Tugas Kk Melati.docx

  • October 2019
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1. Tuan AS dengan umur 65 tahun dibawa kerumah sakit karena mengalami penurunan kesadaran, sesak, batuk, serta apatis. dengan BB 60 KG, TB 160 CM. TD 166/79 MMHG. suhu 36 c dan urine 500 cc. tuan AS dahulunya seorang perokok aktif serta gemar mengkonsumsi makan yang digulai dan mempunyai riwayat TB serta didiagnosa oleh dokter mengalami COPD disertai stroke dan ancaman gagal nafas. pasien masuk ruang HDU dan diberikan obat ranitidine, inf RL 20 tts/mnt combifent dan dezametil. Dari hasil lab diketahui sebagai berikut. Ureum 55 mg/gl Creatinin 0,9 mg/dl Uric Acid 3,2 mmol/L Bilirubin 1,14 g/dl Hb 13,6 mmol/L Rbc 4,21 mmol/L WBC 6,26 mmol/L HCT 44,6 U/L PLT 142 U/L PCT 0,14 g/dl SGOT 149 U/L SGPT 101 U/L PENYELESAIAN : Kebutuhan basal nutrisi/ hari : -

25 kal x 60 kg 1 gr x 60 kg

= 1500 kalori = 60 gram

Alternatif pemberian cairan nutrisi : HARI I

:

 Dextrose 10% (2) + Dextrose 10% (1) + dextrose 5% (2) + Aminovel (2) =  400 kal + 200 kal + 200 kal = 800 kalori  Protein : 50 = 50 gram HARI II

:

Parenteral partial

:

  

Dextrose 5% (2) + dextrose 10% (2) + panamin G (1) = 200 kkal + 400 kal = 600 kal protein : 27 gram

Enteral 

:

Sonde 600 cc = 600 kkal Komposisi : margarin 5 gr, k.telur 20 gr, gula 10, maizena 5 , susu skim 15 dalam (200 kkal = 200 cc)

Hari III : Parenteral partial   

Dextrose 5% (1) + dextrose 10% (2) + Panamin (1) = 100 kkal + 400 kal = 500 kal protein : 27 gram AA

Enteral 

:

:

Sonde 1000 cc = 1000 kkal Komposisi : margarin 5 gr, k.telur 15 gr, gula 10, maizena 8 , susu skim 15 dalam (200 kkal=200 cc)

Hari IV : Enteral 

:

Sonde 1250 cc = 1250 kkal + sari buah jeruk 250 cc = 300 kkal = 1500 kkal Komposisi : margarin 9 gr, telur 25 gr, gula 15, maizena 10 , susu skim 20 dalam (250 kkal = 250 cc) protein : 50,4 gram

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