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Seminar Managed in Mr.

MF patients with Nursing


Diagnosis Shares in rehabilitation of men's special
programs spital Sambang Lihum
06 -14 March 2018

Profession Ners Program Study Science Nursing


Medical Faculty
University of Lambung Mangkurat
Group D
 Fransisca Purba, S.Kep NIM. 1730913320003
 Ranchika May I, S.kep NIM. 1730913320008
 Isnawati, S.Kep NIM. 1730913320011
 Nadia, S. Kep NIM. 1730913320012
 Heriyadi S. Kep NIM. 1730913320022
 Anisa Rahmawati,S.Kep NIM. 1730913320022
CONCEPT

 Low self esteem


Low self-esteem is a negative feeling to oneself, loss of
self-esteem and self-esteem, failing to achieve desire.
signs and symptoms of low
self-esteem
 signs and symptoms of low self-esteem are:
1.Feel himself lower than others
2. Criticize yourself and others
3. Interference in relation
4. Excessive self-importance
5. Feelings of inadequacy
6. Guilt
7. A pessimistic outlook on life
8. Rejection of personal ability
9. Social withdrawal
10. Worry and withdraw from reality
Nursing Care Mr.MF
ASSESSMENT

 Room care : rehabilitation of men's special programs


 Date in care : 09 March 2018

IDENTITAS KLIEN
 Initial : Mr.MF (L)
 Age : 21 yo
 Education : SMP
 occupation : nothing
 Informan : client and medical records
 Marital status : single
 No.RMK : 02-39-XX
 Tanggal Pengkajian: 23-29 March 2018
ASSESSMENT

 Reason for sign in


Clients say brought to the hospital by the supplier and the family (mother) using the car because the client
rampaged, angry, turned on the television aloud, and fighting with his father while carrying a knife due to
the influence of drug abuse, clients using shabu, alcohol, glue fox, inex , paramex, dextro and zineth.
Clients also say seeing black shadows and occult whisperings at night when clients use substance. The client
often laughs and speaks alone at night until no sleep during the night. In the beginning when the client was
seen, he responded more curtly and loudly at the time of the interview

DX : the risk of violent behavior

Currents major complains


Pada saat dilakukan pengkajian klien tidak fokus pada pembicaraan. Klien terlihat lebih sering menunduk dan diam pada saat
ditanya. Klien mengatakan malu bila berbicara dengan banyak orang. Klien mengatakan lebih senang menyendiri dan tidak suka
keramaian. Klien terlihat sulit berkomunikasi dengan teman diruangan. Klien mengatakan kurang percaya diri dibandingkan
teman yang lainnya. Pada jam istirahat klien lebih sering tidur daripada melakukan aktivitas. Klien terlihat kurang bersemangat
dalam melakukan kegiatan. Klien tidak dapat memulai percakpan terlebih dahulu dengan orang lain. Pada saat pengkajian klien
beberapa kali menolak untuk diwawancarai.

DX : low self esteem


ASSESSMENT

 Precipitations Factor

Client said the use of drugs (inex, dextro, zineth) from 2012 to one day
before entering RSJ with the frequency of use 2 grains per day. Clients say
the use of shabu from 2015 with the frequency of a packet per day, the client
initially given by his friends then because it was addicted to the client bought
it yourself with the price of 300,000 packs, the client said comfortable, clear
mind, and the load was lost when using shabu. Clients say using paramex
since 2017 clients use as much as 1 chip a day (4 seeds), after drinking
perceived client is not stress and comfortable. The client also said using
alcohol such as (tuak and wine malaga) to get drunk with his friend every
drunk client says a bottle runs out.
ASSESMENT
ASSESSMENT

 An unpleasant past experience


 Clients say her mother takes care of divorce in 2017,
and divorced a month before entering the RSJ, so
now clients live with mother, sister and grandmother
in one house. Clients say his father is often rude to
his mother so often trigger a quarrel within the
house. Clients say it would be preferable if their
father and mother separated.
 Physical examination
 · Vital signs : TD: 120/90 mmHg, N: 82x / min, R: 22x /m,
Q: 36,5̊C
 · Measure : TB = 166 cm BB = 50 kg
 · Physical complaints : Yes No
ASSESSMENT

 Psikosocial

1. Genogram

In the data obtained by the nurse, the client is a child who


has both living parents but has a divorce in 2016. The
client has an eight-year-old sister. The client lives in the
same house with his mother, grandmother and sister.
DX : family coping is not effective
ASSESSMENT

 Self Concept: The client says no body parts are preferred


 Social Relations: Clients say satisfied to be male
 Spritual: client acts as a child to his mother and father, playing a role
as grandchild for her grandmother and as kaka for her sister. Clients work as
laborers bangunan.
 Ideal self: The client hopes to be a useful and useful person
for others, can work and study.
 Self-esteem: Clients feel ashamed of their state of being only graduates
Elementary school and can not continue school. Clients say they want to be
like other families, intact. Clients said they were embarrassed to see Dad
coming home drunk and angry. The client says it does not have any merit.
ASSESMENT

Social Relationship :
a Person who means:
The client says the person closest to her is her biological mother. But if
there is a problem, the client solves his problem by taking illicit drugs.
b Participation in group / community activities:
While at home, clients say they are not involved in group or community
activities. Clients do not like to mingle with the crowd. Clients prefer to be
alone and do their own activities. Clients only out of the house if the invite
friends - drunk, while the client at the RSJ clients are seen more often quiet
and sleep to play with other people. The client must be directed by the
nurse to perform the activity.
c Obstacles in dealing with others:
Client can not start a conversation with other people. Clients prefer solitary
and silent indoors.

DX : low self esteem


ASSESSMENT

Conversation :
When conducting the assessment, the client answers the
questions given in a slow, slow voice, the client is seen
more often silent and indirectly answered when given a
question. The client is unable to start a conversation with
the nurse or with friends in the room.
motorik activity :
Clients follow the activities in the room on schedule.
When clients are on the move, clients look lethargic and
uninspired. Clients walk slowly, more down and prefer to
sleep than on the move. The client has no initiative to
start activities.

DX : low self esteem


ASSESSMENT

Natural Feelings :
Clients are seen more silent and bow their heads. The client said earlier
that he did not want to be rehabilitated, but now the client has a family-
defined choice. When asked about the client's current feelings, the client
responds to his usual feelings, no sadness, no fear, no despair, no worry
and no excessive excitement
DX : family coping is not effective
Affect :
client affair is flat. The client shows a flat expression every time he or
she talks and interacts
DX :low self esteem
ASSESSMENT

Interaction during interview :


Clients answer questions with short words. Clients only want to talk to
one person only, and do not want to talk too long. Client eye contact is
missing with the nurse, the client is more likely to bend down and
answer questions slowly and slowly.
DX :low self esteem
Coping Mechanism :
Clients say if you have a problem always solve it by drinking alcohol and
taking drugs. The client is seen to have a slow reaction each time the
nurse asks for things related to her life. The client is seen always
avoiding when the nurse approaches too much and gives too many
questions. Clients also always dodge and sit on the end while watching
tv in the room or during rest hours.
DX : individual coping is not effective
ASSESSMENT
ASSESSMENT

Lack of knowledge about :


Clients say if you have a problem or a mind that
disturbs them, the client solves them by consuming
alcohol and illegal drugs.
DX : Individual coping is not effective
Diagnosa Medis dan Terapi
Diagnosis Medik:

F. 19. 5 dan F.20


Terapi Medik

Clozapine

THP
Analisis Data
Maladaftif data Nursing problems
DS :
1. The client says shy of talking to the crowd
2. Clients say prefer to be alone and do not like crowd low self esteem

DO :
1. The client is seen more often ducked and silent when asked
2. Clients find it difficult to communicate with friends in the room.

DS ;
1. Clients say if you have a problem always vent with drinking alcohol
and taking illegal drugs. Individual coping is not effective

2. Client said the use of drugs (inex, dextro, zineth) from 2012 to one
day before entering RSJ with the frequency of usage 2 grains per
day.
DO :
1. The client seems to have a slow reaction every time the nurse asks
her life-related questions
2. The client is seen always avoiding when the nurse approaches too
much and gives too many questions
Maladaftif data Nursing problems

DS
1. At home, clients say seeing black shadows and occult whisperings at
night when clients use substance. Hallucinations
DO
1. At home, clients often laugh and speak for themselves at night, and can
not sleep all night.

DS :
1. Client says fighting with his father and carrying a knife the risk of violent behavior
2. Client said never committed acts of violence that hit his biological
father before entering the RSJ.
DO :
1. In the beginning when the client is seen more and more reply cute and
hard at the time of the interview.
Nursing Diagnose

low self esteem hallucinations

the risk of violent behavior


individual coping is not effective
Tree Problems
the risk of violent
hallucinations
behavior

low self esteem

Individual coping is not effective