ASUHAN KEPERAWATAN

POST PARTUM SPONTAN

Kelompok 1:
1. Alfina Choirunisa (1902040)
2. Angga Daniel R S (1902041)
3. Anggita Rizki K (1902042)
4. Aprilia Saputri (1902043)
5. Atik Surahmiyati (1902044)
6. Aulia Nur R. (1902045)
Post Partum atau masa nifas
adalah masa yang dimulai
setelah plasenta keluar dan
berakhir ketika alat-alat
kandungan kembali seperti
keadaan semula (sebelum
hamil). Masa nifas
berlangsung selama kira-
kira 6 minggu (Ary
Sulistyawati, 2009).
 Etiologi
Teori penurunan hormone
1-2 minggu sebelum partus mulai, terjadi penurunan hormone progesterone dan estrogen.
Fungsi progesterone sebagai penenang otot –otot polos rahim dan akan menyebabkan
kekejangan pembuluh darah sehingga timbul his bila progesterone turun. Teori placenta menjadi tua
Turunnya kadar hormone estrogen dan progesterone menyebabkan
Teori distensi rahim kekejangan pembuluh darah yang menimbulkan kontraksi rahim.
Rahim yang menjadi besar dan merenggang menyebabkan iskemik otot-
otot rahim sehingga mengganggu sirkulasi utero-plasenta. Teori iritasi mekanik
Induksi partus Di belakang servik terlihat ganglion servikale(fleksus franterrhauss). Bila
ganglion ini digeser dan di tekan misalnya oleh kepala janin akan timbul
Dapat pula ditimbulkan dengan jalan gagang laminaria yang dimasukan dalam kontraksi uterus.
kanalis servikalis dengan tujuan merangsang pleksus frankenhauser, amniotomi
pemecahan ketuban), oksitosin drip yaitu pemberian oksitosin menurut tetesan
perinfus.
PATOFISI Dalam masa post partum atau masa nifas, alat-alat genetalia interna
maupun eksterna akan berangsur-angsur pulih kembali seperti keadaan
sebelum hamil. Perubahan-perubahan alat genetal ini dalam

OLOGI keseluruhannya disebut “involusi”. Disamping involusi terjadi perubahan-

perubahan penting lain yakni memokonsentrasi dan timbulnya laktasi yang
terakhir ini karena pengaruh hormon laktogen dari kelenjar hipofisis
terhadap kelenjar-kelenjar mamae.
Otot-otot uterus berkontraksi segera post psrtum, pembuluh-pembuluh
darah yang ada antara nyaman otot-otot uretus akan terjepit. Proses ini
akan menghentikan pendarahan setelah plasenta lahir. Perubahan-
perubahan yang terdapat pada serviks ialah segera post partum bentuk
serviks agak menganga seperti corong, bentuk ini disebabkan oleh korpus
uteri terbentuk semacam cincin.
Klasifikasi Masa Nifas Menurut
Anggraini (2010)

01 Purperium dini
Waktu 0-24 jam post partum. Purperium dini yaitu kepulihan
dimana ibu telah diperbolehkan berdiri dan berjalan-jalan.

02 Purperium intermedial,
Waktu 1-7 hari post partum. Purperium intermedial yaitu
kepulihan menyeluruh alat-alat genetalia yang lamanya
6 minggu
 .

03 Remote purperium
 Waktu 1-6 minggu post partum. Adalah waktu yang
diperlukan untuk pulih dan sehat sempurna.
Tanda dan Gejala Masa Post Partum Menurut
Masriroh (2013)

Organ-organ Masa
reproduksi kembali
normal pada posisi
menyusui anak
sebelum dimulai
kehamilan.

Perubahan-perubahan Penyembuhan ibu dari stress

psikologis lain yang kehamilan dan persalinan di
terjadi selama asumsikan sebagai tanggung
kehamilan berbalik jawab untuk menjaga dan
(kerumitan). mengasuh bayinya..
Perubahan Fisiologis Masa Nifas

BUBBLE-LE yaitu termasuk Breast (payudara), Uterus (rahim), Bowel (fungsi

usus), Bladder (kandung kemih), Lochia (lokia), Episiotomy
(episiotomi/perinium), Lower Extremity (ekstremitas bawah), dan Emotion
(emosi). Menurut Hacker dan Moore Edisi 2 adalah :
1. Involusi Rahim : Melalui proses katabolisme jaringan, berat rahim
dengan cepat menurun dari sekitar 1000gm pada saat kelahiran
menjadi 50 gm pada sekitar 3 minggu masa nifas. Serviks juga
kehilangan elastisnya dan kembali kaku seperti sebelum kehamilan.
PowerPoint
Proses involusi uterus adalah sebagai berikut:
Presentation
Iskemia Miometrium, Atrofi jaringan , Autolysis, Efek Oksitosin .
2. Uterus
3. Uterus tempat plasenta
4. Vagina
5. Perubahan Sistem Pencernaan
6. Sistem kardiovaskuler
7. Perubahan Sistem Perkemihan
8. Perubahan psikososial
9. Kembalinya haid dan ovulasi
10.Perubahan Sistem Muskuloskeletal Ligamen, fasia, dan diafragma
pelvis
Yang meregang pada waktu persalinan
 Perubahan Psikologi
01 Taking In (istirahat/penghargaan)
selama waktu ini, ibu yang baru melahirkan memerlukan perlindungan dan perawatan, fokus perhatian ibu terutama pada
dirinya sendiri. Pada fase ini ibu lebih mudah tersinggung dan cenderung pasif terhadap lingkungannya disebabkan kare-na
faktor kelelahan. Oleh karena itu, ibu perlu cukup istirahat untuk mencegah gejala kurang tidur.

02 Fase Taking On/Taking Hold (dibantu tetapi dilatih)

Pada fase ini timbul kebutuhan ibu untuk mendapatkan perawatan dan penerimaan dari orang lain dan keinginan untuk
bisa melakukan segala sesuatu secara mandiri. Ibu mulai terbuka untuk menerima pendidikan kesehatan bagi dirinya dan
juga bagi bayinya..

03 Fase Letting Go (berjalan sendiri dilingkungannya)

Fase ini merupakan fase menerima tanggung jawab akan peran
barunya yang berlangsung setelah 10 hari postpartum.
 Kunjungan Masa Nifas
Kunjungan masa nifas paling sedikit 4 kali, kunjungan masa
nifas dilakukan untuk menilai status kesehatan ibu dan bayi
baru lahir (Saifuddin, 2010)

Penatalaksanaan

Menurut Masriroh (2013) penatalaksanan yang diperlukan untuk klien

dengan post partum adalah sebagai berikut:
1. Memperhatikan kondisi fisik ibu dan bayi.
2. Mendorong penggunaan metode-metode yang tepat dalam memberikan
makanan pada bayi dan mempromosikan perkembangan hubungan baik
antara ibu dan anak.
3. Mendukung dan memperkuat kepercayaan diri si Ibu dan
memungkinkannya mingisi peran barunya sebagai seorang Ibu, baik dengan
orang, keluarga baru, maupun budaya tertentu.
KONSEP ASUHAN KEPERAWATAN
PADA POST PARTUM SPONTAN

1. PENGKAJIAN

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 DIAGNOSA KEPERAWATAN

05
04
03 Gangguan intergritas kulit/jaringan bd luka
episiotomi perineum
Diagnosa keperawatan yang muncul
02
.
pada pasien nifas spontan adalah
01 Ansietas bd tanggung jawab menjadi orang
tua

Defisit nutrisi bd peningkatan kebutuhan

karena laktasi
.
Nyeri akut bd agen pencedera fisik, luka
episiotomi post partum spontan
.
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THANK YOU