ASUHAN KEPERAWATAN

PADA ANAK DENGAN

GANGGUAN ASMA
Dosen : Yusiana Vidhiastutik.,S.Kep.,Ns

1. Nur Kholis (2020030041)

2. Moh. Bahrawi A.R (2020030040)
3. Qatrunnada Fitri Zahranie R.S (2020030049)
4. Elsa Agustin (2020030050)
5. Syifa Hayati (2020030057)
6. Florensia Kamat (2020030091)
 PENGERTIAN

Asma adalah suatu peradangan pada bronkus akibat reaksi

hipersensitif mukosa bronkus terhadap bahan allergen. Reaksi
hipersensitif pada bronkus dapat mengakibatkan
pembengkakan pada mukosa bronkus (Riyadi & Sukarmin,
2013). Asma merupakan suatu penyakit dengan ciri
meningkatnya respon trakhea dan bronchus terhadap berbagai
rangsangan dengan manifestasi adanya penyempitan jalan
napas yang luas dan derajatnya dapat berubah-ubah secara
spontan maupun sebagai hasil pengobatan (Muttaqin, 2012).

Menurut pendapat yang dinyatakan Somantri (2012), asma adalah suatu gangguan pada
saluran bronkial yang mempunyai ciri bronkospasme periodik (kontraksi spasme pada
saluran napas) terutama pada percabangan trakeobronkial yang dapat diakibatkan oleh
berbagai stimulus 10 seperti oleh faktor biokemikal, endokrin, infeksi, otonomik, dan
psikologi (SUSETHA, 2020).
ETIOLOGI

Faktor perinatal seperti prematuritas

dan berat badan lahir rendah diduga
memiliki asosiasi positif dengan
kejadian asma pada anak. Beberapa
penelitian menunjukkan hasil yang
berbeda. Penelitian yang dilakukan di
USA menunjukkan adanya hubungan
antara usia gestasional ≤ 37 minggu
dengan kejadian asma. Munculnya
asma pada anak dengan riwayat BBLR
(Berat Badan Lahir Rendah)
dan prematur diduga berhubungan
dengan gangguan suplai nutrien yang
menyebabkan terhambatnya
pertumbuhan paru.
 Patofisiologi!

Asma pada anak terjadi adanya penyempitan pada jalan napas dan hiperaktif dengan
respon terhadap bahan iritasi dan stimulus lain Bahan iritasi atau allergen otot-otot
bronkus menjadi spasme dan zat antibodi tubuh muncul (immunoglobulin E atau Ig
E) dengan adanya alergi. Ig E muncul pada reseptor sel mast yang menyebabkan
pengeluaran histamin dan zat mediator lainnya yang akan memberikan gejala asma.
Respon asma terjadi dalam tiga tahap: pertama tahap immediate yang ditandai dengan
bronkokonstriksi (1-2 jam), tahap delayed di mana bronkokonstriksi dapat berulang
dalam 4-6 jam, tahap late ditandai dengan peradangan dan hiperresponsif jalan napas
beberapa minggu/bulan. Selama serangan asma, bronkiolus menjadi meradang dan
peningkatan sekresi mukus.
 Patofisiologi!

Keadaan ini menyebabkan lumen jalan napas menjadi bengkak, kemudian

meningkatkan resistensi jalan napas dan menimbulkan distres pernapasan
(Marni, 2014). Anak yang mengalami asma mudah untuk inhalasi dan sukar
untuk ekshalasi karena ada edema jalan napas. Kondisi seperti ini
menyebabkan hiperinflasi pada alveoli dan terjadi perubahan pertukaran gas.
Jalan napas menjadi obstruksi yang kemudian tidak adekuat ventilasi dan
saturasi oksigennya, sehingga terjadi penurunan PaO2 (hipoksia), selama
serangan karbondioksida tertahan dengan meningkatnya resistensi jalan napas
selama ekspirasi, dan menyebabkan asidosis respiratorik dan hiperkapnea.
Kemudian sistem pernapasan akan mengadakan kompensasi dengan
meningkatkan pernapasan (takipnea), yang bisa menimbulkan hiperventilasi
dan dapat menurunkan kadar karbondioksida dalam darah yang disebut
sebagai hipokapnea (Suriadi dan Yuliani, 2010: 14 dikutip dari Marni, 2014).
Manifestasi Klinis

Penderita asma biasanya keluhan bisa dirasakan pada saat serangan. Tanda dan gejala yang jelas
terlihat pada saat serangan adalah sesak napas. Sesak napas ini sangat menyiksa anak, anak akan
terlihat gelisah, cemas, labil, dan kadang-kadang bisa terjadi perubahan tingkat kesadaran. Jika anak
kita ajak komunikasi, anak akan terlihat sulit berbicara, dan akan menjawab sepatah dua patah kata
(Marni, 2014). Gejala lain yang bisa kita lihat adalah takipnea, takikardi, othopnea disertai
wheezing, diaphoresis, dan bisa juga muncul nyeri abdomen karena penggunaan otot abdomen
dalam pernapasan. Gejala diperberat apabila mengalami dyspnea dengan lama ekspirasi:
penggunaan otot-otot asesori pernapasan, cuping hidung, retraksi dada, dan stridor. Keadaan tersebut
menandakan adanya pneumonia, disertai batuk berdahak dan demam tinggi. Pada saat serangan
seperti ini pasien tidak toleran terhadap aktivitas, baik makan, bermain, berjalan, bahkan berbicara
(Marni, 2014).
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“This is a quote, words full of
wisdom that someone important
said and can make the reader get
inspired.”

—Someone Famous
 Identifying information

Mercury Venus Mars

It’s the closest planet to Venus has a beautiful Despite being red, Mars is
the Sun and the smallest name and is the second actually a cold place. It’s
one in the Solar System planet from the Sun full of iron oxide dust
 A picture is
worth a
thousand words
 Patient medical history

Age 27 Allergies None

Gender Female Location Madrid, Spain

2018 2019 2022

Mercury Mars Neptune
Mercury is the closest Despite being red, Mars is It’s the farthest planet
planet to the Sun actually a very cold place from the Sun
 Review of systems

Venus Jupiter
Venus is the Jupiter is the
second planet Mars biggest planet Saturn
from the Sun of them all
Despite being Saturn is a gas
red, Mars is a giant and has
cold place several rings
 Physical examination

Mercury
It’s the closest planet to the
Sun and the smallest one in
the Solar System—it’s only
a bit larger than the Moon
Venus
Venus has a beautiful name
and is the second planet
from the Sun. It’s has a
poisonous atmosphere
 Findings
Evolution Prevalence

75%
Jupiter is a gas giant and the
biggest planet in the Solar
System

Follow the link in the graph to modify its data and then paste the new one here. For more info, click here
 Discussion

Dr. Jenna Doe

“Mercury is the closest planet to the Sun and
the smallest one in the Solar System—it’s
only a bit larger than the Moon”

Dr. John James

“Venus has a beautiful name and is the
second planet from the Sun. It’s hot and has a
poisonous atmosphere”
Discussion summary

Mercury is the closest planet to the Sun

and the smallest one in the Solar System
—it’s only a bit larger than the Moon.
The planet’s name has nothing to do
with the liquid metal, since Mercury was
named after a Roman god
 Comparison

Mercury Yes No Yes No No

Jupiter No No Yes No Yes

Mars Yes No Yes Yes No

Saturn Yes Yes No Yes No

 Diagnosis

Mercury Venus Mars

It’s the closest planet Venus is the second Mars is actually a very
to the Sun planet from the Sun cold place

Jupiter Saturn Neptune

Jupiter is the biggest It’s composed of It’s the farthest planet
planet of them all hydrogen and helium from the Sun
 Patient monitoring

Week 1 Week 2

Mercury is the closest planet to the Sun Venus has a beautiful name and is the
and the smallest one of them all—it’s second planet from the Sun. It’s hot and
only a bit larger than the Moon has a poisonous atmosphere

Topic 1 60%
Week 3
Topic 2 70%
Topic 3 80% Venus Mars
Topic 4 65% 80% 60%
Awesome
words
 Treatment

Venus Saturn
Venus has a beautiful name Saturn is a gas giant and has
and is the second planet from several rings. It's composed
the Sun. It’s terribly hot mostly of hydrogen

Mars Jupiter
Despite being red, Mars is Jupiter is actually a gas giant
actually a cold place. It's full and the biggest planet in the
of iron oxide dust Solar System
 Contraindications & indications

Contraindications Indications

● Describe the reasons to stop the treatment
here
● Describe the reasons to stop the treatment
here
● Describe the reasons to stop the treatment
here
● Describe the reasons to stop the treatment
here
● Describe the reasons to stop the treatment
here
● Describe the reasons to start the treatment
here
● Describe the reasons to start the treatment
here
● Describe the reasons to start the treatment
here
● Describe the reasons to start the treatment
here
● Describe the reasons to start the treatment
here
9h 55m 23s
Jupiter’s rotation period

333,000
The Sun’s mass compared to Earth’s

386,000 km
Distance between Earth and the Moon
 Post-prevention

Mercury Jupiter
It’s the closest planet to It’s the biggest planet of
the Sun them all

Venus Saturn
It’s the second planet Saturn is giant and has
from the Sun several rings
 Case timeline

Day 1 Day 2 Day 3 Day 4 Day 5

Mercury Venus Mars Jupiter Saturn

It’s the closest It has very high Mars is actually a It doesn’t have a It’s a gas giant
planet to the Sun temperatures very cold place solid surface with rings
150,000
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Saturn
Saturn is a gas giant and has
several rings. It's composed
mostly of hydrogen and helium

Neptune
It’s the farthest planet from the
Sun. It's also the fourth-largest
object by diameter
 Conclusions
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