Ikterus Neonatorum MR 2016
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Transcript of Ikterus Neonatorum MR 2016
8/19/2019 Ikterus Neonatorum MR 2016
http://slidepdf.com/reader/full/ikterus-neonatorum-mr-2016 1/101
LAPORAN PAGISENIN, 15 MARET 2016
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CHECK LIST REKAM MEDIS
(JCI)15 MARET 2016
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LEMBAR
IDENTITAS PASIEN
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FOTO PASIEN (diambi b!"da#a"$a% i&i%
'"a%*a +a#i!%)
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FOTO GELANG IDENTITAS
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KIE
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PEN,ANTAR RA-AT INAP
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REKAM MEDIS ILMU KESEHATAN
ANAK
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,ENERAL CONSENT
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HASIL LAB
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Pa#i!%#!ama.D'$!"
#!ama
@copyr!"#$SMF%IKA%SANGLAH
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STANDAR M&I'Management of Communication and Information(
@copyr!"#$SMF%IKA%SANGLAH
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6 #a#a"a% IPS, 'International Safety Goal(
– M)*+-+. /).#+ )c+r+ #)p+#
–
M)..!+#+. o-.+ y+.! )3)#3 – M)..!+#+. )++.+. p).!!-.++. o4+#
y+.! ))r*-+. p)r"+#+.
– M).!-r+.! ro +*+" *o+, +*+" p+).
/+. +*+" #./++. – M).!-r+.! ro .3)
– M).!-r+.! ro p+). c)/)r+ +r).+ +#-"
@copyr!"#$SMF%IKA%SANGLAH
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La$#a%a$a% id!%i/$a#i+a#i!%
• S++# )4)r+. o4+#
• S++# )4)r+. /+r+" /+. pro/-/+r+"
• S++# ).!+4* +p)* /+r+"
• S++# ).!+4* +p)* *+..y+-.#- p))r++.
• S++# )*+-+. #./++. /+.pro)/-r
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m!%*%a$a% !a%
+a#i!%• G)*+.! bi"* -.#- p+). *+$*+
• G)*+.! +i%$ -.#- p+). p)r)p-+.
• G)*+.! $*%i% -.#- p+). ro +#-"
• G)*+.! m!"a -.#- p+). +*)r!
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IDENTITAS
• NAMA BPAP
• 7ENIS KELAMIN L+$*+
• TANGGAL LAHIR 1180982016
• USIA 9 "+r• ALAMAT 7*% P-*+- K+) No%6
• NO &M 1600:502
•
TANGGAL MRS 1;80982016 '20%00 <ITA(
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HETEROANAMNESIS
• K-..!
KELHAN TAMA
• P+). /)*-"+. -..! y+.! /+/+r )+ 2 "+r)4)*- +- RS '++# -+ 1 "+r(% A=+*.y+-..! /+#++. #+p+ p+/+ +#+ /+. =++",.+-. )+. "+r )+. )*-+% S++# .-..! /#)-+. ".!!+ / #-.!+ 4+y, .+-.
#/+ ).c+p+ #)*+p+ #+.!+. /+. +%• B+y +- .- ASI /+. )+p-+. "+p/+#++. 4+ '#/+ -.#+"(, pro/- ASI/+#++. 4+, 4+y /4)r .- + 4+y).+.!, /+. + #/-r /4+.!-.+. )#+p 2 +-.#- /4)r .-%
• B+y "+.y+ )./+p+#+. ASI #+.p+ -- 3or-*+%
RI-A3AT PEN3AKIT SEKARAN,
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• R=+y+# /)+, )+.!, 4+#-$p*) +-p-. )+.+p+ /+.!+*%
• BAB /+#++. )#+r 9 > )"+r, o.#). ).#+*,=+r.+ )-..!+., BAB /)p-* /+.!+*
• BAK /+#++. .or+* =+r.+ -..!, BAK #)r+"r 15).# )4)*- +- r-+" +# .+-. ?o*-)#/+ /)#+"- '/+p)r 4+y #+p+ p).-"(
• R=+y+# ).!!-.++. +p-r 4+r- p+/+ p+++. +#+-)#+r #)p+# #/-r 4+y #/+ +/+%
•
R=+y+# #r+-+ +*+. *+"r +-p-. p+c+ *+"r/+.!+*
RI-A3AT PEN3AKIT SEKARAN,
HETEROANAMNESIS
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•
P+). )r-p++. +.+ p)r#++, I4-r-#. o.#ro* )"+*+. ) /o#)r Sp%OG%USG '( ;>, /+#++. .or+*% S++#"+* /+#++. "+.y+ ).!o.-?#+. y+.! /4)r+. /o#)r
+./-.!+.%• HPHT *-p+• TP 11809816
RI<AAT ANTENATAL
• P+). *+"r /).!+. )c#o c+))+,/#o*o.! o*)" /o#)r, /+#++. *+"r)!)r+ ).+.!, /).!+. BBL 2:00!r+ /+. PBL ;C c, )*+.+. 4+=++.
#/+ /#)-+. ++# *+"r%
&ARA PERSALINAN
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R=+y+# p).y+# )p)r# D+4)#) M)*#-,H)p+## B, TB, +.#-.!, +-p-. ++ /+.!+*o*)" 4- p+).%
RI<AAT PENAKIT IBU
•
R=+y+# p)r/+r+"+. )*++ )"+*+. '$(,r=+y+# )#-4+. p)c+" /. '$(, #+./+$#+./+!+=+# +.. '$(, .y)r ++# BAK '$(, /)+'$(, )p-#"+. '$(, r=+y+# #)r+p/)>+)#"+o.) *).!+p '$( r=+y+# #)r+p
*+. '$(
RI<AAT INTRANATAL
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FAKTOR RISIKO
MAOR MINORI4- /)+'T9:(
'$( KPD '12 +( '$(
KPD 2; + '$( A+ '$(Koro+.o.# '$( BBLSR
'1500('$(
F)#+* /#r) '$( UK 9C !! '$(
K)#-4+. "+- '$( G))* '$(
K)p-#"+. '(
T)r+.!+ ISK '$(
I4- /)+ '$(
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Sa*# P"!#!% 4
A#?#+ To.- R)) &--p
T+.! &--pD).y-# 7+.#-.! 1;0>8).#, r)!-*)r , c--p
R)pr+ ;2>8).#
S-"- +>**+ 96,0 º&
SpO2 5 /).!+. -/+r+ r-+.!+.Sor Ny)r 'NPAT( 0
P))r++. F
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B!"a Bada% Lai" (BBL) 200 !r+
P+.+.! B+/+. L+"r 'PBL( ;C c
L.!+r K)p+*+ 'LK( 99 c
L.!+r D+/+ 'LD( 99 cB!"a Bada% S!$a"a% 200
!r+
P+.+.! 4+/+. )+r+.! ;: c
L.!+r K)p+*+ )+r+.! 99 c
L.!+r D+/+ )+r+.! 9; c
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KEPALA
Bentuk : Normosefali
UUB : Terbuka datar
UUK : Terbuka datar
Sefal hematom : tidak ada
Caput succedaneum : tidak ada
Wajah : dismorfik (!
MATA : Konjun"ti#a pucat ($!% sklera kuning (+/+)% reflek
pupil (&$&!% pupil isokor (&$&!
THT
Napas cupin" hidun" (!% sianosis (!Telin"a : lipatan sempurna pada semua ba"ian pinna% kartila"o pada pinna sudah
terbentuk% teraba anti tra"us' Kelainan (!
MULUT
Sianosis (!% celah palatum (!% mukosa bibir basah% sianosis mukosa dan lidah (!
PEMERIKSAAN FISIS
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LEHER
P)4)+r+. K)*).+r G)#+" B)..! '$(, +- -/- '$(
THORA4B).#- )#r, r)#r+ '$(Ar)o*+ ++) #)r+4+ / +#+ -*#, /+)#)r ; 8;
C'" 4I pr)cor/+* 4-*!.! '$(, c#- cor/ '$(, /).y-#)p!+#r- #/+ #+p+A- S1 S2 #)r/).!+r .or+*, r)!-*)r, -r-r '$(
P*m'4I 4).#- .or+*, )#r #+#8/.+, r)#r+
-4co#+*8.#)rco#+* '$(
P+ !)r++. /+/+ )#r #+#8/.+
A- 4ro.o?)-*+r 8, r+*) $8$, =")).! $8$
PEMERIKSAAN FISIS
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ABDOMEN
istensi : tidak ada
Bisin" usus : (&! normal
)ena : pembuluh #ena besar tidak tampak
*epar : just palpable
lien : tidak teraba
Tali +usat : tera,at
Tanda perdarahan : +etekie tidak ada% purpura tidak ada
ANUS : (&!% kelainan tidak ada
GENTALA EKSTE!NA :
-akilaki
E"T!EMTAS +lantar crease pada .$/ anterior% Capillar0 1efill Time 2 / detik%
KULIT
k#erus Kra$er %
KUKU : mencapai ujun" jari
KELANAN BA&AAN : tidak ada
PEMERIKSAAN FISIS
RESM
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RESME
P+). *+$*+8-+ 9 "+r /).!+. )*-"+. -..!,
+=+*.y+ -..! /+#++. #+p+ p+/+ +#+ /+.=++" /+. )*-+ ".!!+ ++# . -..! #+p++p+ #-.!+ .+-. #/+ p+/+ #)*+p+ #+.!+./+. +%
B+y +- .- ASI /+. )+p-+. "+p/+#++. 4+ '#/+ -.#+"% Pro/- ASI/+#++. 4+, 4+y /4)r .- + 4+y).+.!, /+. + #/-r /4+.!-.+. -.#- /4)r
.-% R=+y+# /)+ '$(%
P+/+ p))r++. p+). /#)-+. #)r-r+)r IJ%
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DIAGNOSIS KER7A
Ikterus Neonatorum
et causa breast feeding jaundice(P59.!
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PLAN OF CAREDa7a"
Ma#aa
R!%8a%a
I%!"9!%#i
Ta"!
I#)r-.)o.+#or-
Fo#o#)r+p 9 > 2; +ASI o. /)+./
I#)r- #)r+#+/+*+ =+#- 9 >2; +
R)oHpo#)r
7+!+ )"+.!+#+. S-"- #)r+!+96,5$9C,5 º&
Ri#i$' I%7!$#i Ra:a ai +*#a Tida$ !";adi
i%7!$#i +adaba<i
R)oHypo!*)+
P)4)r+. ASI o./)+./
Hypo!*)+#/+ #)r+/
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P))r++. P).-.+.!
P+r+)#)r RSUPS+.!*+"P%
11%09<ITA
S+#-+.
N*+R--+.
B*r-4. #o#+* 16.1= !8/* 0,00$6,00
B*r-4. /r) 0.6 !8/L 0,00$0,;0
B*r-4../r)
15.>? !8/L 0,00$0,:0
TERAPI @
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TERAPI @TINDAKAN
P*+...! T!"a+i
• MRS• R+=+# 4o>, O2 r-+.!+.
• K)4-#-"+. c+r+. 0 L8! BB8 "+r 252 L8 "+r 20 )*++ 3o#o#)r+p
902 L8 "+r ASI o. /)+./ .+* 90 L @ 9 +• Fo#o#)r+p 9 > 2; +
Dia%'#i# •
&) 4*r-4. p+c+ 3o#o#)r+p '1580982016(M'%i'"i%
• 7+!+ )"+.!+#+., r+=+# #+* p-+#, ?#+* !.
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ASSESMENT
Ikterus Neonatorum
et causa breast feeding jaundice (P59.!
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FOLLO- P (15 Ma"! 2016. P$0600)
KELUHAN S4 I.#+4*#+ -"- '$(, -..! '(
O4 S#+#- Pr)).# A#?#+ To.- R)) &--p
T+.! &--pD).y-# 7+.#-.! 1;2>8).#, r)!-*)r
R)pr+ ;2>8).#S-"- +>**+ 9C,2&SpO2 C /).!+. -/+r+ r-+.!+.Sor Ny)r 'NPAT( 0
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KEPALA
Bentuk : Normosefali
UUB : Terbuka datar UUK : Terbuka datar
Sefal hematom : tidak ada
Caput succedaneum : tidak ada
Wajah : dismorfik (!%
MATA : konjun"ti#a pucat ($!% sklera kunin" (&$&!% reflek
pupil (&$&!% pupil isokor (&$&!
THT
Napas cupin" hidun" (!% sianosis (!
Telin"a : lipatan sempurna pada semua ba"ian pinna% kartila"o pada pinna sudahterbentuk% teraba anti tra"us' Kelainan (!
MULUT
Sianosis (!% celah palatum (!% mukosa bibir basah% sianosis mukosa dan lidah
(!
PEMERIKSAAN FISIS
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LEHER
P)4)+r+. K)*).+r G)#+" B)..! '$(, +- -/-'$(
THORA4B).#- )#r, r)#r+ '$( Ar)o*+ ++) #)r+4+ / +#+ -*#, /+)#)r 9
89
C'" 4
I. pr)cor/+* 4-*!.! '$(, c#- cor/ '$(, /).y-#)p!+#r- #/+ #+p+
A- S1 S2 .or+* r)!-*)r, -r-r '$(
P*m'4
I. 4).#- .or+* )#r #+#8/.+, r)#r+-4co#+*8.#)rco#+* '$(
A- Bro.o?)-*)r 8, r"+*) $8$, =")).! $8$
PEMERIKSAAN FISIS
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ABDOMEN
istensi : tidak ada
Bisin" usus : (&! normal
)ena : pembuluh #ena besar tidak tampak
*epar : Just palpable
lien : tidak teraba
Tali +usat : Sudah lepas
ANUS : (&!% kelainan tidak ada
GENTALA EKSTE!NA :
-akilaki
E"T!EMTAS
+lantar crease pada .$/ anterior% Capillar0 1efill Time 2 / detik KULIT
k#erus (+) Kra$er %
KUKU : mencapai ujun" jari
KELANAN BA&AAN : tidak ada
PEMERIKSAAN FISIS
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ASSESSMENT
Ikterus Neonatorum
et causa breast feeding jaundice
(P59.!
TERAPI @
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TERAPI @TINDAKAN
P*+...! T!"a+i R+=+# 4o>, O2 r-+.!+.
• K)4-#-"+. c+r+. 0 L8! BB8 "+r 252 L8 "+r 20 )*++ 3o#o#)r+p
902 L8 "+r ASI o. /)+./ .+* 90 L @ 9 +• Fo#o#)r+p 9 > 2; +
Dia%'#i# •&) 4*r-4. p+c+ 3o#o#)r+p '1580982016(
M'%i'"i%• 7+!+ )"+.!+#+., r+=+# #+* p-+#, ?#+* !.
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TERIMA KASIH
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D).
HIPERBILIRBINEMIA
B*r-4. )r- #o#+* 'BST( 5 !8/L ' :6 o*8L(
ENSEFALOPATI BILIRBIN AKT
M+.3)#+ +-# /+r #o#+ 4*r-4., #)r*"+#p+/+ .!!-$.!!- p)r#++ )"/-p+.
KERNIKTERS
S)-)* *. #o#+ 4*r-4. y+.! ro. p)r+.).
Subcommitee on "y#erbilirubinemia. Clinical #ractice guidelines$ Management of %y#erbilirubinemia in t%e ne&born '5 or more
&eeks gestation. Pediatrics ))*+ ,,*$9-',/.Porter M01 2ennis 30. "y#erbilirubinemia in t%e term ne&born. 4m am P%ysic ))+ /5$599/)/.
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P!"ma#aaa% K*%i%Pada Ba<i C*$*+ B*a%
• S)#+r 60 4+y 4+r- *+"r y+.!)"+# /).!+. -+ !)#+ 95
.!!- /+p+# ).+/ -..!' jaundice(
• S)4+!+. 4)+r jaundice +/+*+" .+
•
O*)" +r).+ po#). #o /+r4*r-4.
Semua bayi baru la%ir %arusdi#antau untuk mendeteksi
kemungkinan menjadi
yperbilirubinemia. Clinical practice guidelines: Management of hyperbilirubinemia in the newborn 35 or more weeks gestation. Pediatrics!!"# $$":%&'3$(
Por#)r ML, D).. BL% Hyp)r4*r-4.)+ . #") #)r .)=4or.)% A F+ P"yc 2002 655$606%
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P!"ma#aaa% K*%i%Pada Ba<i K*"a% B*a%
• S)#+r :0 4+y -r+.! 4-*+.).!+*+ jaundice p+/+ .!!-
p)r#++ )"/-p+.• S)+. -/+ -+ !)#+
–U+ )r#ro# *)4" .!+#
–K)+p-+. ")p+r 'u#take o.-!+ /+*+ "+#( 4)*- op#+*
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Permasalahan )uning Pada *ayi)urang *ulan+ ,sambungan-
• M))r*-+. *)4" 4+.y+=+#- -.#- ).!"*+.!+p+ /).!+. 2 .!!-
katan /okter 0nak ndonesia ,/0-. Paket Pelatihan Pelayanan 1bstetri dan 2eonatal mergensi )omprehensif
,P12)-: 0suhan 2eonatal sensial. !!4
A=#+. #)r+/ *)4" /.
P-.c+ *)4" *+4+#
K+/+r p-.c+ *)4" #.!!
F $ Ri i$ Hi bii bi i B
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Fa$'" Ri#i$' Hi+!"bii"*bi%!mia B!"a(Pada Ba<i #ia ,!#a#i 5 Mi%*)
F+#or Ro M+yor
• S)4)*- p-*+.! BST 4)r+/+ / +r)+ ro #.!! '!r+(
• 6aundice #)r*"+# /+*+ 2; + p)r#++ )"/-p+.
• I.op+#4*#+ !o*o.!+. /+r+" /).!+. #) +.#!*o4-*./r) y+.! '(, p).y+# ")o*# ' /)). G6PD(
• U+ !)#+ 95$96 .!!-
• S+-/+r+ +./-.! /).!+. r=+y+# 3o#o#)r+p
• S)3+*")+#o +#+- )+r y+.! !.+.
• ASI )*-3, #)r-#++ 4*+ p)r+=+#+. #/+ 4+
p).-r-.+. BB +.!+# 4+.y+
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Gr+ Ro
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Fa$'" Ri#i$' Hi+!"bii"*bi%!mia B!"a(Pada Ba<i #ia ,!#a#i 5 Mi%*)
F+#or Ro M.or
• S)4)*- p-*+.! .*+ BST 4)r+/+ / *)?)* ).).!+"
• U+ !)#+ 9C$9: .!!-
• 6aundice #)r*"+# )4)*- 4+y /p-*+.!+.
• S+-/+r+ +./-.! /).!+. r=+y+# jaundice
• B+y +roo /+r 4- /+4)#
• U+ 4- 25 #+"-.
• 7). )*+. *+$*+
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Gr+ Ro
P!d'ma% T!"a+i Si%a"
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P!d'ma% T!"a+i Si%a"Pada Ba<i #ia ,!#a#i 5 Mi%*
• G-.++. 4*r-4. #o#+*% 7+.!+. /-r+.! /).!+. 4*r-4. /r) +#+- 4*r-4. #)ro.-!+• F+#or ro p).y+# ")o*# o-., /)). G6PD, ++, *)#+r! !.+.,
.#+4*#+ -"-, )p, +/o +#+- +*4-. 9%0 !r8/L '+ /--r(• U.#- .)o.+#- 95$9C .!!- /).!+. o./ )"+# .#)r?). /+p+# ).!+c- p+/+ !+r
/ )#+r ro )/+.!%• T)r+p .+r o.?).o.+*8#+./+r /+p+# /*+-+. / R-+" S+# +#+- / r-+" 4*+ +/+r
BST 2$9 !8/L /4+=+" !+r cut o7 #oint '95$50 o*8L(% T)r+p .+r / r-+" #/+/+.-r+. p+/+ 4+y y+.! )p-.y+ 3+#or ro%
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Pedoman erapi SinarPada *ayi 6sia 7estasi+ ,sambungan-
• P).!!-.++. 3o#o#)r+p .#).3B*+ .*+ BST -/+" )*+p+- cut
o7 #oint -.#- 3o#o#)r+p p+/+)#+p +#)!or%
50
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APAKAH FOTOTERAPI INTENSIF
–
8adiasi dalam spektrum biru'hi9au ,pan9anggelombang antara "3!'"%! nm- setidaknya
3! ;<=cm per nm ,diukur pada kulit bayi
secara langsung di bawah pertengahan unit
fototerapi- > diarahkan ke permukaan kulit
bayi seluas'luasnya
• Pengukuran harus dilakukan dengan
radiometer spesi?k dari manufaktur unit
fototerapi tersebut 51
Hyperbilirubinemia. Clinical practice guidelines: Management of hyperbilirubinemia in the newborn 35 or more weeks gestation. Pediatrics
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EFEK SUMBER &AHAA DAN 7ARAK DARI SUMBER &AHAA
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EFEK SUMBER &AHAA DAN 7ARAK DARI SUMBER &AHAA TERHADAP BAI DALAM RADIASI SPEKTRAL RATA$RATA
52
• T! +''!"a+< *%i :a# /!d :i !i 2>i% '*"!#!8!% *b!#
• I%di8a!# #+!8ia b*!. ,!%!"a E!8"i8 20- F20T12@BB *b!
• B*!. ,!%!"a E!8"i8 20- F20T12@B b*! *b!#
• Da<i b*!. > ,!%!"a E!8"i8 20- F20T12@B b*! *b!# > S<9a%ia 20-
F20T12@D da<i *b!#
• Da<i. S<9a%ia 20- F20T12@D da<i *b!
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LEBIH LANJT TENTAN,FOTOTERAPI
• B*+ +/+r BST ).c+p+ 8 )*)4"
!+r #r+.3- #-+r, $ /+r
bassinet , .-4+#or, +#+- p).!"+.!+#
"+r- /*+p /).!+. )r#+
+*-.- +#+- *.). =+r.+ p-#"
"+* . ++. Q *-+ p)r-++.
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Hyperbilirubinemia. Clinical practice guidelines: Management of hyperbilirubinemia in the newborn 35 or more weeks gestation. Pediatrics
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BERAPA PENRNAN BILIRBIN 3AN,
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BERAPA PENRNAN BILIRBIN 3AN,DIHARAPKAN BILA MEN,,NAKAN
FOTOTERAPI INTENSIF G
• K+/+r 4*r-4. )#/+.y+ 0%51
!8/L p)r + /+*+ ;: +
p)r#++
• K+/+r 4*r-4. 90$;0 o*8L /+*+
2; + '/4+./.!+. +/+r
4*r-4. 6$20 o*8L /).!+.
3o#o#)r+p #+./+r( 5;
Hyperbilirubinemia. Clinical practice guidelines: Management of hyperbilirubinemia in the newborn 35 or more weeks gestation. Pediatrics
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FOTOTERAPI
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FOTOTERAPIINTERMITEN S KONTIN3
B*+ +/+r 4*r-4. ).c+p+ o.+ #r+.3- #-+r
3o#o#)r+p "+r- /4)r+. )c+r+ o.#.y-
+p+ #)r+/ p).-r-.+. BST y+.! /"+r+p+.
+#+- +p+ /*+-+. #r+.3- #-+r%
Fo#o#)r+p /+p+# /.#)r-p8/#op )++# p+/+
++# p)4)r+. .- +#+- p))r++.
y+.! .!+# #/+ +/+ 4-# *+" y+.!
).y+#++. )3)#?#+ 3o#o#)r+p .#)r#).%
55
Hyperbilirubinemia. Clinical practice guidelines: Management of hyperbilirubinemia in the newborn 35 or more weeks gestation. Pediatrics
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PEDOMAN TRANSFSI TKAR
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PEDOMAN TRANSFSI TKARPADA BA3I SIA ,ESTASI 5 MIN,,
• Tr+.3- #-+r )!)r+ /r)o)./++. + .)o.+#- ).-.-+. #+./+ ).)3+*op+# 4*r-4.+-# '"p)r#o., )+.!, retrocollis, op#o#o.-, /)+, %ig% #itc% cry ( +#+- 4*+ +/+r BST 5!8/* ':5 o*8L( /+r !+r y+.! /#).#-+.
• U-r )r- +*4-. /+. "#-.! p)r4+./.!+. 4*r-4.8+*4-.•
G-.++. 4*r-4. #o#+*% 7+.!+. /-r+.! /).!+. 4*r-4. /r) +#+- 4*r-4. #)ro.-!+
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KAPAN FOTOTERAPI HARSDIHENTIKAN G
• T/+ +/+ #+./+r p+# -.#- ).!").#+.
3o#o#)r+p%
• Fo#o#)r+p /+p+# /").#+. 4*+ +/+r BST
-/+" 4)r+/+ / 4+=+" .*+ cut o7 #oint /+r
)#+p +#)!or%
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KAPAN FOTOTERAPI HARUS
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KAPAN FOTOTERAPI HARUSDIHENTIKAN %%% (sambungan!
• U.#- 4+y y+.! /r+=+# / RS p)r#++ +*
)#)*+" *+"r '--.y+ /).!+. +/+r BST
1: !8/L or 90: o*8L(
5:
ototera#i da#at di%entikan bila kadar 3S8
turun sam#ai di ba&a% ,',* mgd0 ('9
:mol0!
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KAPAN FOTOTERAPI HARUS
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KAPAN FOTOTERAPI HARUSDIHENTIKAN %%% (sambungan!
U.#- 4+y y+.! /r+=+# / RS -.#- )/-+ +*
/).!+. "p)r4*r-4.)+ /+. )-/+. /p-*+.!+.
5
;ekambu%an yang signi<kan jarang terjadi.
Pemeriksaan ulang bilirubin berdasarkan indikasiklinis.
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)+/++. *+. y+.! /3o#o#)r+p / -+ /. /+.
/p-*+.!+. )4)*- 4+y 4)r-+ 9$; "+r
2irekomendasikan untuk #emeriksaan ulang bilirubin* jam setela% di#ulangkan.
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PAPARAN SINAR MATAHARI
• S.+r +#+"+r )4)r+. r+/+ y+.!
c--p p+/+ !)*o4+.! ;25$;C5 . )4+!+
3o#o#)r+p%
• H./+r )#)rp+p+r+. .+r +#+"+r )c+r+
*+.!-.!, #)r-#++ o./ 4+y #)*+.+.!,
#)r"+/+p )-.!.+. -*# #)r4++r%
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RASIO BILIRUBIN ALBUMIN
Kopo.). #o 4*r-4. /p)rc+y+ 4)r+/+ /+*+ 3r+
4)4+ '#/+ #)r+#( /+. #/+ #)ro.-!+ './r)(
P).!--r+. +*4-. )r- )-.!.+. p).!--r+.
+p+#+ po#).+* p).!+#+. 4*r-4.
R+o 4*r-4. #o#+* +*4-. /+p+# /!-.++. )4+!+
p)/o+. #+4+"+. -.#- ).).#-+. +p++" #)r/+p+#
./+ #r+.3- #-+r
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RASIO BILIRUBIN ALBUMIN
U+ G)#+ /+. K)*opoRo
R+o B*r-4. A*4-.
9: .!!- /+. )"+# :%0
9: .!!- ")o*, A#+-
95 $$ 9C 68C /+. )"+#C%2
95 $$ 9C 68C ")o* 6%:
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6;
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TATALAKSANA 64=N2IC>
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TATALAKSANA 64=N2IC> PADA BAI KURANG BULAN
USIAB)r+# 1500 !K+/+r B*r-4.
'o*8L(
B)r+# 1500 2000!
K+/+r B*r-4.'o*8L(
B)r+# 2000!K+/+r B*r-4.
'o*8L(
2; +
Ro #.!! y+.!*+..y+ C0
Ro #.!! C0L+..y+ C0
:5
2; ;: +
:5 120 1;0
; C2 +
120 155 200
C2 + 1;0 1C0 2;0
F''!"a+i
1 !8/L V 1C%1o*8L
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TATALAKSANA 64=N2IC>
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TATALAKSANA 64=N2IC> PADA BAI KURANG BULAN
USIAB)r+# 1500 !K+/+r B*r-4.
'o*8L(
B)r+# 1500 2000!K+/+r B*r-4.
'o*8L(
B)r+# 2000!K+/+r B*r-4.
'o*8L(
2; + 1C0 255 255 2C0 $ 910
2; ;: +
1C0 255 255 2C0 $ 910
; C2 +
1C0 255 2C0 20 $ 920
C2 + 255 20 910 $ 9;0
T"a%#7*#i T*$a"
1 !8/L V 1C%1o*8L
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KESIMPULAN
• Fo#o#)r+p ++.
– )omplikasi signi?kan 9arang
• Fo#o#)r+p / r-+" +#
)+"+. 4+y /+r 4-.y+ /+.
p).-#-p +#+ 4+y #/+ /-+
or+.! #-+
C0
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Perkiraan %aktu'ahir
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Bersih dari mekonium ? Bernapas atau menangis ? Tonus otot baik ? Warna kulit kemerahan ? Cukup bulan ?
Berikan kehangatan Posisikan; bersihkan jalan napas* (bila perlu) Keringkan, rangsang, posisikan lagi Beri ! (bila perlu)
"#aluasi pernapasan, $rekuensi jantung, dan %arna kulit
Berikan #entilasi tekanan positi$*
Berikan &TP* 'akukan kompresi dada
Berikan epine$rin*
Tidak
pne atau + --
+ .- / .-
01 + .-
Penilaian
"#aluasi
B
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C
"#aluasi
3 0
d e t i k
3 0
d e t i k
3 0
d e t i k
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N!:b'"%R!#*#8iai
'%A'"im
M)+.) )"*+.!+. p+.+
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p+/+ 4+y 4+r- *+"r 1 Radia#i4 /+r o4) ) p+.+ 4+y &o.#o" #4+.!+. 4+y /.!.
#+.p+ +*+2% E9a+'"a#i 4 +r).+ p).!-+p+. c+r+. y+.! )*)+# p+/+ -*#%&o.#o" +r )#-4+. p+/+ #-4-" 4+y, 4+r- *+"r, #/+ c)p+#/)r.!+.%9% K'%d*$#i 4 p+.+ #-4-" /+4* o*)" -+#- p)r-++. y+.!)*)+# /#-4-"% &o.#o" p+++. 4+y y+.! 4++" #/+ c)p+# /!+.#%;% K'%9!#$i 4 p).!-+p+. /+r #-4-" ) -/+r+% &o.#o" +.!. /+r#-4-" 4+y 4+r- *+"r
APGAR S&ORE
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APGAR S&ORE
• A++!a"a%8! P).+p*+., y+.!/*"+# /+r =+r.+ -*#%
• P*#! Fr)-). /).y-# +.#-.!%
• ,"ima8!4 U+"+ 4)r.+p+ y+.!/*"+# /+r -+# *)+".y+ #+.!+.%
• A8i9i<4 A#3 +#+- #/+.y+ #o.-
o#o#%• R!#+i"a#i4 p).*++. po*+ .+p+%
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B ** /
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B+**+r/ cor)
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