ASUHAN KEPERAWATAN

DIARE PADA ANAK

MK KEPERAWATAN ANAK I
DOSEN: SURIYANTI SYARIFUDDIN, S.KEP.,NS.,M.KEP.
POKOK BAHASAN
Pengertian, Klasifikasi Diare
01
Etiologi dan Patofisiologi Diare
02
Manifestasi Klinis dan Penanganannya
03
Pengkajian Keperawatan
04
Diagnosa dan Rencana Keperawatan
05
 PENGERTIAN

Diare adalah.............
Keadaan frekuensi buang air besar lebih dari 4 kali pada bayi dan lebih dari 3 kali
pada anak, dengan konsistensi feses cair, dapat berwarna hijau atau dapat
bercampur lendir dan darah, atau lendir saja.
 Klasifikasi Diare
Diare Akut
Diare yg terjadi secara mendadak dan
berlangsung kurang dari 7 hari pada bayi
dan anak yg sebelumnya sehat.
Biasanya lebih dari 3x sehari
Dapat disertai demam dan muntah
Penyebab utama rotavirus (50-60%),
cholera, E.coli dan salmonella
Sindrom disentri apabila diare dengan
tinja encer disertai lendir dan darah.
Penyebab utama Shigella.
Diare Kronik
Sekitar 5% diare akut karena sesuatu hal
akan memanjang >14 hari dan disebut
diare kronik atau diare persisten.
Faktor resiko antara lain :
Usia <1tahun, gizi kurang, prematuritas,
anemia, gangguan antibiotik, dan diare
berulang.
Penyebab diare persisten antara lain
intoleransi laktosa, alergi susu sapi,
sindrom malabsorpsi, bakteri tumbuh
lampau, infeksi persisten, AAD dan HIV.
 Etiologi

Faktor infeksi Faktor Malabsorbsi

Enteral : infeksi saluran Malabsorbsi
pencernaan oleh bakteri, karbohidrat Faktor Makanan Faktor Psikologis
virus, dan parasit Intoleransi laktosa,
Parenteral : infeksi penyebab diare Dapat terjadi karena
diluar saluran umumnya pada bayi mengkonsumsi Dapat terjadi karena
pencernaan. dan anak. makanan basi, beracun, rasa takut dan cemas
Malabsorbsi lemak dan dan alergi terhadap berlebihan
protein makanan tertentu.
 Patofisiologi

Gangguan Osmotik Gangguan Sekresi Gangguan Motilitas Usus

Adanya makanan atau zat Akibat rangsangan tertentu Hiperperistaltik akan
yang tidak dapat diserap (misalnya toksin) pada menyebabkan
akan menyebabkan dinding usus akan terjadi berkurangnya kesempatan
tekanan osmotik dalam peningkatan sekresi ,air usus untuk menyerap
lumen usus meningkat dan elektrolit ke dalam makanan sehingga timbul
sehingga terjadi lumen usus dan diare. Sebaliknya bila
pergeseran air dan selanjutnya timbul diare peristaltik usus menurun
elektrolit ke dalam lumen karena peningkatan isi akan mengakibatkan
usus. Isi rongga usus yang lumen usus. bakteri tumbuh berlebihan,
berlebihan akan selanjutnya dapat tinbul
merangsang usus untuk diare pula.
mengeluarkannya
sehingga timbul diare.
 Manifestasi Klinis
Akibat diare Sering BAB dgn konsistensi tinja cair 01
1. Kehilangan air dan Kram perut, kembung
elektrolit
2. Gangguan gizi
3. Hipoglikemi
4. Gangguan sirkulasi
Suhu badan meningkat 02
.
darah
Mual, muntah, anoreksia
Mukosa bibir kering, turgor kulit 03
jelek

Lemah dan pucat 04

ubun- ubun cekung, kelopak
mata cekung, urine output
menurun.
PENGKAJIAN KEPERAWATAN
 Riwayat Kesehatan
Aktivitas Sehari-hari Keluhan Utama Riwayat Kesehatan Lalu
Nutrisi, Cairan, Eliminasi, Riwayat Kesehatan *Prenatal
Istirahat Tidur, Olahraga, Diagnosa masuk. *Natal
Personal Hygiene,
*Postnatal ►
Rekreasi.

Riwayat Untuk semua Usia

Riwayat Kesehatan Keluarga Riwayat penyakit sebelumnya
Riwayat Psikososial Riwayat konsumsi obat-obatan.
Riwayat Spiritual Riwayat Alergi
Riwayat Hospitalisasi Riwayat Imunisasi
Tumbuh kembang
 Riwayat Kesehatan Lalu
Prenatal Natal Post Natal

Riwayat pemeriksaan
kehamilan, kehamilan yg
Tempat melahirkan,
Berat badan lahir,
keberapa, keluhan selama lama dan jenis
panjang badan ,
hamil, Riwayat konsumsi persalinan, penolong
kondisi kesehatan
obat-obatan selama hamil, persalinan, penyulit
waktu lahir, apgar
riwayat imunisasi, usia persalinan, komplikasi
gestasi. score, ada kelainan
waktu lahir.
kongenital.
 Pemeriksaan Fisik (1)
Tanda-tanda Vital TD, Nadi, Suhu, Pernapasan

Biasanya pernapasan agak cepat,

01 bentuk dada normal, dan tidak
ditemukan bunyi nafas tambahan
Sistem Pernapasan
Biasanya tidak ditemukan adanya
02 kelainan, denyut nadi cepat dan lemah. Sistem Kardiovaskular
Ditemukan gejala mual dan muntah,
mukosa bibir dan mulut kering,
03 peristaltik usus meningkat, anoreksia,
BAB lebih dari 3 kali dengan
Sistem Pencernaan
konsistensi encer
 Pemeriksaan Fisik (2)
04 Kelemahan fisik akibat output
yang berlebihan Sistem Muskuloskeletal

Mata cekung. Hidung dan telinga

05
tidak ada kelainan Sistem Indera
06 Volume diuresis menurun. Sistem Perkemihan
Lecet sekitar anus, kulit teraba hangat,
07 turgor kulit jelek Sistem Integumen
Pemeriksaan Tingkat Perkembangan
0-6 tahun dengan menggunakan DDST
 Motorik kasar
01  Motorik Halus
 Bahasa
 Personal Sosial
02

6 Tahun ke atas
03  Perkembangan Kognitif
 Perkembangan Psikoseksual
 Perkembangan Psikososial
04
Diagnosa Keperawatan
Diare b.d. Faktor fisiologis (inflamasi, malabsorbsi, proses infeksi, iritasi),
01 faktor situasional (keracunan, efek samping obat, kontaminasi), faktor psi
kologis (stress dan cemas tinggi)

Hipertermi b.d. Peningkatan metabolisme, dehidrasi, proses

02 infeksi

Ketidakseimbangan volume cairan kurang dari kebutuhan tubuh

03 b.d. Kehilangan cairan aktif, kegagalan mekanisme pengaturan.

Resiko Syok
04
Kecemasan orang tua b.d. Penyakit anaknya
05
 Diare
Observasi
Identifikasi penyebab diare Edukasi
Identifikasi riwayat pemberian Anjurkan makanan porsi kecil dan
makanan sering secara bertahap
Monitor karakteristik dan volume tinja Anjurkan menghindari makanan
Monitor iritasi kulit perianal pembentuk gas
Monitor tanda dan gejala hipovolume Anjurkan melanjutkan pemberian ASI

Manajemen
Diare
Terapeutik Kolaborasi
•Berikan asupan cairan oral Kolaborasi pemberian cairan
intravena
Kolaborasi pemberian obat
Ketidakseimbangan volume cairan kurang dari kebutuhan tubuh

Observasi
Periksa tanda dan gejala hipovolemia Edukasi
(misalnya frek. Nadi meningkat, nadi Anjurkan meningkatkan asupan
teraba lemah, TD meningkat, turgor cairan oral
kulit menurun, membran mukosa kering, Anjurkan melanjutkan pemberian ASI
hematokrit meningkat, haus, lemah) Anjurkan menghindari perubahan
Monitor intake dan output cairan posisi mendadak

Manajemen
Hipovolemia
Terapeutik Kolaborasi
•Hitung kebutuhan cairan Kolaborasi pemberian obat
•Berikan asupan cairan oral
 Our Services

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Manifestasi Klinis
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