LAPORAN PENDAHULUAN DAN

ASUHAN KEPERAWATAN
PADA PASIEN DENGAN EPILEPSI
Disusun Oleh : Kelompok 9
 
Abdul Majid (201801155)
Heni Rahayaan (201801173)
Vivi Nur Wijayanti (201801147)
Yonas Tayanan (201801167)
 Epilepsi adalah penyakit serebral kronik dengan
Epilepsi ? karekteristik kejang berulang akibat lepasnya muatan listrik
otak yang berlebihan dan bersivat reversibel. Epilepsi
adalah gangguan kronik otak dengan ciri timbulnya gejala-
gejala yang datang dalam serangan-serangan, berulang-
ulang yang disebabkan lepas muatan listrik abnormal sel-sel
saraf otak, yang bersifat reversibel dengan berbagai
etiologi .
 
Epilepsi adalah sindroma otak kronis dengan berbagai
macam etiologi dengan ciri-ciri timbulnya serangan
paroksismal dan berkala akibat lepas muatan listrik neron-
neron otak secara berlebihan dengan berbagai manifestasi
klinik dan laboratorik. Epilepsi dapat menyerang anak-anak,
orang dewasa, para orang tua bahkan bayi yang baru lahir
(Utopias,2008).
 Klasifikasi Epilepsi

Place Your Picture Here Place Your Picture Here Place Your Picture Here

Epilepsi Epilepsi
Epilepsi
Grand Mal Fokal
Petit Mal
 Etiologi Epilepsi
Penyebab pada kejang epilepsi Cedera Kepala,
sebagian besar belum diketahui Infeksi sistem
(Idiopatik) Sering terjadi pada: syaraf

Kelainan Keracunan CO,

pembuluh intoksikasi
darah obat/alkohol

Trauma lahir,
Tumor Asphyxia
Otak neonatorum

hipokalsemia,
Demam, ganguan
hiponatremia)
metabolik
(hipoglikemia,
 Manifestasi Klinis
1. gejala kejang yang spesifikakan
tergantung pada macam kejangnya. 85% 35% 65% 45%
Jenis kejang dapat bervariasi antara
pasien, namun cenderung serupa.
2. kejang komplek parsial dapat
termasuk gambaran somatosensori
atau motor fokal.
3. Kejang komplek parsial dikaitkan
dengan perubahan kesadaran
4. ketiadaan kejang dapat tampak
relative ringan, dengan periode
perubahan kesadaran hanya sangat
singkat (detik)
5. Kejang tonik klonik umum
merupakan episode konvulsif utama
dan selalu dikaitkan dengan
kehilangan kesadaran (Yuliana
elin,2009)
 Place Your Picture Here And Send To Back

PATOFISIOLOGI
EPILEPSI
 Komplikasi
100%
1. Kerusakan otak akibat
90%
hypoksia dan retardasi
80%
mental dapat timbul akibat
70%
kejang berulang ulang.
60%
2. Dapat timbul depresi dan
50%
keadaan cemas.
40% 3. Komplikasi utama yang
30% berkaitan dengan kejang
20% umum.
10% 4. Kejang disebabkan oleh
0% kontak neuro serebral yang
Category 1 Category 2 Category 3 Category 4
beraturan, cepat dan tiba-
tiba.
 Penatalaksanaa

Tujuan utama dari terapi epilepsi adalah tercapainya kualitas hidup

penderita yang optimal. Ada beberapa cara untuk mencapai tujuan tersebut
antara lain Menghentikan bangkitan, mengurangi frekuensi bangkitan tanpa
efek samping ataupun dengan efek samping seminimal mungkin serta
menurunkan angka kesakitan dan kematian. (Arif, Mansjoer)
 Lanjutan

Non
farmakologi

Farmakologi
Dalam
farmakoterapi
 PENGKAJIAN
Identitas klien meliputi nama, umur, jenis kelamin,
tangal pengkajian, No register, tanggal rawat dan
penanggung jawab dan perawat mengumbpulkan
informasi informasi tentang riwayat kejang pasien.
ASUHAN Pasien ditanyakan tentang faktor atau kejadian yang
KEPERAWATAN dapat menimbulkan kejang. Asupan alkohol dicatat.
Efek epilepsi pada gaya hidup dikaji (Utopias,2008):
• ada keterbatasan yang ditimbulkan oleh gangguan
kejang
• pasien mempunyai program rekreasi atau Kontak
sosial
• pengalaman kerja
• Mekanisme koping yang digunakan
• Obsevasi dan pengkajian selama dan setelah
kejang akan membantu dalam mengindentifikasi
tipe kejang dan penatalaksanaannya.
 
Lanjutan Selama serangan

Sesudah serangan

Riwayat sebelum serangan

Riwayat Penyakit
Riwayat kesehatan

Riwayat kejang
Riwayat penggunaan obat
Pemeriksaan fisik

Psikososial

Pengetahuan pasien dan keluarga

 • Ketidakefektifan bersihan jalan nafas
berhubungan dengan sumbatan lidah di
endotrakea, peningkatan sekresi saliva,
keruskan neromuskuler
• Termogulasi tidak efektif : Hipertermi
Diagnosa berhubungan dengan peningkatan
metabolik, proses infeksi
Keperawatan • Resiko terhadap cidera berhubungan
dengan perubahan kesadaran,
keruskan kognitif selama kejang, atau
kerusakan mekanisme perlindungan diri
dan aktivitas kejang yang terkontrol
( gangguan keseimbangan )
• Kurang pengetahuan mengenai kondisi
dan aturan pengobatan berhubungan
dengan kurang pemanjaan, kesalahan
interprestasi, kurang mengingat
(Rencana Asuhan Keperawatan :262-
 INTERVENSI
Rencana asuhan  
Keperawatan 1. Anjurkan klien untuk
mengosongkan mulut dari
benda/zat tertentu
1. Ketidakefektifan bersihan jalan nafas 2. Letakkan klien dalam
berhubungan dengan sumbatan lidah di posisi miring dan pada
endotrakea, peningkatan sekresi saliva, permukaan datar
keruskan neromuskuler.
3. Tanggalkan pakaian klien
Tujuan : Setelah dilakukan askep 3x24 Jam
pada daerah leher atau
masalah bersihan jalan nafas tidak efektif tidak
dada dan abdomen
terjadi dan teratasi.
Kriteria hasil : nafas normal ( 25 – 30 x/menit ),
4. Melakukan penghisapan
tidak tejadi aspirasi, tidak ada dispnea, tidak ada
sesuai indikasi
penumpukan sekret.  
5. Berikan oksigen sesuai
program terai
RASIONAL
 
1. Menurunkan resiko aspirasi
atau masuknya sesuatu benda
asing kedalam tirah baring
2. Meningkatkan aliran (drainase),
sekret, mencegah lidah jatuh
dan menyumbat jalan nafas
3. Untuk memudahkan usaha klien
dalam bernafas dan ekspansi
dada
4. Mengeluarkan mukus yang
berlebihan menurunkan resiko
aspirasi atau afeksia
5. Membantu pemenuhi kebutuhan
oksigen adar tetap adekuat.

2. Termogulasi tidak efektif :
Hipertermi berhubungan
dengan peningkatan
metabolik, proses infeksi
Tujuan : Setelah dilakukan askep
3x24 Jam, masalah termogulasi tidak
efektif teratasi.
Kriterua hasil : Demam berkurang,
suhu normal 36,5 – 37,5 ̊ C , Nadi dan
RR normal, tidak ada perubahan warna
kulit
INTERVENSI
1. Kaji faktor-faktor terjadinya
peningkatan suhu
2. Observasi tanda – tanda vital
3. Ajarkan keluarga cara
memberikan kompres dibagian
kepala / ketiak
4. Anjurkan untuk menggunakan
pakaian tipis yang terbuat dari
kain katun
5. Berikan ekstra cairan dengan
menganjurkan klien banyak
minum
RASIONAL
1. Mengetahui penyebab terjadinya
peningkatan suhu tubuh karena
penambahan pakaian / selimut dapat
menghambat penurunan suhu.
2. Pemantauan tanda vital yang teratur
dapat menentukan perkembangan
keperawatan selanjutnya.
3. Proses konduksi / perpindahan panas
dengan suatu bahan perantara.
4. Proses hilangnya panas akan
terhalangi oleh pakaian tebal dan
tidak dapat menyerap keringat.
5. Kebutuhan cairan meningkat karena
penguapan tubuh yang meningkat.
 INERVENSI RASIONAL
   
3. Resiko terhadap cidera 1. Identifikasi faktor lingkungan 1. Dengan menjauhkan barang-barang
berhubungan dengan
yang memungkinkan resiko disekitarnya dapat membahayakan
perubahan kesadaran,
terjadinya cidera saat terjadinya kejang
keruskan kognitif selama
2. Pasang penghalang ditempat 2. Penjagaan untuk keamanan, untuk
kejang, atau kerusakan
mekanisme perlindungan diri tidur mencegah terjadinya cidera pada
dan aktivitas kejang yang 3. Letakkan klien ditempat tidur klien
terkontrol ( gangguan yang rendah & datar 3. Area yang rendah dan datar dapat
keseimbangan ) 4. Siapkan kain lunak untuk mencegah terjadinya cidera pada
Tujuan : Setelah dilakukan askep mencegah terjadinya klien
selama 3x24 Jam masalah resiko tergigitnya lidah saat kejang  4. Lidah berpotensi tergigit saat kejang
terhadap cidera teratasi dan tidak
5. Berikan obat anti kejang karena saat kejang biasanya lidah
terjadi.
menjulur kedepan 
Kriteria Hasil : tidak terjadi cidera
5. Mengurangi aktivitas kejang yang
fisik pada klien, klien dalam kondisi
aman, tidak ada memar dan tidak ada berkepanjangan yang dapat
resiko terjatuh. mengurangi suplai oksigen
 INTERVENSI RASIONAL
1. Jelaskan mengenai prognosis 1. Memberikan kesempatan untuk
4. Kurang pengetahuan penyakit dan perlunya mengklarifikasi kesalahan persepsi &
mengenai kondisi dan aturan pengobatan keadaan penyakit yang ada
pengobatan berhubungan 2. Berikan informasi yang adekuat 2. Pengetahuan yang diberikan mampu
dengan kurang pemanjaan, tentang prognosis penyakit dan menurunkan resiko dari efek bahay
kesalahan interprestasi, kurang tentang interaksi obat yang satu penyakit & cara menanganinya
mengingat.
potensial 3. Kebutuhan terpeutik dapat berubah
Tujuan : Setelah dilakukan askep 1x24
3. Tekankan perlunya untuk sehingga mempersiapkan
Jam masalah kurang pengetahuan
mengenai kondisi dan aturan pengobatan melakukan evaluasi yang kemungkinan yang akan terjadi
teratasi. teratur/melakukan pemeriksaan 4. Aktivitas yang sedang & teratur dapat
Kriteria hasil : Mampu mengungkapkan laboratorium sesuai indikasi membantu
pemahaman tentang gangguan dan 4. Diskusikan manfaat kesalahan menurunkan/mengendalikan faktor
berbagai rangsangan yang telah umum yang baik, seperti diet presdiposisi
diberikan, mulai merubah perilaku, yang adekuat, & istirahat yang
mentaati peraturan obat yang diresepkan. cukup
 Implementasi

Pelaksanaan keperawatan
merupakan kegiatan yang Evaluasi
dilakukan sesuai dengan Tahap evaluasi dalam proses
rencana yang telah keperawatan menyangkut
ditetapkan. Selama pengumpulan data subyektif
pelaksanaan kegiatan dapat dan obyektif yang akan
bersifat mandiri dan menunjukkan apakah tujuan
kolaboratif. Selama pelayanan keperawatan sudah
melaksanakan kegiatan dicapai atau belum. Bila perlu
perlu diawasi dan dimonitor langkah evaluasi ini
merupakan langkah awal dari
kemajuan kesehatan klien
identifikasi dan analisa
( Santosa. NI, 1989;162 )
. masalah selanjutnya
( Santosa.NI, 1989;162).
 
THANK YOU
Kelompok 9
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Get a modern PowerPoint Get a modern PowerPoint Get a modern PowerPoint
Presentation that is Presentation that is Presentation that is
beautifully designed. beautifully designed. beautifully designed.
 Infographic Style

Your Text Here Your Text Here Your Text Here Your Text Here

Simple PowerPoint Simple PowerPoint Simple PowerPoint Simple PowerPoint

Presentation Presentation Presentation Presentation

You can simply impress You can simply impress You can simply impress You can imply impress
your audience and add a your audience and add a your audience and add a your audience and add a
unique zing and appeal to unique zing and appeal to unique zing and appeal to unique zing and appeal to
your Presentations. your Presentations. your Presentations. your Presentations.

$29.99 $14.99 $10.99 $9.99

Column 01 PowerPoint Presentation
Style You can simply impress your audience and add a unique zing and appeal to your
Presentations. Easy to change colors, photos and Text. I hope and I believe that this
Template will your Time, Money and Reputation. I hope and I believe that this
Template will your Time, Money and Reputation. Get a modern PowerPoint
Presentation that is beautifully designed. Easy to change colors, photos and Text.
You can simply impress your audience and add a unique zing and appeal to your
Presentations. I hope and I believe that this Template will your Time, Money and
Reputation.

You can simply impress your audience and add a unique zing and appeal to your
Presentations. Easy to change colors, photos and Text. I hope and I believe that this
Template will your Time, Money and Reputation. I hope and I believe that this
Template will your Time, Money and Reputation. Get a modern PowerPoint
Presentation that is beautifully designed. Easy to change colors, photos and Text.
Get a modern PowerPoint Presentation that is beautifully designed. You can simply
impress your audience and add a unique zing and appeal to your Presentations.
Easy to change colors, photos and Text. I hope and I believe that this Template will
your Time, Money and Reputation.

Get a modern PowerPoint Presentation that is beautifully designed. Easy to change

colors, photos and Text.
THANK YOU
Insert the Subtitle of Your Presentation
Fully Editable Shapes
Fully Editable Shapes
 Fully Editable Icon Sets: A

You can Resize without

losing quality
You can Change Fill
Color &
Line Color

FREE
PPT
TEMPLATES
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 Fully Editable Icon Sets: B

You can Resize without

losing quality
You can Change Fill
Color &
Line Color

FREE
PPT
TEMPLATES
www.allppt.com
 Fully Editable Icon Sets: C

You can Resize without

losing quality
You can Change Fill
Color &
Line Color

FREE
PPT
TEMPLATES
www.allppt.com