LAPORAN PENDAHULUAN

INFEKSI SALURAN KEMIH

A. PENGERTIAN
1. Infek
Infeksi
si salu
saluran
ran kemi
kemi
 !ISK"
!ISK" a#ala
a#ala
 infek
infeksi
si aki$
aki$a%
a% $erk
$erkem$
em$an
an&$
&$ia
iakn
kn'a
'a
mikr((r&an
mikr((r&anisme
isme #i #alam saluran kemi) 'an& #alam kea#aan n(rmal air 
kemi %i#ak men&an#un& $ak%eri) *irus a%au mikr((r&anisme lain. Infeksi
saluran kemi !ISK" meru+akan sala sa%u +en'aki% infeksi 'an& serin& #i
%emukan #i +rak%ik umum. Infeksi saluran kemi #a+a% %er,a#i +a#a +ria
#an
#an mau+
mau+un
un -ani
-ani%a
%a #ari
#ari semu
semuaa umur
umur)) #an
#an #ari
#ari ke#u
ke#uaa ,eni
,eniss kelam
kelamin
in
%ern'a%a -ani%a le$i serin& men#eri%a infeksi saluran kemi #ari +a#a +ria
!Sukan#ar) //0".
. Infeks
Infeksii saluran
saluran kemi !ISK"
!ISK" a#ala #i%emu
#i%emukan
kann'
n'aa $ak%eri
$ak%eri +a#a
+a#a urine #i
kan#un& kemi) 'an& umumn'a s%eril. Is%ila ini #i+akai seara $er&an%ian
#en&an
#en&an is%ila
is%ila infeks
infeksii urin.
urin. Termasu
ermasuk
k +ula
+ula $er$a&
$er$a&ai
ai infeks
infeksii #i salura
saluran
n
kemi 'an& %i#ak an'a men&enai kan#un& kemi !+r(s%a%i%is) ure%ri%is"
!Arief Mans,(er) //2".
3. Infek
Infeksi
si salur
saluran
an kemi
kemi
 a#ala
a#ala
 $erk
$erkem
em$a
$an&
n&$i
$iak
akn'
n'aa mikr
mikr((
((r&
r&an
anism
ismee #i
#alam
#alam saluran
saluran kemi)
kemi) 'an&
'an& #alam
#alam kea#aa
kea#aan
n n(rmal
n(rmal %i#ak
%i#ak men&an
men&an#un
#un&
&
 $ak%eri) *irus a%au mikr((r&anisme lain. !Suar'an%( T(%()
T(%() //4".
5. Infeks
Infeksii saluran
saluran kemi
kemi #i #ia&n(s
#ia&n(sis
is #en&an
#en&an mem$ia
mem$iakk (r&anism
(r&anismee s+esifi
s+esifik.
k.
6ak%eri
6ak%eri +en'e$a$
+en'e$a$ +alin& umum a#ala Eseria 7(li) (r&anisme aer($ik 
'an& $an'ak %er#a+a% #i #aera usus $a&ian $a-a !Tam$a'(n&)
!Tam$a'(n&) //2".
Dari $er$a&ai +en&er%ian #isim+ulkan
#isim+ulkan $a-a Infeksi Saluran Kemi !ISK"
a%au Urinar
Urinarius
ius Tra%
Tra%us
us Infe%i
Infe%i(n
(n !UTI"
!UTI" a#ala
a#ala sua%u
sua%u kea#aan
kea#aan a#an'a
a#an'a infasi
infasi
mikr((r&anisme +a#a saluran kemi.

6. ETIO
ETIOLOLOGI
GI ISK
ISK !IN
!INFE
FEKS
KSII SALU
SALURA
RANN KEMI
KEMIH"
H"
8enis9,enis mikr((r&anisme 'an& men'e$a$kan ISK !Infeksi Saluran kemi"
an%ara lain :
1.  Escherichia Coli: 4/ ; +en'e
n'e$a$
$a$ ISK !In
!Infeksi sal
saluran Kemi
emi""
uncomplicated (simple).
.  Pseudomonas, Proteus, Klebsiella : +en'e
+en'e$a$
$a$  ISK (Infeksi saluran kemih)
complicated.
3.  Enterobacter,
 Enterobacter, staphylococcus epidemidis, enterococci, #an lain9 lain.
5. Pre*al
Pre*alens
ensii +en'e$a$
+en'e$a$ ISK !Infeksi
!Infeksi Salura
Saluran
n kemi"
kemi" +a#a usia lan,u%
lan,u% an%ara
lain :
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<. Sisa
Sisa urin
urin #ala
#alam
m kan#
kan#un
un&
& kemi
kemi
 'an&
'an& meni
menin&
n&ka
ka%% aki$
aki$a%
a% +en&
+en&(s
(s(n
(n&a
&an
n
kan#un& kemi 'an& kuran& efek%if.
=. M($i
M($ili
li%as
%as menu
menuru
run.
n.
0. Nu%risi
Nu%risi 'an&
'an& serin
serin&
& kuran
kuran&
& $aik
$aik..
2. Sis%em imuni%as
imuni%as menuru
menurun)n) $aik
$aik seluler
seluler mau+un
mau+un um(ral
um(ral..
4. A#an'a
A#an'a am$a%
am$a%an
an +a#a
+a#a aliran
aliran urin
urin..
1/. Hilan&n'a
Hilan&n'a efek $ak%erisi#
$ak%erisi# #ari sekresi +r(s%a%

7. INSIDEN
Ham+ir 1/ ,u%a 'an& #a%an& ke #(k%er un%uk memeriksakan kesea%ann'a
a#ala +asien infeksi saluran kemi !ISK". >ani%a </ kali le$i $an'ak #ari +a#a
laki9laki. 1 #ari < -ani%a men&alami ISK) #i$an#in&kan +ria) +erem+uan le$i
ren%an %erinfeksi saluran kemi. Pen'e$a$n'a a#ala saluran ure%ra !saluran 'an&
men&u
men&u$un
$un&ka
&kan
n kan%un
kan%un&
& kemi
kemi ke lin&ku
lin&kun&a
n&an
n luar
luar %u$u"
%u$u" +erem+
+erem+uan
uan le$i
le$i
 +en#ek !seki%ar 39< en%i me%er". 6er$e#a #en&an ure%ra +ria 'an& +an,an&)
se+an,
se+an,an&
an& +enisn'
+enisn'a)
a) sein&
sein&&a
&a kuman
kuman suli%
suli% masuk.
masuk. 6eriku
6eriku%% fak%(r
fak%(r risik(
risik( 'an&
'an&
mem$ua% sese(ran& $isa %erkena ISK !Infeksi Saluran Kemi".

D. PATOFISIO
OFISIOLOLOGI GI ISK !INFEK
!INFEKSI SI SALURA
SALURAN N KEMIH
KEMIH""
Masukn'a mikr((r&anisme ke #alam saluran kemi #a+a% melalui :
1. Pen'e$aran
Pen'e$aran en#(&
en#(&enen 'ai%u
'ai%u k(n%ak
k(n%ak lan&sun&
lan&sun& #ari %em+a%
%em+a% %er#eka%.
%er#eka%.
. Hema%(&en.
3. Limf
imf(&en.
5. Eks(&en
Eks(&en se$a&ai
se$a&ai aki$a%
aki$a% +emakaian
+emakaian ala% ala% $eru+a
$eru+a ka%e%er
ka%e%er a%au sis%(sk(+i.
sis%(sk(+i.
Fak%(r9fak%(r 'an& mem+ermu#a %er,a#in'a infeksi saluran kemi 'ai%u:
1. 6en#
6en#unun&a
&an
n alir
aliran
an urin
urinee
a. Ana%
Ana%(m
(mii k(n&i
k(n&ine ne%a
%al.
l.
 $. 6a%u saluran kemi.
. Oklusi
Oklusi ure%er
ure%er ! se$a&
se$a&ianian a%au %(%al
%(%al ".
".
. Urine
Urine sisa
sisa #alam
#alam $uli
$uli 9 $uli
$uli karena
karena :
a. Neur
Neur(&
(&en
enik
ik $la#
$la##e #err.
 $. S%rik%ur ure%ra.
. Hi+e
Hi+er%
r%r(
r(+i
+i +r(
+r(s% s%a%
a%
3. Gan&
Gan&&u&uan
an me%a$
me%a$(l(lik
ik
a. Hi+e
Hi+erk
rkal
alse
semi
mia.a.
 $. Hi+(kalemia.
. A+am
A+ama& a&l(
l($u
$uliline
nemimia.
a.
#. Ins%
Ins%ru
rume
men%n%as
asi.
i.
e. Dila%
Dila%asi
asi ure%r
ure%raa sis%
sis%(sk
(sk(+(+ii
5. Keamilanlan
a. Fak%
Fak%(r
(r s%a%i
s%a%iss #an $en$en#u#un&
n&anan..
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Infeksi
Infeksi %rak%us
%rak%us urinarius
urinarius %eru%ama
%eru%ama $erasal #ari mikr((r&an
mikr((r&anisme
isme +a#a faees
'an& naik #ari +erineum ke ure%ra #an kan#un& kemi ser%a menem+el +a#a
 +ermukaan muk(sa. A&ar infeksi #a+a% %er,a#i) $ak%eri arus mena+ai kan#un&
kemi)
kemi) meleka
meleka%% +a#a
+a#a #an men&k(
men&k(l(n
l(nisas
isasii e+i%eli
e+i%elium
um %rak%us
%rak%us urinar
urinarius
ius un%uk 
un%uk 
men&in#ar
men&in#arii +em$ilasan
+em$ilasan melalui
melalui $erkemi)
$erkemi) mekanisme
mekanisme +er%aan
+er%aan +en,amu
+en,amu #an
e%usan inflamasi.
Inflamasi) a$rasi muk(sa ure%ral) +en&(s(n&an kan#un& kemi 'an& %i#ak 
len&
len&ka
ka+)
+) &an&
&an&&u
&uan
an s%a%
s%a%us
us me%a$
e%a$(l
(lis
isme
me !#ia
!#ia$e
$e%e
%es)
s) kea
keami
mila
lan)
n) &(u%
&(u%"" #an
#an
imun
imun(s
(su+
u+re
resi
si meni
menin&
n&ka
ka%k
%kan
an resi
resik(
k( infe
infeks
ksii salu
salura
ran
n kemi
kemi
 #en&
#en&an
an ara
ara
men&&a
men&&an&&
n&&u
u mekanis
mekanisme
me n(rmal
n(rmal.. Infeks
Infeksii saluran
saluran kemi
kemi #a+a%
#a+a% #i$a&i
#i$a&i men,a#
men,a#ii
sis%isis #an +iel(nefri%is. Piel(nefri%is aku% $iasan'a %er,a#i aki$a% infeksi kan#un&
kemi asen#ens. Piel(nefri%is aku% ,u&a #a+a% %er,a#i melalui infeksi ema%(&en.
Infeksi #a+a% %er,a#i #i sa%u a%au #i ke#ua &in,al.
Piel(n
Piel(nefri
efri%is
%is kr(nik
kr(nik #a+a%
#a+a% %er,a#i
%er,a#i aki$a%
aki$a% infeks
infeksii $erula
$erulan&)
n&) #an $iasan'
$iasan'aa
#i,um+ai +a#a in#i*i#u 'an& men&i#a+ $a%u) ($s%ruksi lain) a%au refluks
*esi
*esik(
k(ur
ure%
e%er
er.. Sis%i
Sis%i%i
%iss !infl
!inflama
amasi
si kan#
kan#un
un&
& kemi
kemi"
" 'an&
'an& +ali
+alin&
n& serin
serin&
&
#ise$a$kan
#ise$a$kan (le men'e$arn'
men'e$arn'aa infeksi
infeksi #ari ure%ra. Hal ini #a+a% #ise$a$kan
#ise$a$kan
(le
(le alir
aliran
an $ali
$alik
k rine
rine #ari
#ari ure%
ure%ra
ra ke #ala
#alam
m kan#
kan#un
un&
& kemi
kemi
 !ref
!reflu
luks
ks
ur%r(*esikal") k(n%aminasi fekal) +emakaian ka%e%er a%au sis%(sk(+.
Ure%ri%is
Ure%ri%is sua%u inflamasi $iasan'a
$iasan'a a#ala sua%u infeksi 'an& men'e$ar
men'e$ar naik 
'an& #i&(l(n&kan se$a&ai &eneral a%au m(n&(n(real. Ure%ri%is &n(real #ise$a$kan
(le
(le niesser
niesseria
ia &(n(r
&(n(r(ea
(eaee #an #i%ula
#i%ularkan
rkan melalu
melaluii k(n%ak
k(n%ak seksua
seksual.
l. Ure%ri%
Ure%ri%is
is
n(n&(n
n(n&(n(re
(real)
al) ure%ri%
ure%ri%is
is 'an&
'an& %i#ak
%i#ak $eru$
$eru$un&
un&an
an #en&an
#en&an niesse
niesseria
ria &(n(r
&(n(r(eae
(eae
 $iasan'a #ise$a$kan (le klami#ia frak(ma%ik a%au urea +lasma urel'%ikum.
Piel(nefri%i
Piel(nefri%iss !infeksi
!infeksi %rak%us
%rak%us urinarius
urinarius a%as" meru+akan infeksi $ak%eri
$ak%eri +iala
&in,al) %($ulus #an ,arin&an in%er%isial #ari sala sa%u a%au ke#ua &in,al. 6ak%eri
mena+ai kan#un& kmi melalui ure%ra #an naik ke &in,al meski+un &in,al / ;
sam+ai < ; ura ,an%un&? $ak%eri ,aran& mena+ai &in,al melalui aliran #ara ?
kasus +en'e$aran seara ema%(&en kuran& #ari 3 ;.
8enis Infeksi Saluran Kemi an%ara lain :
1. Kan#
Kan#unun&
& Kemi
Kemi !sis
!sis%i%
%i%is"
is"..
. Ur ra !u i%is
i%is".
".
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1. ISK
ISK !Infek
!Infeksi
si Salu
Saluran
ran kem
kemi
i"" uncomplicated (simple).
(simple).
ISK !Infeksi saluran kemi" se#erana 'an& %er,a#i +a#a +en#eri%a #en&an
saluran kenin& %ak $aik) ana%(mi mau+un fun&si(nal n(rmal. ISK !Infeksi
Saluran kemi" ini +a#a usi lan,u% %eru%ama men&enai +en#eri%a -ani%a #an
infeksi an'a men&enai muk(sa su+erfiial kan#un& kemi.
. ISK
ISK !Infek
!Infeksi
si Salu
Saluran
ran kem
kemi
i"" complicated.
Serin& menim$ulkan $an'ak masala karena serin& kali kuman +en'e$a$
suli% #i$eran%as) kuman +en'e$a$ serin& resis%en %era#a+ $e$era+a maam
an%i$i(%ika) serin& %er,a#i $ak%erimia) se+sis #an s(k. ISK !Infeksi Saluran
kemi" ini %er,a#i $ila %er#a+a% kea#aan9kea#aan se$a&ai $eriku% :
a. Kelain
Kelainan
an a$n(rmal
a$n(rmal salura
saluran
n kenin&)
kenin&) misaln'
misaln'aa $a%u) refle@
refle@ *esik(
*esik(
ure%ral ($s%ruksi) a%(ni kan#un& kemi) +ara+le&ia) ka%e%er kan#un&
kenin& mene%a+ #an +r(s%a%i%is.
 $. Kelainan faal &in,al : GGA mau+un GGK.
. Gan&
Gan&&u
&uanan #a'
#a'aa %aan
%aan %u$
%u$u
u..
#. Infeks
Infeksii 'an&
'an& #ise$a$ka
#ise$a$kan n karena (r&ani
(r&anisme
sme *irulen
*irulen s+er%i
s+er%i +r(s%eus
+r(s%eus
s++ 'an& mem+r(#uksi urease.
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E. PATH>A
Mikr((
Mikr((rr anisme
anisme H'&ien$uruk  K(n%
K(n%ra
rase
se si #iaf
#iafra
ra ma Ka%e%erisasi

Hema%(&en S's%em limf(%ik  K(n%aminasi 7e&a +en&(s(n&an

 $ak%eri re%um B urin sem+urna
Kuman men'e$ar 
Gin,al 'an& &in,al
su#a %erinfeksi Mea%us urinarius
Refluks *esik(

Melalui #ara Aliran $alik 

urin #ari ure%ra

6ak%eri $erkem$an& K(l(nisasi e+i%alium In*asi kuman ke 8arin

8arin an %eriri
%eriri%as
%asii
 $iak C $erk(l(ni %rak%us urinari Urin $eram+ur 
kan#un& kemi
#ara
Dialiriurin

MK: Resti Kan#un& kemi 6ak%eri $erkem$an&

penyebaran infeksi mere&an&  $iak C $erk(l(ni
D s ur
uri a

Sis%i%is Ure%ri%is
Su+ra+u$ik %e&an& Dis%ensi kan#un& MK 
kemi

inflamas Reak
Reaksi
si A 9A$
9A$
Men#esak $erkemi
P'uria
IL91
MK :Perubahan
Mens%imulasi
ola eliminasi Suu %u$u naik 
i+(%alamus
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F. MANIFESTASI KL
KLINIK
1. Ure%ri%
Ure%ri%isis $iasan'
$iasan'aa mem+erli
mem+erlia%a%kan
kan &e,al
&e,alaa :
a. Muk(
Muk(sasa mem
memera
era #an
#an e#ee#emama..
 $. Ter#a+a%
Ter#a+a% airan eksu#a% 'an& +urulen%.
. A#aA#a ulse
ulsera
rasi
si +a#
+a#aa ure%
ure%ra
ra..
#. A#an'
A#an'aa rasa
rasa &a%al
&a%al 'an&
'an& men&men&&el
&eli%ik
i%ik..
e. A#an
A#an'a'a nana
nana  a-a
a-all mik
miksi. si.
f. N'er
N'erii +a#
+a#aa saa
saa%% mik
miksi
si..
&. Kesuli%a
Kesuli%ann un%u
un%uk
k memu
memulai lai miksi.
miksi.
. N'eri
N'eri +a#a
+a#a a$#(m
a$#(men en $a&i
$a&ian an $a-a
$a-a. .
. Sis%i%
Sis%i%is
is $iasan'
$iasan'aa mem+erli
mem+erlia% a%kan
kan &e,al
&e,alaa :
a. Disuri
Disuriaa !n'eri
!n'eri -ak%u
-ak%u $erkem
$erkemi" i"..
 $. Penin&ka%an frekuensi $erkemi.
. Peras
Perasaan
aan in&i
in&in
n $erk
$erkemi
emi. .
#. A#an'
A#an'aa sel9sel
sel9sel #ara
#ara +u%i
+u%i #alam
#alam urin.
urin.
e. N'eri
N'eri +un&
+un&&u&un&
n& $a-a
$a-a  a%au
a%au su+ra+
su+ra+u$i u$ik.
k.
f. Dema
Demam m 'an&
'an& #iser
#iser%ai
%ai a#an'
a#an'aa #ara
#ara #alam
#alam urin
urinee +a#a
+a#a kasus
kasus 'an&
'an&
 +ara.
3. Piel(n
Piel(nefri
efri%is
%is aku%
aku% $iasan'a
$iasan'a mem+eri
mem+eria%
a%kan
kan &e,ala
&e,ala :
a. Demam.
 $. Men&&i&il.
. N'er
N'erii +in
+in&&an
&&an&
&.
#. Disuria
Piel(n
Piel(nefri
efri%is
%is kr(nik
kr(nik mun&k
mun&kin
in mem+erl
mem+erlia
ia%kan
%kan &am$ara
&am$aran
n miri+
miri+ #en&an
#en&an
 +iel(nefri%is aku%) %e%a+i #a+a% ,u&a menim$ulkan i+er%ensi #an akirn'a #a+a%
men'e$a$kan &a&al &in,al.

G. TES DIAGNOSTIK
Urinalisis :
1. Leuk(suria
Leuk(suria a%au
a%au +iuria
+iuria : meru+akan
meru+akan sala
sala sa%u
sa%u +e%un,uk
+e%un,uk +en%in
+en%in&
& a#an'a
a#an'a ISK 
!Infek
!Infeksi
si Salura
Saluran
n Kemi"
Kemi".. Leuk(s
Leuk(suria
uria +(si%i
+(si%iff $ila
$ila %er#a+a%
%er#a+a% le$i
le$i #ari
#ari <
leuk(si%Bla+an& +an#an& $esar !LP6" se#imen% air kemi.
. Hema%u
Hema%uria
ria : ema%u
ema%uria
ria +(si%if
+(si%if $ila %er#a+a%
%er#a+a% <91/ eri%r(si%B
eri%r(si%BLP6
LP6 se#imen
se#imen%% air 
kemi. Hema%uria #ise$a$kan (le $er$a&ai kea#aan +a%(l(&is $aik $eru+a
kerusakan &l(merulus a%au+un ur(li%iasis.
3. 6ak%
6ak%er
eri(
i(l(
l(&i
&iss :
a. Mikr
Mikr(s(sk(
k(+i
+is.
s.
 $. 6iakan $ak%eri.
5. Kul%ur
Kul%ur urine
urine un%uk
un%uk men&i#en%i
men&i#en%ifikasi
fikasi a#an'a
a#an'a (r&anisme
(r&anisme s+esifik.
s+esifik.
<. Hi%un&
Hi%un& k(l(ni
k(l(ni:: i%un&
i%un& k(l(ni
k(l(ni seki%ar
seki%ar 1//.///
1//./// k(l(ni
k(l(ni +er millil
millili%er
i%er urin #ari
uri ali &a #ari
#ari ime #al ka% #ia
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a. Tes dipstick mul%is%ri+ un%uk >67 !%es es%erase lek(si%" #an ni%ri%
!%es Griess un%uk +en&uran&
+en&uran&an
an ni%ra%".
ni%ra%". Tes
Tes es%erase lek(si% +(si%if:
+(si%if:
maka
maka +sien
+sien men&ala
men&alami
mi +iuria.
+iuria. Tes +en&ur
+en&uran&
an&an
an ni%ra%)
ni%ra%) Griess
Griess
 +(si%if ,ika %er#a+a% $ak%eri 'an& men&uran&i ni%ra% urin n(rmal
men,a#i ni%ri%.
 $. Tes
Tes Pen'aki% Menular Seksual !PMS" : Ure%ri%ia aku% aki$a%
(r&ani
(r&anisme
sme menula
menularr seara
seara seksual
seksual !misal
!misal)) klami#
klami#ia
ia %rak(ma
%rak(ma%is
%is))
neisseria &(n(rr(eae) er+es sim+lek".
. Tes9%es
s9%es %am$a
%am$aa
ann : Ur(&
Ur(&ram
ram in%ra
in%ra*e
*ena
na !IU"
!IU".. Piel
Piel(&
(&raf
rafii !IP
!IP")
")
msis
msis%(
%(&r
&rafi
afi)) #an
#an ul%ra
ul%ras(
s(n(
n(&r
&raf
afii ,u&a
,u&a #a+a
#a+a%% #ilak
#ilakuk
ukan
an un%u
un%uk 
k 
menen
menen%u
%uka
kan
n a+ak
a+aka
a infek
infeksi
si aki$
aki$a%
a% #ari
#ari a$n(
a$n(rm
rmali
ali%a
%ass %rak
%rak%u
%uss
urinarius) a#an'a $a%u) massa renal a%au a$ses) (#r(ner(sis a%au
i+e
i+er+
r+la
lasi
siee +r(s
+r(s%a
%a%e
%e.. Ur(&
Ur(&ra
ram
m I a%au
a%au e*al
e*alua
uasi
si ul%r
ul%ras
as(n
(ni
i))
sis%(
sis%(sk
sk(+
(+ii #an
#an +r(s
+r(se#
e#ur
ur ur(#
ur(#in
inam
amik
ik #a+a
#a+a%% #ila
#ilaku
kukan
kan un%u
un%uk 
k 
men&i#en%ifikasi +en'e$a$ kam$un'a infeksi 'an& resis%en.

H. PENA
PENAT TALAKS
AKSANAANAAN MED
MEDIIK
1. Tera+i
ra+i an%i
an%i$i
$i(%
(%ik
ik un%u
un%uk
k mem$
mem$un
unu
u $ak%
$ak%er
erii &ram
&ram +(si%
+(si%if
if mau+u
mau+un
n &ram
&ram
ne&a%if.
. A+a$
A+a$il
ilaa +iel(
+iel(ne
nefri
fri%i
%iss kr(n
kr(nik
ikn'
n'aa #ise$
#ise$a$
a$ka
kan
n (le
(le ($s%r
($s%ruk
uksi
si a%au
a%au reflu
refluks
ks))
maka
maka #i+erlu
#i+erlukan
kan +ena%al
+ena%alaks
aksana
anaan
an s+esifi
s+esifik
k un%uk
un%uk men&a%
men&a%asi
asi masala
masala99
masala %erse$u%.
3. Dian,urkan
Dian,urkan un%uk
un%uk serin&
serin& minum
minum #an 6AK
6AK sesuai
sesuai ke$u%uan
ke$u%uan un%uk
un%uk mem$ila
mem$ilass
mir((r&anisme 'an& mun&kin naik ke ure%ra) un%uk -ani%a arus mem$ilas
#ari #e+an ke $elakan& un%uk men&in#ari k(n%aminasi lu$an& ure%ra (le
 $ak%eri faees.
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Ka%e%er
Ka%e%er urinar
urinarius
ius %er+asan
%er+asan&)
&) urine
urine ,erni)
,erni) $isin&
$isin& usus
usus %i#ak
%i#ak a#a)
a#a)
samar a%au ,elas.
3. Maka
Makana
nanB
nB7a
7air
iran
an
A$#(men lunak #an %i#ak a#a #is%ensi +a#a a-al.
5. Neur
Neur(s
(sen
ens(
s(ri
ri
Kerusakan &erakan #an sensasi #i $a-a %in&ka% anas%esi s+inal
e+i#ural.
<. N'eri
N'eriBK
BKe%i
e%i#a
#akn'
kn'am
aman
anan
an
Ke%i
Ke%i#ak
#akn'
n'am
amana
anan
n #ari
#ari $er$
$er$a&
a&ai
ai sum$e
sum$er)
r) misal
misaln'
n'aa : %rau
%rauma
ma
 $e#aBinsisi) n'eri +en'er%a) #is%ensi kan#un& kemiBa$#(men)
efek9efek anas%esi) mulu% kerin&.
=. Keamanan
6alu%an a$#(men %er#a+a% se#iki% n(#a a%au kerin& #an u%u) ,alur 
 +aren%eral $ila #i&unakan +a%en #an insisi $e$as eri%ema) $en&kak 
#an n'eri %ekan.
 $. Dia&n(sa Ke+era-a%an
1. Infeksi 'an& $B# a#an'a
a#an'a $ak%eri
$ak%eri +a#a
+a#a saluran
saluran kemi
. Gan&&u
Gan&&uanan rasa n'aman
n'aman n'eri $B# Inflamasi
Inflamasi)Ka
)Kan#u
n#un&
n& Kemi)#
Kemi)#an
an
s%ruk%ur %rak%us urinarius lain
3. Peru$a
Peru$aan
an +(la elimina
eliminasi
si urine !#isuria
!#isuria)) #(r(n&
#(r(n&an)
an) frekuensi
frekuensi)) #an
a%au n(k%uria" 'an& $B# ISK
5. Kuran&
Kuran& +en&e%a
+en&e%aua
uan
n 'an&
'an& $B# kuran&n
kuran&n'a
'a inf(rma
inf(rmasi
si %en%an&
%en%an& +r(ses
+r(ses
 +en'aki%
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Diagnosa Keperawatan/ Rencana keperawatan

Masalah Kolaborasi Tujuan dan Kriteria asil
Risiko infeksi !"# : !$# :
 Immune S%a%us • Per%aankan %eknik
Fak%(r9fak%(r risik( :  Kn(-le#&e : Infe%i(n (n%r(l • 6a%asi +en&un,un&
9 Pr(se#
Pr(se#ur
ur Infasif 
Infasif   Risk (n%r(l • 7ui %an&an se%ia+
9 Kerusakan
Kerusakan ,arin&an
,arin&an #an
#an
Se%ela
Se%ela #ilaku
#ilakukan
kan %in#ak
%in#akan
an ke+era-
ke+era-a%an
a%an ke+era-a%an
 +enin&ka%an +a+aran
• Gunakan $a,u) saru
lin&kun&an selama +asien %i#ak men&alami infeksi • Gan%i le%ak I +er 
9 Malnu%
Malnu%risi
risi #en&an kri%eria asil:
9 Penin&ka%an
Penin&ka%an +a+aran
+a+aran  +e%un,uk umum
 Klien $e$as #ari %an#a #an &e,ala infeksi
• Guna
Gunaka
kann ka%e
ka%e%e
%err
lin&kun&an +a%(&en  Menun,uk,ukkan kemam+u
am+uaan un%uk 
9 Im(nus
Im(nusu+r
u+resi
esi infeksi kan#un& ke
mene&a %im$uln'a infeksi
9 Ti#ak
Ti#ak a#ekua%
a#ekua% +er%aanan
+er%aanan • Tin&ka%kan in%ake n
 8umla leuk(si% #alam $a%as n(rmal
6erikan %era+i an%i$
sekun#er !+enurunan H$)  Menun,ukkan +erilaku i#u+ sea%
• M(ni%(r %an#a #an
 S%a%us imun) &as%r(in%es%inal)
Leuk(+enia) +enekanan • Per%aankan %eknik
res+(n inflamasi" &eni%(urinaria #alam $a%as n(rmal • Ins+
Ins+ek
eksi
si kuli
kuli%% #a
9 Pen'aki
Pen'aki%% kr(nik 
kr(nik 
kemeraan) +anas)
9 Imun(s
Imun(su+r
u+resiesi
• M(ni%(r a#an'a luk 
9 Maln
Malnu%
u%ris
risii
9 Per%aan
Per%aan +rimer
+rimer %i#ak • D(r(n& masukan 
• D(r(n& is%iraa%
a#ekua% !kerusakan kuli%)
• A,ark
A,arkan
an +asi
+asien
en #
%rauma ,arin&an)
infeksi
&an&&uan +eris%al%ik" • Ka,i suu $a#an +
 ,am
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Diagnosa Keperawatan/ Rencana keperawatan

Masalah Kolaborasi Tujuan dan Kriteria asil
!yer akut  $eru$un&an
!yerii akut !"# : !$# :
 Pain Le*el)  Lakuka
Lakukan
n +en&ka
+en&ka,ia
,ia
#en&an:
  +ain (n%r(l)
A&en in,uri !$i(l(&i) kimia) %erm
%ermas
asuk
uk l(ka
l(kasi
si)) k 
 (mf(r% le*el
fisik) +sik(l(&is") kerusakan kuali%as #an fak%(r +r 
 ,arin&an Se%ela
Se%ela #ilaku
#ilakukan
kan %infak
%infakan
an ke+era-a%an
ke+era-a%an O$ser*asi reaksi n(n
 6an%u
an%u +asi
+asien
en #an
#an
selama . Pasien %i#ak men&alami n'eri)
DS: menemukan #ukun&
9 La+(
a+(ran
ran sea
seara
ra *er$
*er$al
al #en&an kri%eria asil:
 K(n%r(l lin&kun&an
DO: • Mam+u men&(n%r(l n'eri !%au +en'e$a$
9 P(sisi un%uk menaan se+er%i suu ruan&an)
n'er
n'eri)
i) mam+u
am+u men& en&&una
&unaka
kan
n %e
%enik 
nik 
 Kuran&i fak%(r +resi
n'eri n(nfarmak(l(&i un%uk men&uran&i n'eri) Ka,i
a,i %i+e #an su
9 Tin&ka
n&ka laku
laku $er
$era%
a%i9
i9a
a%i
%i
9 Gan&&uan %i#ur !ma%a menari $an%uan" in%er*ensi
• Mela
Mela+(
+(rk
rkan
an $a-a
a-a n'ern'erii $erk
$erku
uran
ran& A,arkan
A,arkan %en%an&
%en%an& %ek 
sa'u) %am+ak a+ek) suli%
#en&an men&&unakan mana,emen n'eri relaksasi) #is%raksi) k 
a%au &erakan kaau)
• Mam+u men&enali n'eri !skala) in%ensi%as) 6erikan anal&e%ik un
men'erin&ai"  Tin&ka%kan
Tin&ka%kan is%iraa%
is%ir aa%
9 Terf(k
rf(kus
us +a#a
+a#a #iri
#iri sen#
sen#ir
irii frekuensi #an %an#a n'eri"
 6erika
6erikann inf(rm
inf(rmasiasi %
9 F(kus men'em+i% • Men'a%ak
Men'a%akanan rasa n'aman
n'aman se%ela
se%ela n'eri
n'eri
n'er
n'eri)
i) $era
$era+a
+a lam
lam
!+enurunan +erse+si  $erkuran&
• Tan#a
Tan#a *i%al #alam ren%an& n(rmal an%isi+asi ke%i#akn'a
-ak%u)
-ak%u) kerusa
kerusakan
kan +r(ses
+r(ses  M(ni%(r *i%al si&n s
• Ti#ak men&alami &an&&uan %i#ur 
 $er+ikir) +enurunan
anal&esik +er%ama ka
in%e
in%era
raks
ksii #en&
#en&an
an (ran
(ran&
&
#an lin&kun&an"
9 Tin&ka laku #is%raksi)
(n%( : ,alan9,alan)
menemui (ran& lain
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!mun&k
!mun&kin
in #alam
#alam ren%an
ren%an&
&
#ari lema ke kaku"
9 Tin&ka laku eks+resif  
!(n%( : &elisa)
merin%i) menan&is)
-as+
-as+a#
a#a)
a) iri%a
iri%a$el
$el)) nafas
nafas
 +an,an&B$erkelu kesa"
9 Peru$aan #alam nafsu
makan #an minum
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Diagnosa Keperawatan/ Rencana keperawatan

Masalah Kolaborasi Tujuan dan Kriteria asil
Defisit %olume #airan !"#: !$# :
6eru$un&an #en&an:  Flui# $alane
• Per%aankan a%a%
9Keilan
9Keilan&an
&an *(lume
*(lume airan
airan  H'#ra%i(n
• M(ni%
M(ni%(r
(r s%a%u
s%a%uss
  Nu%ri%i(nal S%a%us : F((# an# Flui#
seara ak%if
9Ke
9Ke&a&al
a&alaan meka
ekanisme
sme muk(sa) na#i a#e
In%ake
 +en&a%uran  ,ika #i+erlukan
Se%ela
Se%ela #ilaku
#ilakukan
kan %in#ak
%in#akan
an ke+era-
ke+era-a%an
a%an • M(ni%
M(ni%(r(r asi
asill la
DS : selama
selama.. .. #efisi%
#efisi% *(lume
*(lume airan
airan %era%asi
%era%asi airan !6UN ) H
9Haus
DO: #en&an kri%eria asil: %(%al +r(%ein "
9Penurunan %ur&(r kuli%Bli#a  Mem+er
Mem+er%a%aank
ankanan urine
urine (u%+u%
(u%+u% sesuai
sesuai • M(ni%(r *i%al si&n
9Mem
9Mem$r $ran
an muk(s
uk(saB
aBk
kuli%
uli% #en&an usia #an 66) 68 urine n(rmal) • K(la$(rasi +em$
kerin&  Tekanan #ara) na#i) suu %u$u #alam • M(ni%(r s%a%us nu
9Pen
9Penin
in&k
&ka%
a%an
an #en'
#en'u%
u% na#i
na#i)) • 6erikan airan (r 
 $a%as n(rmal
• 6erikan +en&&an%
 +enurunan %ekanan #ara)  Ti#ak a#a a#a %an#an#a %an#
an#a #ei#ras
rasi)
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Diagnosa Keperawatan/ Rencana keperawatan

Masalah Kolaborasi Tujuan dan Kriteria asil
Kurang Pengetahuan !"#: !$# :
6er
eru$un&an #en&
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 K(-le#&e : eal% 6ea*i(r  • Ka,i %in&ka% +en&e%
ke%er$a%asan k(&ni%if)
• 8elaskan +a%(fisi(l
in%er+re%asi %era#a+ Se%ela
Se%ela #ilaku
#ilakukan
kan %in#ak
%in#akan
an ke+era-
ke+era-a%an
a%an
al ini $eru$un&
$eru$un&
inf(rmasi 'an& sala) selama . +asien menun,ukkan
#en&an ara 'an& %
kuran&n'a
kuran&n'a kein&inan
kein&inan un%uk   +en&e%auan %en%an& +r(ses +en'aki%
• Gam$ar
Gam$arkan
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k  #en&an kri%eria asil:
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sum$er9sum$er  sien #an kelu
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ra  Pasien #an keluar&a mam+u
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 +erilaku %i#ak sesuai
men,elaskan kem$ali a+a 'an&  +asien #en&an ara
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DAFTAR PUSTAKA

Arief Mans,(er. //1. Kapita

//1.  Kapita Selekta Kedokteran.
Kedokteran. 8akar%a: Pener$i% Me#ia
Aesula+ius FKUI.
6runner #an Su##ar%. 1440.  Keperaatan
  Keperaatan !edikal "edah
"edah E#isi 2. 8akar%a:
EG7
Mar'lin E. D(en&(es. ///.  #encana
 #encana $suhan
$suhan Keperaatan
Keperaatan 8akar%a: EG7.
 Nurs.Nursalam. //=.Asuan ke+era-a%an +a#a +asien
+asien &an&&uan sis%em
 +erkemian. 8akar%a: Salem$a Me#ika
Prie) S'l*ia. 144<.  Patofisiolo%i, Konsep Proses
Proses Penyakit . 8akar%a: EG7.
Susan Mar%in Tuker e%. all) 1442. Standar Peraatan Pasien. 8akar%a: EG7.
Suar'an%()T(%(.
Suar'an%()T(%(. //4. Asuan Ke+era-a%an Pa#a Klien Den&an Gan&&uan
Sis%em Perkemian. 8akar%a: Trans
Trans inf( Me#ia.
Tam$a'(n& #r.8an. ///. Patofisiolo%i
///.  Patofisiolo%i untuk keperaatan.
keperaatan. 8akar%a: EG7.