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MANAJEMEN ASUHAN GIZI KLINIK PADA PASIEN

KANKER LIDAH, DAN HIPERTENSI DI IRNA II RUANG 21


DENGAN STATUS GIZI OVERWEIGHT DI RSUD Dr. SAIFUL
ANWAR MALANG

LAPORAN
PRAKTEK KERJA LAPANG
(PKL)

Diajukan sebagai salah satu syarat untuk menyelesaikan Pendidikan


Program Studi D-IV Gizi Klinik Jurusan Kesehatan

Oleh:
Mailia Yunda Suryadi
NIM. G42141183

KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI


POLITEKNIK NEGERI JEMBER
2018

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KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI
POLITEKNIK NEGERI JEMBER

MANAJEMEN ASUHAN GIZI KLINIK PADA PASIEN KANKER LIDAH,


DAN HIPERTENSI DI IRNA II RUANG 21 DENGAN STATUS GIZI
OVERWEIGHT DI RSUD Dr. SAIFUL ANWAR MALANG

Oleh:

Mailia Yunda Suryadi


NIM. G42141183

Malang, April 2018


Menyetujui Supervisor,
Clinical Instructur

Ina Wahyu R, S.Tr.Gz


NIP 19820326 200312 2 008 NIP.

Mengetahui,
Kepala Instalasi Gizi,

Ruliana, S.ST, M. MKes,


NIP. 19680305 199003 2 004

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KATA PENGANTAR

Puji syukur kehadirat Allah SWT, karena atas rahmat dan hidayah-Nya
penulis dapat menyelesaikan laporan MAGK (Manajemen Asuhan Gizi Klinik) di
RSUD Dr. Saiful Anwar Malang yang berjudul “Manajemen Asuhan Gizi Klinik
pada pasien kanker lidah dan hipertensi di IRNA II ruang 21 dengan status gizi
overweight di RSUD Dr. Saiful Anwar Malang” sebagai salah satu syarat dalam
menyelesaikan Praktek Kerja Lapangan di RSUD Dr. Saiful Anwar Malang.
Untuk itu penyusun tidak lupa mengucapkan terimakasih yang sebesar
besarnya kepada:
1. Ir. Nanang Dwi Wahyono, MM selaku Direktur Politeknik Negeri Jember.
2. Sustin Farlinda, S.Kom, MT selaku Kepala Jurusan Kesehatan
3. Ruliana, S.ST, M.Kes selaku Kepala Instalasi Gizi di RSUD Dr. Saiful
Anwar Malang.
4. Ina Wahyu R, S.Tr.Gz selaku Clinical Instructure studi kasus di Ruang 21
IRNA II RSUD Dr. Saiful Anwar Malang.
5. Semua pihak yang telah membantu dalam proses penyelesaian laporan ini.
Penulis menyadari sepenuhnya bahwa laporan kegiatan MAGK ini masih
kurang sempurna, sehingga penulis mengharapkan kritik dan saran yang sifatnya
membangun guna perbaikan di masa mendatang. Semoga laporan kegiatan
MAGK ini dapat bermanfaat bagi penulis serta pembaca.

Malang, 10 Maret 2018

Penulis

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DAFTAR ISI

Halaman
HALAMAN JUDUL.................................................................................. i
HALAMAN PENGESAHAN.................................................................... ii
PRAKATA.................................................................................................. iii
DAFTAR ISI............................................................................................... iv
DAFTAR TABEL....................................................................................... vii
DAFTAR GAMBAR.................................................................................. viii
DAFTAR LAMPIRAN.............................................................................. ix

BAB 1. PENDAHULUAN......................................................................... 1
1.1.....................................................................................................Latar
Belakang.......................................................................................... 1
1.2.....................................................................................................Rumus
an Masalah...................................................................................... 2
1.3.....................................................................................................Tujuan
..........................................................................................................3
1.3.1 Tujuan Umum.......................................................................... 3
1.3.2 Tujuan Khusus......................................................................... 3
1.4.....................................................................................................Manfaat
Penelitian......................................................................................... 4
1.4.1 Bagi Mahasiswa...................................................................... 3
1.4.2 Bagi Pasien/Keluarga Pasien................................................... 4
1.4.3 Bagi Rumah Sakit................................................................... 4

BAB 2. TINJAUAN PUSTAKA................................................................ 5


2.1.....................................................................................................Kanker
Lidah............................................................................................... 5
2.1.1 Definisi.................................................................................... 5
2.1.2 Etiologi.................................................................................... 5
2.1.3 Patofisiologi............................................................................ 6
2.1.4 Manifestasi.............................................................................. 7
2.1.5 Penatalaksanaan Terapi Kanker Lidah.................................... 8
2.1.6 Penatalaksanaan Asuhan Gizi untuk Pasien Kanker Lidah..... 11
2.2.....................................................................................................Hiperten
si....................................................................................................... 14

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2.2.1 Definisi.................................................................................... 14
2.2.2 Etiologi.................................................................................... 15
2.2.3 Patofisiologi............................................................................ 16

2.2.4 Tanda dan Gejala..................................................................... 16


2.1.5 Penatalaksanaan Asuhan Gizi Pasien dengan Hipertensi........ 17

BAB 3. PROSES ASUHAN GIZI TERSTANDART............................... 19


3.1.....................................................................................................Data
Dasar Pasien................................................................................... 19
3.1.1 Identitas Pasien....................................................................... 19
3.1.2 Antropometri........................................................................... 19
3.1.3 Biokimia.................................................................................. 19
3.1.4 Fisik Klinis.............................................................................. 20
3.1.5 Riwayat Gizi........................................................................... 21
3.1.6 Riwayat Personal..................................................................... 23
3.1.7 Daftar Masalah........................................................................ 23
3.2.....................................................................................................Diagnosis
Gizi................................................................................................... 24
3.3.....................................................................................................Intervens
i Gizi................................................................................................ 28
3.3.1 Prinsip Diet.............................................................................. 28
3.3.2 Tujuan Diet.............................................................................. 28
3.3.3 Syarat Diet............................................................................... 28
3.3.4 Kebutuhan zat Gizi.................................................................. 28
3.3.5 Rencana Edukasi Gizi............................................................. 29
3.3.6 Rencana Monitoring dan Evaluasi.......................................... 30
3.3.7 Implementasi........................................................................... 31
BAB 4. HASIL DAN PEMBAHASAN..................................................... 34
4.1 Monitoring dan Evaluasi Antropometri.......................................... 34
4.2 Monitoring dan Evaluasi Biokimia................................................. 35
4.3 Monitoring dan Evaluasi Fisik Klinis............................................. 37
4.4 Monitoring dan Evaluasi Asupan Zat Gizi...................................... 38
4.5 Monitoring dan Evaluasi Perkembangan Diet................................ 47
4.6 Monitoring dan Evaluasi Edukasi................................................... 48
BAB 5. PENUTUP...................................................................................... 49
5.1 Kesimpulan.................................................................................... 49
5.1.1 Perkembangan Status Gizi...................................................... 49
5.1.2 Diagnosa Gizi.......................................................................... 49
5.1.3 Terapi Gizi............................................................................... 50
5.2 Saran.............................................................................................. 50

DAFTAR PUSTAKA................................................................................. 51

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LAMPIRAN................................................................................................ 52

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DAFTAR TABEL

Halaman

Tabel 1 Data laboratorium pengambilan data dasar ............................................19

Tabel 2 Data pemeriksaan awal fisik klinis.........................................................20

Tabel 3 Hasil recall awal 24 jam asupan makan..................................................21

Tabel 4 Food Frequency Quisioner ....................................................................22

Tabel 5 Resume PAGT (Proses Asuhan Gizi Terstandart)...................................25

Tabel 6 Monitoring dan Evaluasi.........................................................................32

Tabel 7 Hasil pemeriksaan laboratorium.............................................................35

Tabel 8 Hasil pemeriksaan fisik Klinis ...............................................................37

Tabel 9 Hasil tingkat asupan energi dan zat gizi..................................................39

Tabel 10 Kebutuhan dan intake energi ................................................................41

Tabel 11 Kebutuhan dan intake protein ..............................................................42

Tabel 12 Kebutuhan dan intake lemak ................................................................44

Tabel 13 Kebutuhan dan intake karbohidrat .......................................................45

Tabel 14 Kebutuhan dan intake natrium .............................................................46

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DAFTAR GAMBAR

Halaman

Gambar 1. Asupan Energi....................................................................................42

Gambar 2. Asupan Protein...................................................................................43

Gambar 3. Asupan Lemak....................................................................................44

Gambar 4. Asupan Karbohidrat...........................................................................45

Gambar 5. Asupan Natrium.................................................................................47

DAFTAR LAMPIRAN

Halaman

Lampiran 1 Hasil Recal sebelum MRS................................................................52

Lampiran 2. Hasil Pengamatan asupan makan hari pertama ..............................53

Lampiran 3. Hasil pengamatan asupan makan hari kedua ..................................54

Lampiran 4. Hasil pengamatan asupan makan hari ketiga .................................55

Lampiran 5. Contoh menu sehari ........................................................................56

Lampiran 6. Leaflet diet antioksidan...................................................................57

Lampiran 7. Daftar bahan penukar .....................................................................58