis, tetapi kemungkinan mempunyai
penyakit liver residu. Meskipun angka kematian hepatitis relatif lama, pada hepatitis
virus akut bisa berakhir dengan kematian
B. ETIOLOGI
1. Infeksi Virus
Hepatitis merupakan hasil infeksi yang disebabkan oleh salah satu dari lima golongan
besar jenis virus , antara lain :
Virus Hepatitis A ( HAV )
Virus Hepatitis B ( HBV )
Virus Hepatitis C ( HCV )
Virus Hepatitis D ( HDV ) atau Virus Delta
Virus Hepatitis E ( HEV )
Hepatitis F dan G mempunyai kesamaan atau identitas tersendiri , tetapi jenis ini jarang
ada.
2. Obat-obatan, bahan kimia, dan racun.
3. Reaksi transfusi darah yang tidak terlindungi virus hepatitis.
C. TANDA DAN GEJALA
Gejala dan tanda penyakit hepatitis adalah sebagai berikut :
- Selera makan hilang
- Rasa tidak enak di perut
- Mual sampai muntah
- Demam tidak tinggi
- Kadang-kadang disertai nyeri sendi
- Nyeri dan bengkak pada perut sisi kanan atas (lokasi hati)
- Bagian putih pada mata (sklera) tampak kuning
- Kulit seluruh tubuh tampak kuning
- Air seni berwarna coklat seperti air teh
Pada orang dewasa sebagian besar infeksi virus hepatitis akut akan sembuh dan hanya
sebagian kecil (5 10%) yang akan menetap/ menahun.
Pada kasus yang menahun :
- manifestasi bisa tanpa keluhan/ gejala atau dengan keluhan/ gejala ringan
- diagnosis umumnya ditemukan pada waktu mengadakan konsultasi ke dokter, hasil
laboratorium menunjukkan peninggian SGPT/ SGOT.
D. PATOFISIOLOGI
Setelah liver membuka sejumlah agen seperti virus, liver menjadi membesar dan terjadi
peradangan sehingga dalam kuadran kanan atas terasa sakit dan tidak nyaman . Sebagai
kemajuan dan kelanjutan proses penyakit , pembelahan sel-sel hati yang normal berubah
menjadi peradangan yang meluas, nekrosis dan regenerasi dari sel-sel hepar.
Meningkatnya penekanan dalam lintasan sirkulasi disebabkan karena virus masuk dan
bercampur dengan aliran darah kedalam pembelahan jaringan-jaringan hepar ( sel-sel
hepar ) . Oedema dari saluran-saluran empedu hati yang terdapat pada jaringan
intrahepatik menyebabkan kekuningan.
Data spesifik pada patogenesis hepatitis A , hepatitis C , hepatitis D , dan hepatitis E
sangat terbatas . Tanda-tanda investigasi mengingatkan pada manifestasi klinik dari
peradangan akut HBV yang ditentukan oleh respon imunologi dari klien . Komplex
kekebalan Kerusakan jaringan secara tidak langsung memungkinkan untuk manifestasi
DAFTAR PUSTAKA
Barbara, CL., 1996, Perawatan Medikal Bedah (Suatu Pendekatan proses keperawatan),
Bandung.
Brunner & Suddarth, 2002, Buku Ajar Keperawatan Medikal Bedah, alih bahasa: Waluyo
Agung., Yasmin Asih., Juli., Kuncara., I.made karyasa, EGC, Jakarta.
Carpenito, L.J., 2000, Diagnosa Keperawatan Aplikasi pada Praktek Klinis, alih bahasa:
HEPATITIS Papers
I. INTRODUCTION
A. BACKGROUND
Infection with hepatitis B virus by common people known as' kuning'masih disease is a
serious health issue until recently. Infections that occur can be temporary (transient),
namely the hepatitis B acute. This is mainly found in adult patients with good immune
competence. Generally, patients with acute hepatitis in adults will recover completely (>
90%). Only a minority of persistent (permanent) and become chronic (50-10%).
Conversely, if infection occurs in infancy and children, most will become chronic (people
with> 90%). This is because the baby's immunological system is not perfect and are
tolerant to the virus. Most of these sufferers will develop into liver cirrhosis and even
primary hepatocellular carcinoma. There is a phenomenon, in which the higher
prevalence of hepatitis B infection in one place, then the infection in infants and children
more and more common.
Required comprehensive nursing care and peripurna for hepatitis can be cured and, more
important is that patients know the treatment and prevention at home. With the
appropriate treatment of hepatitis are not expected to be a deadly disease.
B. PURPOSE
Purposes of this Preliminary Report is:
1. Knowing about hepatitis disease
2. Knowing the nursing problems that arise in cases of hepatitis.
3. Knowing the process of nursing provided to patients with hepatitis.
II. CONCEPT THEORY
A. UNDERSTANDING
Hepatitis is an inflammation of the liver cells that spread / spread, hepatitis viruses are the
most dominant species. Injury to the organ liver with inflammation can develop after the
opening to a number of pharmacological and chemicals from inhalation, ingestion, or
parenteral administration of drugs (IV). Toxin and Drug Induced Hepatitis is the result of
opening or hepatotoxin exposure, such as industrial toxins, alcohol and medications that
are used in medical therapy.
Hepatitis may happen as a secondary infection during the course of infection with other
viruses, such as:
Cytomegalovirus
Epstein-Barr virus
Herpes simplex virus
Varicella-zoster virus
Clients usually recover completely from hepatitis, but are likely to have residual liver
disease. Although the mortality rate of hepatitis is relatively long, in acute viral hepatitis
can lead to death
B. Etiology
1. Virus Infection
Hepatitis is the result of an infection caused by one of five categories of the types of
viruses, among others:
Hepatitis A virus (HAV)
Hepatitis B virus (HBV)
Hepatitis C virus (HCV)
Hepatitis D virus (HDV) or delta virus
Hepatitis E virus (HEV)
Hepatitis F and G have in common or separate identity, but this kind are rare.
2. The drugs, chemicals, and toxins.
3. Blood transfusion reactions that are not protected viral hepatitis.
C. SIGNS AND SYMPTOMS
Symptoms and signs of hepatitis were as follows:
- Appetite loss
- Discomfort in the abdomen
- Nausea, vomiting
- Fever is not high
- Sometimes accompanied by joint pain
- Pain and swelling on the right side upper abdomen (liver location)
- The white of the eye (sclera) appear yellow
- The skin all over your body looks yellow
- Urine is brown like tea water
In adults the majority of acute hepatitis virus infection will be gone and only a small
proportion (50-10%) which will be settled / chronic.
In chronic cases:
- Manifestation can be no complaints / symptoms or with symptoms / mild symptoms
- Diagnosis is usually found at the time held a consultation to physicians, laboratory
results showed elevation of ALT / AST.
D. Pathophysiology
After the liver opening a number of agents such as viruses, the liver becomes enlarged
and inflammation that occurs in the right upper quadrant pain and discomfort. As the
advancement and continuation of the disease process, cell division, normal liver cells turn
into widespread inflammation, necrosis and regeneration of liver cells. The increased
emphasis in the trajectory caused by a virus circulating in and mingled with the blood
flow into the cleavage liver tissues (liver cells). Edema of the liver bile ducts found in
intrahepatic causes yellowish tissue.
Specific data on the pathogenesis of hepatitis A, hepatitis C, hepatitis D, and hepatitis E
are very limited. Signs of an investigation reminiscent of the clinical manifestations of
acute inflammation as determined by HBV immunological response from the client.
Immune Complex - Damage to tissue is indirectly allows for the manifestation of acute
hepatitis B extrahepatik. Hepatitis B is believed to enter the circulation of immune stored
in blood vessel walls and is active in charging system. (Dusheiko, 1990). Clinical
responses of mixed pain illness that occurs everywhere.
Phase or recovery phase of hepatitis is characterized by phagocytosis activity and activity
number of false positive results in the presence of screening tests performed. At the same
event drain version with Hepatitis C will be delayed sanpai next year. Despite the
increasing ImonoAssay results will add to the specification and sensitivity for the test.
Anti-HCV determine a proper diagnosis, a combination of biochemical and clinical
examination results of serology. This is not to the researchers serology Hepatitis E.
Assessment of Radiography.
Only with the use of X-Ray may find enlargement of the liver by placing the X-Ray just
above the abdominal.
Diagnostic Assessment of the Other.
Chronic hepatitis is a common diagnosis in percutaneous liver biopsy tissue. Biopsy to
distinguish between chronic antif with chronic persistent hepatitis.
The discovery that fat tissue into the liver biopsy specimens and inflammation with
neutrophils that remain with Hepatitis Laennecs (caused by alcohol).
F. MANAGEMENT
TREATMENT OF HEPATITIS VIRUS PREVENTION INFORMATION
Use the general precautions or body substance precautions to keep the germs
perpindaham between clients or between client and staff health nurse
Eliminating the use of needles and other sharp objects by replacing the system of
sharing needles
Take the hepatitis B vaccine (hepatovax-B, recombinex HB) is given by three series of
injections. The vaccine is also to maintain or prevent hepatitis B
To prevent hepatitis B postexposure, see or look for immediate medical attention to the
possibility of administration of hepatitis B immune globulin (HBIG) or immune globulin
(Ig)
Report all cases of hepatitis in the Regional Health Department.
PREVENTION OF HEPATITIS VIRUSES
Maintain good sanitation and personal hygiene. Wash your hands before eating and after
the toilet.
Drink water that has been cooked by water washing system
If transportation is not developed or non-industrial town, drink only bottled water.
Avoid foods that have been washed with water, such as raw vegetables, fruit and soup.
Use good sanitation to prevent panyebaran germs between family members. Do not use
the bed linen, towels, cutlery and glass beverage fellow family,
Do not share injection needles
MANAGEMENT:
1. Patients rested total
2. Drug therapy: symptomatic, vitamin supplements, anti-emetic.
3. Diet: a diet low in fat and high glucose
G. COMPLICATIONS
Complications that may occur are:
REFERENCES
Barbara, CL., 1996, Medical Surgical Nursing (A nursing process approach), Bandung.
Brunner & Suddarth, 2002, Medical Surgical Nursing Textbook, translation: Great
Waluyo., Yasmin Asih., July., Renowned., I.made karyasa, EGC, Jakarta.
Carpenito, LJ, 2000, Applications of Nursing Diagnosis in Clinical Practice, translation:
Team Edition PSIK UNPAD-6, EGC, Jakarta
Doenges, ME, Moorhouse, MF, Geissler, AC, 1993, nursing care plan for patient care
planning and pendukomentasian, 3rd Edition, Translation; Kariasa, IM, Sumarwati, NM,
EGC, Jakarta
Lectures in pathology PSIK - UGM, 2004, Tim specialist dr. disease in RSUP dr.Sardjito,
yogyakarta.
McCloskey & Bulechek, 1996, Nursing Interventions Classifications, Second edition, By
Mosby-Year book.Inc, New York