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KASUS : Nenek 76

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menderita penyakit jantung, level.. , met.
A. Penyakit Jantung.
Penyakit jantung merupakan penyakit yang mematikan. Di seluruh dunia, jumlah penderita
penyakit ini terus bertambah. Kategori penyakit ini tidak lepas dari gaya hidup yang kurang
sehat yang banyak dilakukan seiring dengan berubahnya pola hidup. Di Indonesia, penyakit
jantung koroner adalah penyebab kematian ketiga dan setiap tahun angka penderita penyakit
jantung koroner kian bertambah.Penyakit jantung jenis ini diperkirakan terus meningkat seiring
dengan meningkatnya pendapatan masyarakat.
Ada beberapa gejala yang lebih spesifik, antara lain:
Nyeri. Jika otot tidak mendapatkan cukup darah (suatu keadaan yang disebut iskemi),
maka oksigen yang tidak memadai dan hasil metabolisme yang berlebihan menyebabkan
kram atau kejang. Angina merupakan perasaan sesak di dada atau perasaan dada diremas-
remas, yang timbul jika otot jantung tidak mendapatkan darah yang cukup. Angina adalah
gejala yang ditunjukkan dengan ketidaknyamanan pada dada yang memiliki hubungan
dengan stress secara emosional. Sakit pada dada bisa menjalar dari dekat ulu hati ke rahang
dan lengan kiri. Terkadang pada angina yang telah akut, penderita jantung koroner mudah
berkeringat, mual, dan muntah. Kelelahan juga menjadi bagian dari angina.
Angina dikatakan bertambah parah jika terjadi pengurangan tenaga secara besar-besaran
dalam waktu singkat. Puncak dari angina yang semakin memburuk ini adalah nyeri pada
saat istirahat.
Jika myokard infark terjadi, gejalanya adalah nyeri dada yang hebat, mudah berkeringat,
mual, muntah, hingga hilangnya kesadaran. Kondisi kematian otot jantung ini juga bisa
menyebabkan kematian. Gejala myokard infark ini berbeda-beda tergantung seberapa
banyak otot jantung yang rusak.
Sesak napas merupakan gejala yang biasa ditemukan pada gagal jantung. Sesak merupakan
akibat dari masuknya cairan ke dalam rongga udara di paru-paru (kongesti pulmoner atau
edema pulmoner).
Kelelahan atau kepenatan. Jika jantung tidak efektif memompa, maka aliran darah ke otot
selama melakukan aktivitas akan berkurang, menyebabkan penderita merasa lemah dan
lelah. Gejala ini seringkali bersifat ringan. Untuk mengatasinya, penderita biasanya
mengurangi aktivitasnya secara bertahap.
Palpitasi (jantung berdebar-debar)
Pusing & pingsan. Penurunan aliran darah karena denyut atau irama jantung yang abnormal
atau karena kemampuan memompa yang buruk, bisa menyebabkan pusing dan pingsan.

Serangan jantung adalah puncak bencana dari sebuah proses kerusakan yang berlangsung
lama, yang sering melibatkan kejutan-kejutan emosional, kekacauan fisiologis dan
kelelahan mental. Tanda-tanda peringatan dini begitu subyektif dan begitu tersamar.



B. Aktifitas Terapeutik
1. Approach.
RESTORATION APPROACH
2. Metode.

The various frames of reference in Occupational Therapy are
useful in relating the care plans from the perspectives of
different team members. These frames of references provide
a systematic way of considering performance problems, and
help therapists identify priorities for intervention to address
the problem. It is important to look into several options
when determining the care plan.

Rehabilitation Frame of Reference
Rehabilitation is when you are "enabling someone with an impairment to regain
maximal function in daily activities" (Seidel, 2003) within OT this is enforced through
remaining client - centred and promoting the clients independence through various
goals of which have meaning to that individual. For example; a client with MS may
have fatigue of which affects their function in their activities of daily living and so the
OT could suggest occupations which can act as a 'means to' improving or adapting
their level of function within specific areas. Rehabilitation does not mean that a
client will return back to their ful function or their impairment can be rectified and
so other techniques and approaches assist the rehabilitation frame. The
rehabilitation frame of reference is often used in conjunction with various
approaches in practice for example; teaching, learning and compensatory
approaches. In relation to our chosen occupation of Yoga for clients with MS, the
application of the rehabilitation frame of reference allows us to remain focused on
the clients overall function and participation within the occupation of Yoga and is
taken into consideration throughout the planning and intervention process.
Depending on the type of MS the client has and their various symptoms, the clients
level of function can be impacted as a result.

Through our 'Task Analysis' and 'Task Sequencing' we were able to break down the
occupation of Yoga into the core components and level of function required to
participate. This is a key stage in configuring the appropriatness of the occupation to
the client in compatability of their level of mobility and function to carry out the
occupation. This is where we were able to apply the compensatory approach to
enable clients who did not necessarily have that physical level of function for a
specific sequence within the Yoga session. For example; the 'ragdoll' position within
Yoga requires the physical ability to stand whilst crouching forward with your arms
folded. This requires various physical abilities such as; balance, stability and muscle
strength within your legs and arms. A client who may not have the required level of
function in particualr their leg muscle strength or balance, they would compensate
through the use of supportive equipment such as a chair to sit on. This is still
enabling the client to participate and use their level of function such as their arm
muscle stregth as much as they were able to and overtime build up their staminar.
Other compensatory techniques such as use of equipment may be temporary and
can be gradually fased out through the client slowly building up strength and
staminar and ultimately benefiting their symptoms of MS such as fatigue.


3. Teknik
4. Media
5. Tahapan
6. Aktivitas