KEPERAWATAN PERIOPERATIF

LOGO MANAJEMEN NYERI

PRINSIP PRINSIP PENGELOLAAN NYERI PADA POST
OPERASI

DI SUSUN OLEH KELOMPOK 4 DOSEN PEMBIMBING :

TINGKAT III.B Detiana,S.Kep,Ners,M.Kes
1.Anjani
2.Bella Meilyanti
3.Cici Windiani
4.Dicky Dwi Cahyo
5.Dimas Abriantori Yogantara
6.Dinda Yunita
7.Elvira Eka Agustina
8.Erin Mariska
9.Eska Dwi Prajayanti
10.Gelora Tiara Insani

POLTEKKES KEMENKES PALEMBANG PRODI DIII KEPERAWATAN LAHAT

PENGERTIAN
The International Association for the Study of Pain (IASP)
mendefinisikan nyeri sebagai berikut nyeri merupakan pengalaman

? sensorik dan emosional yang tidak menyenangkan akibat adanya

kerusakan atau ancaman kerusakan jaringan.

Nyeri merupaakan kondisi berupa perasaan yang tidak menyenangkan, bersifat sangat
subjektif. Perasaan nyeri pada setiap orang berbeda dalam hal skala ataupun tingkatannya,
dan hanya orang tersebutlah yang dapat menjelaskan atau mengevaluasi rasa nyeri yang
dialaminya (Tetty, 2015). Menurut Smeltzer & Bare (2002), definisi keperawatan tentang
nyeri adalah apapun yang menyakitkan tubuh yang dikatakan individu yang mengalaminya,
yang ada kapanpun individu mengatakkannya.
FISIOLOGI NYERI
1 Reseptor khusus yang disebut nociceptors, pada
sistem saraf perifer, mendeteksi dan menyaring
intensitas dan tipe stimulus noxious.(orde 1)

2 Saraf aferen primer (saraf A-delta dan C)

mentransmisikan stimulus noxious ke CNS.

Kornu dorsalis medulla spinalis adalah tempat dimana

3 terjadi hubungan antara serat aferen primer dengan
neuron kedua dan tempat kompleks hubungan antara
lokal eksitasi dan inhibitor interneuron dan traktus
desenden inhibitor dari otak.
Traktus asending nosiseptik (antara lain traktus
4 spinothalamikus lateralis dan ventralis)
menyampaikan signal kepada area yang lebih
tinggi pada thalamus. (orde 2)
 JENIS-JENIS NYERI
1.Nyeri somatik luar
Nyeri yang stimulusnya berasal dari kulit, jaringan subkutan dan
membran mukosa. Nyeri biasanya dirasakan seperti terbakar, jatam dan
terlokalisasi
2. Nyeri somatik dalam
Nyeri tumpul (dullness) dan tidak terlokalisasi dengan baik akibat
rangsangan pada otot rangka, tulang, sendi, jaringan ikat.
3. Nyeri viseral
Nyeri karena perangsangan organ viseral atau membran yang
menutupinya (pleura parietalis, perikardium, peritoneum). Nyeri tipe ini
dibagi lagi menjadi nyeri viseral terlokalisasi, nyeri parietal terlokalisasi,
nyeri alih viseral dan nyeri alih parietal.
Berdasakan derajat nyeri dikelompokan menjadi:
1.Nyeri ringan adalah nyeri hilang timbul, terutama saat beraktivitas
sehari hari dan menjelang tidur.
2.nyeri sedang nyeri terus menerus, aktivitas terganggu yang hanya
hilan gbila penderita tidur.
3. Nyeri berat adalah nyeri terus menerus sepanjang hari, penderita tidak
dapat tidur dan dering terjaga akibat nyeri.
Berdasarkan jenisnya nyeri juga dapat diklasifikasikan menjadi:
1. Nyeri nosiseptif
2.Nyeri neurogenik
3.Nyeri psikogenik
Berdasarkan timbulnya nyeri dapat diklasifikasikan menjadi:
1. Nyeri akut
2. Nyeri kronik
 Diagnostik Nyeri

1.Anamnesis Yang teliti

2. Pemeriksaan fisik
3. Pemeriksaan psikologis
4. Pemeriksaan penunjang
 Manajemen Nyeri
1. Pendekatan farmakologi
Teknik farmakologi adalah cara yang paling efektif untuk menghilangkan nyeri dengan pemberian obat-
obatan pereda nyeri terutama untuk nyeri yang sangat hebat yang berlangsung selama berjam-jam atau
bahkan berhari-hari. Metode yang paling umum digunakan untuk mengatasi nyeri adalah analgesic
(Strong, Unruh, Wright & Baxter, 2002).
Menurut Smeltzer & Bare (2002), ada tiga jenis analgesik yakni:
A. Non-narkotik dan anti inflamasi nonsteroid (NSAID):
B.Analgesik narkotik atau opiad:
C.Obat tambahan atau ajuvant (koanalgesik):

2. Intervensi Keperawatan Mandiri (Non farmakologi)

Intervensi keperawatan mandiri menurut Bangun & Nur’aeni (2013), merupakan tindakan pereda nyeri
yang dapat dilakukan perawat secara mandiri tanpa tergantung pada petugas medis lain dimana dalam
pelaksanaanya perawat dengan pertimbangan dan keputusannya sendiri
 Faktor –faktor yang mempengaruhi nyeri
A. Usia
B. Jenis kelamin
C. Kebudayaan
D. Perhatian
E. Ansietas
F. kelemahan
G. Pengalaman sebelumnya
H. Gaya koping
I. Dukungan keluarga dan sosial
J. Makna nyeri
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