Skenario C Blok 23 Tahun 2014 Kelompok B6
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Transcript of Skenario C Blok 23 Tahun 2014 Kelompok B6
Skenario C Blok 23 Tahun 2014
A female baby was born at Moh. Hosin Hospital from a 19 years old woman. Her mother, Mrs.
Solehah was hospitalized at Moh. Hoesin Hospital due to contraction. It was her first pregnancy.
She forgot when her first day of last period, but she tought that her pregnancy was about 8
months. She said that she never had hypertension or other illness during her pregnancy. Six
hours after admitted, she delivered her baby spontaneously. The labor process was 30 minutes,
and rupture of membrane happened one hour before delivery. The baby didn’t cry spontaneously
after birth, and resuscitation was done. APGAR score at 1 minute was 1, at 5 minute was 3, and
at 10 minutes was 7. One hour later the baby still had grunting and cyanosis.
On physical examination:
Body weight was 1400 gr, body length was 40 cm, and head circumference was 30 cm. The
muscle tone decreased, she poorly flexed at the limbs, she had thin skin, more lanugo over the
body and plantar creased at 1/3 anterior. At 10 minutes of age, she still had grunting and
cyanosis on the whole body. The respiratory rate was 70x/min, heart rate was 150 bpm, the
temperature was 36oC. There was chest indrawing. Other physical examinations were within
normal limit.
As general practitioner please analyze the problem and the management.
A. Klarifikasi Istilah
1. Contraction : Mendekatkan; pemendekkan atau penyusutan
2. Hypertension : Peningkatan tekanan darah di atas normal
3. Resuscitation : Memulihkan kembali kerja jantung dan paru setelah henti jantung atau
kematian mendadak nyata yang disebabkan oleh syok listrik, tenggelam, gagal
pernafasan atau penyebab lain
4. APGAR : Angka yang menunjukkan kondisi bayi, biasanya ditentukkan 60 detik
setelah lahir berdasarkan frekuensi denyut jantung, upaya bernafas, tonus, otot,
irritabilitas reflex, dan warna kulit
5. Cyanosis : Kulit dan membrane mukosa yang berwarna kebiruan atau pucat
6. Lanugo : Rambut halus dan tipis yang muncul pada kulit janin dan menghilang dalam
beberapa waktu setelah lahir.
B. Identifikasi Masalah
1. A female baby was born at Moh. Hosin Hospital from a 19 years old woman. Her
mother, Mrs. Solehah was hospitalized at Moh. Hoesin Hospital due to contraction. It
was her first pregnancy. She forgot when her first day of last period, but she tought
that her pregnancy was about 8 months.
2. She said that she never had hypertension or other illness during her pregnancy.
3. Six hours after admitted, she delivered her baby spontaneously. The labor process
was 30 minutes, and rupture of membrane happened one hour before delivery.
4. The baby didn’t cry spontaneously after birth, and resuscitation was done. APGAR
score at 1 minute was 1, at 5 minute was 3, and at 10 minutes was 7. One hour later
the baby still had grunting and cyanosis.
5. On physical examination:
Body weight was 1400 gr, body length was 40 cm, and head circumference was 30
cm. The muscle tone decreased, she poorly flexed at the limbs, she had thin skin,
more lanugo over the body and plantar creased at 1/3 anterior. At 10 minutes of age,
she still had grunting and cyanosis on the whole body. The respiratory rate was
70x/min, heart rate was 150 bpm, the temperature was 36oC. There was chest
indrawing. Other physical examinations were within normal limit.
C. Analisis Masalah
1. A female baby was born at Moh. Hosin Hospital from a 19 years old woman. Her
mother, Mrs. Solehah was hospitalized at Moh. Hoesin Hospital due to contraction. It
was her first pregnancy. She forgot when her first day of last period, but she tought
that her pregnancy was about 8 months.
a. Apa hubungan umur dengan riwayat kehamilan?
b. Bagaimana cara menentukkan usia kehamilan berdasarkan HPHT?
2. She said that she never had hypertension or other illness during her pregnancy.
a. Apa makna klinis tidak mempunyai hipertensi atau penyakit lain selama
kehamilan?
3. Six hours after admitted, she delivered her baby spontaneously. The labor process
was 30 minutes, and rupture of membrane happened one hour before delivery.
a. Apa hubungan proses persalinan spontan dengan rupture membrane (pecah
ketuban)?
b. Apa dampak rupture membrane pada ibu dan janin?
c. Apa etiologi dan mekanisme rupture membrane?
4. The baby didn’t cry spontaneously after birth, and resuscitation was done. APGAR
score at 1 minute was 1, at 5 minute was 3, and at 10 minutes was 7. One hour later
the baby still had grunting and cyanosis.
a. Apa interpretasi APGAR score di atas?
b. Apa etiologi tidak menangis spontan?
c. Apa etiologi dan mekanisme grunting?
d. Apa etiologi dan mekanisme cyanosis?
5. On physical examination:
Body weight was 1400 gr, body length was 40 cm, and head circumference was 30
cm. The muscle tone decreased, she poorly flexed at the limbs, she had thin skin,
more lanugo over the body and plantar creased at 1/3 anterior. At 10 minutes of age,
she still had grunting and cyanosis on the whole body. The respiratory rate was
70x/min, heart rate was 150 bpm, the temperature was 36oC. There was chest
indrawing. Other physical examinations were within normal limit.
a. Apa interpretasi dan mekanisme abnormal dari pemeriksaan fisik : Body weight
was 1400 gr, body length was 40 cm, and head circumference was 30 cm. The
muscle tone decreased, she poorly flexed at the limbs, she had thin skin, more
lanugo over the body and plantar creased at 1/3 anterior?
b. Apa interpretasi dan mekanisme abnormal dari pemeriksaan fisik : At 10 minutes
of age, she still had grunting and cyanosis on the whole body. The respiratory rate
was 70x/min, heart rate was 150 bpm, the temperature was 36oC. There was chest
indrawing?
c. Apa dampak dari BBLR?
6. DD
7. HTD (pemeriksaan tambahan)
8. WD
9. Epidemiologi
10. Etiologi dan Faktor Resiko
11. Patogenesis
12. Penatalaksanaan
13. Komplikasi
14. Pencegahan
15. Prognosis
16. SKDI
D. Hipotesis
Seorang bayi perempuan lahir pre-term, SGA, BBLSR lahir spontan dengan asfiksia dan
sindrom distress pernafasan
E. Learning Issue
1. APGAR
2. BBLR
3. Neonatal Asfiksia