DAFTAR ISI

Kata Sambutan Ketua Umum Pengurus Besar Ikatan Dokter Indonesia v

CATATAN PENTING.....................................................................................................xix
TIM PENYUSUN............................................................................................................xii
KATA PENGANTAR.......................................................................................................xv
DAFTAR ISI..................................................................................................................xvi
PENDAHULUAN..............................................................................................................1
A. Latar Belakang...................................................................................................1
B. Tujuan................................................................................................................3
C. Dasar Hukum.....................................................................................................3
D. Sasaran..............................................................................................................3
E. Ruang Lingkup...................................................................................................3
F. Struktur Buku Keterampilan Klinis...................................................................4
G. Jenis Keterampilan dalam Panduan Keterampilan Klinis.................................5
BAB I. Universal Precaution.........................................................................................11
1. Cuci Tangan 7 Langkah .......................................PPI..................................11
2. Prinsip Aseptik dan Antiseptik .............................PPI.................................13
3. Alat Pelindung Diri...............................................PPI..................................14
BAB II. Keterampilan Komunikasi................................................................................16
Komunikasi Dokter-Pasien...........................................................................................16
4. Proses Konsultasi........................................................................................16
5. Edukasi Individu dan Kelompok.................................................................18
6. Konseling.....................................................................................................19
7. Menyampaikan Kabar Buruk......................................................................20
8. Persetujuan Tindakan Medik......................................................................20
BAB III. General Survey................................................................................................23
9. Penilaian Kesadaran....................................................................................23
10. Penilaian Postur dan Habitus......................................................................24
11. Penilaian status gizi anak dan dewasa........................................................27

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BAB IV. Tanda Vital......................................................................................................41

12. Pemeriksaan Tekanan Darah..................................................................41
13. Pemeriksaan Denyut Nadi......................................................................44
14. Pemeriksaan Pernapasan.......................................................................46
15. Pemeriksaan Suhu..................................................................................48
BAB V. Sistem Saraf......................................................................................................51
16. Pemeriksaan Rangsang Meningeal.........................................................51
17. Pemeriksaan Nervus Kranialis...............................................................54
18. Pemeriksaan Refleks Fisiologis..............................................................63
19. Pemeriksaan Refleks Patologis...............................................................66
20. Pemeriksaan Sistem Sensorik (Eksteroseptif dan Proprioseptif)..........70
21. Pemeriksaan Sistem Motorik..................................................................72
22. Pemeriksaan Koordinasi.........................................................................79
23. Pemeriksaan Fungsi Luhur.....................................................................81
24. Pemeriksaan Neurologis Lainnya: Patrick dan Kontra Patrick..............83
BAB VI. Psikiatri...........................................................................................................85
25. Anamnesis Psikiatri................................................................................85
26. Diagnosis Multiaksial..............................................................................88
27. Penilaian Status Mental..........................................................................91
28. Penilaian Mini Mental State Examination (MMSE).................................99
29. Indikasi Rujuk pada Kasus Psikiatri.....................................................101
30. Menentukan Prognosis pada Kasus Psikiatri.......................................101
BAB VII. Sistem Indera...............................................................................................104
Indera Penglihatan................................................................................................104
31. Penilaian Penglihatan pada Bayi dan Anak..........................................104
32. Penilaian Refraksi atau Tajam Penglihatan......................................... 106
33. Pemeriksaan Lapang Pandang.............................................................107
34. Pemeriksaan Eksternal Mata...............................................................109
35. Pemeriksaan Media Refraksi................................................................112
36. Pemeriksaan Posisi Bola Mata.............................................................115

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Pemeriksaan Tekanan Intraokular dengan Palpasi dan Tonometer

Schiotz..............................................................................................................116
38. Penilaian Penglihatan Warna (dengan Buku Ishihara 12 Plate)..........117
39. Pemberian Obat Tetes Mata dan Salep Mata........................................118
40. Pencabutan Bulu Mata......................................................................... 119
41. Membersihkan Benda Asing pada Mata...............................................120
Indera Pendengaran..............................................................................................122
42. Pemeriksaan Fisik Telinga...................................................................122
43. Penilaian Tajam Pendengaran.............................................................128
44. Penilaian Tajam Pendengaran pada Anak............................................131
45. Manuver Valsava..................................................................................133
Pembersihan Meatus Auditorius dan Pengambilan Benda Asing pada
Telinga..............................................................................................................134
Indera Pengecapan................................................................................................137
47. Penilaian Pengecapan..........................................................................137
Indera Penciuman.................................................................................................139
48. Pemeriksaan Fisik Hidung................................................................... 139
49. Pemeriksaan Transluminasi Sinus Frontalis dan Maksilaris...............142
50. Penatalaksanaan Perdarahan Hidung..................................................143
51. Pengambilan Benda Asing pada Hidung.............................................. 147
BAB VIII. Sistem Respirasi.........................................................................................150
52. Pemeriksaan Leher...............................................................................150
53. Pemeriksaan Dada................................................................................152
54. Dekompresi Jarum...............................................................................160
55. Terapi Oksigen dan Inhalasi.................................................................161
BAB IX. Sistem Kardiovaskular..................................................................................168
56. Pemeriksaan Jantung (Inspeksi, Palpasi, Perkusi, dan Auskultasi).......168
57. Pemeriksaan JVP.................................................................................. 171
58. Palpasi Arteri Karotis dan Deteksi Bruit..............................................173
59. Pemeriksaan Tredelenberg..................................................................174
60. Palpasi Denyut Arteri Ekstremitas.......................................................175

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61. Elektrokardiografi (EKG).....................................................................178

BAB X. Sistem Gastrohepatobilier..............................................................................188
62. Pemeriksaan Mulut dan Tenggorokan (Tonsil)...................................188
63. Pemeriksaan Fisik Abdomen................................................................189
64. Pemeriksaan Shifting Dullness dan Undulasi.......................................195
65. Pemeriksaan Fisik untuk Mendiagnosis Apendisitis........................... 196
66. Pemeriksaan Inguinal (Hernia)............................................................198
67. Pemasangan NGT.................................................................................199
68. Prosedur Bilas Lambung......................................................................200
69. Pemeriksaan Colok Dubur....................................................................201
70. Prosedur Klisma/Enema/Huknah (Irigasi Kolon)...............................204
71. Perawatan Kantung Kolostomi............................................................205
BAB XI. Sistem Ginjal dan Saluran Kemih..................................................................206
72. Pemeriksaan Ginjal dan Saluran Kemih...............................................206
73. Pemasangan Kateter Uretra.................................................................208
BAB XII. Sistem Reproduksi.......................................................................................211
74. Pemeriksaan Fisik Ginekologi Wanita.................................................211
75. Asuhan Persalinan Normal...................................................................213
76. Penilaian Post Partum..........................................................................220
77. Perawatan Luka Post Partum...............................................................222
78. Kompresi Bimanual..............................................................................223
79. Inisiasi Menyusui Dini (IMD)............................................................... 225
80. Pemeriksaan Payudara dan Konseling Sadari......................................225
81. Pemeriksaan Genitalia Pria..................................................................231
82. Insisi Abses Bartholini..........................................................................233
83. Konseling Kontrasepsi......................................................................... 235
84. Pemasangan Kontrasepsi.....................................................................236
85. Konseling prakonsepsi.........................................................................241
86. Pemeriksaan ANC.................................................................................242
87. Resusitasi Bayi Baru Lahir................................................................... 243
BAB XIII. Sistem Endokrin, Metabolisme dan Nutrisi................................................248

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88. Pengaturan Diet....................................................................................248

89. Pemberian Insulin pada Diabetes Mellitus (DM) Tanpa Komplikasi....249
90. Penilaian Kelenjar Tiroid: Hipertiroid dan Hipotiroid.........................250
91. Konseling Kasus Gangguan Metabolisme dan Endokrin......................252
BAB XIV. Sistem Hematologi dan Imunologi.............................................................253
92. Palpasi Kelenjar Limfe..........................................................................253
93. Konseling Anemia Defisiensi Besi, Thalassemia dan HIV....................255
BAB XV. Sistem Muskuloskeletal............................................................................... 257
94. Pemeriksaan Tulang Belakang.............................................................257
95. Pemeriksaan Ekstremitas Atas............................................................262
96. Pemeriksaan Ekstremitas Bawah.........................................................274
97. Penilaian dan Stabilisasi Fraktur (tanpa Gips).................................... 287
98. Melakukan Dressing (sling, bandage)..................................................288
BAB XVI. Sistem Kulit dan Integumen....................................................................... 291
99. Pemeriksaan Fisik Kulit, Mukosa dan Kuku.........................................291
Pemeriksaan Efloresensi Kulit dan Pemeriksaan Jaringan Penunjang 292
BAB XVII. Lain-lain.....................................................................................................298
Pemeriksaan dan Tatalaksana Khusus Bayi dan Anak.........................................298
101. Penilaian Skor APGAR..........................................................................298
102. Palpasi Fontanella................................................................................299
103. Pemeriksaan Refleks Primitif...............................................................300
104. Penilaian Pertumbuhan dan Perkembangan.......................................301
105. Tes Rumple Leed..................................................................................304
106. Tatalaksana Berat Bayi Lahir Rendah (BBLR).....................................305
107. Peresepan Makanan Untuk Bayi..........................................................308
108. Tatalaksana Gizi Buruk........................................................................ 310
109. Pungsi Vena pada Anak........................................................................312
110. Finger Prick..........................................................................................314
Kegawatdaruratan................................................................................................ 315
111. Bantuan Hidup Dasar...........................................................................315
112. Resusitasi Jantung Paru........................................................................321

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113. Penilaian Status Dehidrasi...................................................................323

114. Resusitasi Cairan..................................................................................324
115. Tatalaksana Dehidrasi pada Anak........................................................326
116. Manuver Heimlich................................................................................327
Bedah Minor..........................................................................................................330
117. Anestesi (Infiltrasi, Blok Saraf Lokal, Topikal).....................................330
118. Jahit Luka..............................................................................................333
119. Pemberian Analgesik............................................................................335
120. Sirkumsisi.............................................................................................336
121. Insisi dan Drainase Abses.....................................................................338
122. Eksisi Tumor Jinak Kulit.......................................................................340
123. Perawatan Luka....................................................................................341
124. Ekstraksi Kuku..................................................................................... 343
Kompres terbuka dan tertutup, serta Compressive Bandage Therapy344
126. Bebat kompresi pada vena varikosum.................................................345
Keterampilan Prosedural Lain..............................................................................346
127. Peresepan Rasional..............................................................................346
128. Pungsi Vena pada Dewasa....................................................................347
129. Injeksi Intramuskular, Intravena dan Subkutan ..................................348
130. Transport Pasien..................................................................................353
131. Prosedur Skin Test Sebelum Pemberian Obat Injeksi..........................355
132. Insersi Kanula pada Vena Perifer Anak................................................356
Kesehatan Masyarakat, Kedokteran Pencegahan dan Kedokteran Komunitas.....357
133. Panduan Keterampilan Program Jaminan Mutu..................................357
134. Panduan Keterampilan Identifikasi dan Modifikasi Gaya Hidup.........363
135. Keterampilan Diagnosis Komunitas.....................................................368
Panduan Keterampilan Penegakan Diagnosis Holistik dan Keluarga .. 372
137. Panduan Keterampilan 7 Langkah Diagnosis Okupasi........................ 378
138. Surveilans.............................................................................................383
139. Pembinaan Kesehatan Usia Lanjut.......................................................387
140. Rehabilitasi Medis................................................................................402

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141. Rehabilitasi sosial bagi individu, keluarga dan masyarakat................409

Pemeriksaan Penunjang Medis.............................................................................413
142. Interpretasi Rontgen Tulang Belakang................................................413
143. Interpretasi Rontgen Toraks................................................................414
144. Uji Fungsi Paru.....................................................................................417
Pengambilan Spesimen Laboratorium..................................................................418
145. Spesimen Darah...................................................................................419
146. Spesimen Urin......................................................................................420
147. Spesimen Dahak...................................................................................420
148. Swab Tenggorokan...............................................................................421
149. Goresan Kulit........................................................................................422
150. Kerokan kulit........................................................................................423
151. Swab Anal (usap dubur).......................................................................424
152. Spesimen Tinja.....................................................................................424
Keterampilan Pemeriksaan Laboratorium...........................................................424
153. Pemeriksaan Hematologi.....................................................................425
154. Pemeriksaan Hitung Jenis Apus Darah Tepi........................................ 437
155. Pembuatan Sediaan Darah Tepi (Tebal dan Apus)..............................441
156. Pemeriksaan Laju Endap Darah (LED).................................................445
157. Pemeriksaan Masa Perdarahan............................................................446
158. Pemeriksaan Masa Pembekuan...........................................................448
159. Pemeriksaan Golongan Darah dan Antigen Rhesus.............................449
160. Pemeriksaan Tinja................................................................................450
161. Pemeriksaan Urin.................................................................................455
PEMERIKSAAN MIKROBIOLOGI...........................................................................459
162. Pemeriksaan BTA.................................................................................459
163. Pemeriksaan Duh Tubuh......................................................................461
164. Pemeriksaan Jamur Permukaan...........................................................463
165. Tes Kehamilan Rapid/ Imunokromatografi (ICT)............................... 464
166. Penilaian Fertilitas Sederhana.............................................................465
167. Fern Test.............................................................................................. 466

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168. Pemeriksaan IVA (Inspeksi Visual Asam Asetat).................................467

Pemeriksaan Kimia Klinik.....................................................................................470
169. Pemeriksaan Glukosa...........................................................................470
170. Pemeriksaan Protein............................................................................472
Kedokteran Forensik dan Medikolegal.................................................................474
171. Deskripsi luka.......................................................................................474
172. Pemeriksaan Luar pada Mayat.............................................................475
173. Pembuatan Visum et Repertum...........................................................478
174. Pengambilan muntahan atau isi lambung pada kasus medikolegal......479