ASUHAN KEBIDANAN BALITA SAKIT PADA AN. M UMUR 1 TAHUN 6 BULAN DENGAN DIARE AKUT DEHIDRASI SEDANG DI BANGSAL ANAK RSUD SURAKARTA.

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ASUHAN KEBIDANAN BALITA SAKIT PADA AN. M UMUR 1 TAHUN
6 BULAN DENGAN DIARE AKUT DEHIDRASI SEDANG
DI BANGSAL ANAK RSUD SURAKARTA

KARYA TULIS ILMIAH
Diajukan Untuk Memenuhi Sebagian Persyaratan Ujian Akhir Program
Kompetensi Bidan di Program Studi D III Kebidanan
Fakultas Kedokteran Universitas Sebelas Maret

Oleh :
Ida Permatasari
R0312083

PROGRAM STUDI D III KEBIDANAN FAKULTAS KEDOKTERAN
UNIVERSITAS SEBELAS MARET
2015
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ASUHAN KEBIDANAN BALITA SAKIT PADA AN. M UMUR 1 TAHUN
6 BULAN DENGAN DIARE AKUT DEHIDRASI SEDANG
DI BANGSAL ANAK RSUD SURAKARTA

KARYA TULIS ILMIAH
Diajukan Untuk Memenuhi Sebagian Persyaratan Ujian Akhir Program
Kompetensi Bidan di Program Studi D III Kebidanan
Fakultas Kedokteran Universitas Sebelas Maret

Oleh :
Ida Permatasari
R0312083

PROGRAM STUDI D III KEBIDANAN FAKULTAS KEDOKTERAN
UNIVERSITAS SEBELAS MARET

2015
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KATA PENGANTAR

Puji syukur kehadirat Allah SWT yang telah melimpahkan rahmat dan
hidayah-Nya sehingga penulis dapat menyelesaikan KaryaTulisIlmiahyangberjudul
“Asuhan Kebidanan Balita SakitPada An. M Umur 1 Tahun 6 BulanDengan
DiareAkutDehidrasiSedangDi Bangsal Anak RSUDSurakarta”sebagai salah satu
persyaratan ujianakhir program kompetensibidan di Program Studi Diploma III
Kebidanan Fakultas Kedokteran di Universitas Sebelas Maret Surakarta.
KaryaTulisIlmiahini

dapat

diselesaikan

dengan

lancarberkatbantuandariberbagaipihak.Olehkarenaitupenulismengucapkanterimak
asih kepada Bapak/Ibu:
1. Dr. H. Soetrisno, dr, Sp. OG (K),ketua Program Studi Diploma III Kebidanan
Fakultas Kedokteran Universitas Sebelas Maret Surakarta.

2. Hardiningsih,

S.ST.,

M.Kes,

sebagaipembimbing

utama

yang

selalumembimbingdanmemberikan saran sertailmunya.
3. Erindra Budi C, S. Kep, Ns, M. Kes, sebagaipembimbing pendamping yang
selalumembimbingdanmemberikan saran sertailmunya.
4. Fresthy Astrika Y., S. ST, M. Kes, selaku penguji KTI yang telah memberikan
saran dan ilmunya.
5. Dosen pengajar dan staf Progam Studi D III Kebidanan Fakultas Kedokteran
Universitas Sebelas Maret.
6. Direktur RSUD Surakartabeserta staf yang telah memberikan izin dalam

pengambilan data pendukung Karya Tulis Ilmiah.
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7. Bapak,ibu, dankakak tercinta terima kasih selalu mendoakan dan memberikan
kasih sayang, bimbingan, semangat, dukungan moral maupun materi.
8. Teman-teman Mahasiswa D III Kebidanan Fakultas Kedokteran Universitas
Sebelas Maret angkatan 2012 yang selalu mendukung dan membantu dalam
setiap permasalahan dalam penyelesaian Karya Tulis ini.
9. Keluarga balita An. Mataskerelaannya menjadi responden dalam penyusunan
karya tulis ilmiah ini.
10. Serta semua pihak yang tidak dapat penulis sebutkan satu per satuyang telah
membantu dan memberi dukungan demi lancarnya penulisan karya tulis ilmiah ini.
Penulis menyadari keterbatasan dalam penyusunan Karya Tulis Ilmiah ini,
sehingga saran, kritik dan petunjuk yang membangun dari berbagai pihak sangat
penulis harapkan. Semoga KaryaTulisIlmiahini dapat memberikan manfaat bagi

semua pihak.

Surakarta,Mei 2015

Penulis

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ABSTRAK
IDA PERMATASARI. R0312083. ASUHAN KEBIDANAN BALITA SAKIT
PADA AN.M UMUR 1 TAHUN 6 BULAN DENGAN DIARE AKUT
DEHIDRASI
SEDANG
DI
BANGSAL

ANAK
RSUD
SURAKARTA.Program
Studi
D
IIIKebidananFakultasKedokteran
Universitas Sebelas Maret.
Latar
Belakang
:Angkamorbiditasdanmortalitasakibatdiarelebihkurang
80%terjadipadaanakkurangdariduatahun.Di
RSUD
Surakartaanak
yang
diaresebesar6,96%.
Tujuan:Untukmempelajaridanmemahamiasuhankebidananpadakasusdiareakutdeh
idrasisedangdi RSUD Surakarta secarakomprehensif.
Metode:Observasionaldeskriptifdenganpendekatanstudikasus. Subjek penelitian
An. M dengan diare akutdehidrasi sedang. Tempat : RSUD Surakarta.Cara
pengambilan data melalui wawancara, observasi langsung dan studi dokumen

rekam medik. Analisis data dilakukan secara deskriptif berdasar 7 langkah
Varney.
Hasil : An.M umur 1 tahun 6bulandatang dengan keluhan BAB cair kurang lebih
10 kali. Telah diberikan cairanelektrolit, antibiotik,antipiretik, antiemetik,
analgesik,danobatsaluran
cerna.Anaktelahtercukupikebutuhanhidrasinyadankondisimembaik.Kesenjangan
berupapemberianantibiotikdanantiemetikpadaanak, sertatidak dilakukanobservasi
output/intake cairan.
Kesimpulan : An.Mumur 1 tahun 6bulandengandiareakutdehidrasisedang.
Setelah dilakukan perawatan selama 4 hari, tinja anak sudah tidak cair, perut tidak
kembung, status hidrasi baik, dan turgor baik.Tidak dilakukanobservasi
output/intake cairan sertadiberikannyaantibiotikdanantiemetik.

Kata Kunci : Asuhan Kebidanan, Diare Akut, Dehidrasi Sedang

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ABSTRACT
IDA PERMATASARI. R0312083. MIDWIFERY CARE OF AN ILL
TODDLER ON CHILD M AGED 1 YEAR AND 6 MONTHS WITH
ACUTE DIARRHEA AND MODERATE DEHYDRATION AT
PEDIATRIC WARD OF THE LOCAL GENERAL HOSPITAL OF
SURAKARTA. The study Program of Diploma III in Midwifery Science, the
Faculty of Medicine, SebelasMaret University.
Background: The percentage mortality and morbidity of toddlers aged less than
two years due to diarrhea was approximately 80%. At the aforementioned
hospital, the percentage of toddlers suffering from diarrhea was 6.96%.
Objective:To study and understand the midwifery care on the acute diarrhea and
moderate dehydration comprehensively.
Method:This research used the observational descriptive research method with
the case study approach. Its subject was Baby M with acute diarrhea and moderate
dehydration. The data of research were collected through in-depth interview,
direct observation, and content analysis of medical record and descriptively
analyzed by using Varney’s Seven Steps.

Result:Baby M had loose stools for approximately 10 times. The client was given
electrolyte, antibiotic, antipyretic, antiemetic, analgesic, and gastrointestinal
medicines. Following the treatment, the hydration was resolved, and the condition
of the client was good. However, gaps were found that the administration of
antibiotic and antiemetic therapies were not inappropriate, and observation on the
fluid outputs and intakes was not done.
Conclusion: Following the four days of treatment, the loose stools were not
present, the stomach was not bloated, the hydration status and the turgor were
good.

Keywords: Midwifery care, acute diarrhea, moderate dehydration

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ABSTRACT
IDA PERMATASARI. R0312083. MIDWIFERY CARE OF AN ILL
TODDLER ON CHILD M AGED 1 YEAR AND 6 MONTHS WITH
ACUTE DIARRHEA AND MODERATE DEHYDRATION AT
PEDIATRIC WARD OF THE LOCAL GENERAL HOSPITAL OF
SURAKARTA. The study Program of Diploma III in Midwifery Science, the
Faculty of Medicine, SebelasMaret University, Surakarta 2015.
Background: The percentage mortality and morbidity of toddlers aged less than
two years due to diarrhea was approximately 80%. At theLocal General Hospital
of Surakarta, the percentage of toddlers suffering from diarrhea was 6.96%.
Objective: The objective of this research is to study and understand the midwifery
care on the acute diarrhea and moderate dehydration at theLocal General Hospital
of Surakarta comprehensively.
Method:This research used the observational descriptive research method with
the case study approach. The subject of research was Baby M with acute diarrhea
and moderate dehydration. The research was done at theLocal General Hospital of
Surakarta. The data of research were collected through in-depth interview, direct
observation, and content analysis of medical record. The data of research were
descriptively analyzed by using Varney’s Seven Steps.
Result: BabyM aged one year and six months was admitted to the hospital. The
client had loose stools for approximately 10 times. The client was given
electrolyte, antibiotic anti pyretic, anti emetic, analgesic, and gastrointestinal
medicines. Following the treatment, the hydration was resolved, and the condition
of the client was good. However, gaps were found that the administration of anti
biotic and anti emetic therapieswas not in appropriate, and observation on the
fluid outputs and intakes was not done.
Conclusion: Child M aged one year and six monthssuffered from acute diarrhea
and moderate dehydration. Following the four days of treatment, the loose stools
were not present, and the stomach was not bloated, the hydration status was good,
and the turgor was good. Yet, gaps were found that observation on the fluid
outputs and intakes was not done, and the administration of anti biotic and anti
emetic medicines was not in appropriate.
Keywords: Midwifery care, acute diarrhea, moderate dehydration

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DAFTAR ISI

HALAMAN JUDUL ...................................................................................

i

HALAMAN PERSETUJUAN ...................................................................

ii

HALAMAN PENGESAHAN.....................................................................

iii

KATA PENGANTAR.................................................................................

iv

ABSTRAK................................... ................................................................

vi

ABSTRACT................................... ...............................................................

vii

DAFTAR ISI................................................................................................

viii

DAFTAR TABEL .......................................................................................

xi

DAFTAR GAMBAR...................................................................................

xii

DAFTAR LAMPIRAN ...............................................................................

xiii

BAB I.

PENDAHULUAN .......................................................................

1

A. Latar Belakang ........................................................................

1

B. Perumusan Masalah .................................................................

3

C. Tujuan ......................................................................................

3

D. Manfaat ....................................................................................

5

BAB II. TINJAUAN PUSTAKA................................................................ 7
A. TeoriMedis ............................................................................

7

1. Balita ...............................................................................

7

a. Pengertian .................................................................

7

b. PertumbuhandanPerkembangan................................

7

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2. Diare................................................................................

8

a. Pengertian .................................................................

8

b. Etiologi......................................................................

9

c. Patofisiologi ..............................................................

11

d. FaktorPredisposisi.....................................................

15

e. FaktorResiko .............................................................

16

f. TandaKlinis/Laboratori.............................................

16

g. Prognosis...................................................................

18

h. PenatalaksanaanDiare ...............................................

19

1) PenggantianCairan (Rehidrasi) ...........................

19

2) TerapiDietetik .....................................................

21

3) TerapiFarmakologi..............................................

23

B. TeoriManajemenKebidanan..................................................

27

1. Penerapan 7 Langkah Varney..........................................

27

2. Follow Up Data PerkembanganKondisiKlien ................

35

BAB III. METODE PENELITIAN STUDI KASUS ..............................

38

A. Jenis Penelitian......................................................................

38

B. Tempat dan Waktu Penelitian ...............................................

38

C. Subyek Penelitian..................................................................

38

D. Jenis Data ..............................................................................

38

E. Teknik Pengambilan Data.....................................................

39

F.

Analisis Data .........................................................................

40

G. Jadwal Pelaksanaan...............................................................
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BAB IV.HASIL PENELITIAN DAN PEMBAHASAN ..........................

41

A. Hasil Penelitian .....................................................................

41

B. Pembahasan...........................................................................

51

PENUTUP...................................................................................

62

A. Kesimpulan ...........................................................................

62

B. Saran .....................................................................................

64

DAFTAR PUSTAKA..................................................................................

65

BAP V.

LAMPIRAN

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DAFTAR TABEL

Tabel 2.1Derajatdehidrasiberdasarkan MTBS ..............................................

13

Tabel2.2Jumlahpemberianoralit....................................................................

20

Tabel 2.3Jumlahpemberiancairanintravena...................................................

21

Tabel 2.4 Antibiotikuntukdisentriberdasarkan MTBS..................................

24

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DAFTAR GAMBAR

Gambar 2.1 Pathwaydiare.............................................................................

12

Gambar 2.2 Skemapenatalaksanaandiare......................................................

26

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DAFTAR LAMPIRAN

Lampiran 1

: JadwalKegiatanStudiKasus

Lampiran 2

: LembarPermohonan Responden

Lampiran 3

: LembarPersetujuan Responden

Lampiran 4

: AsuhanKebidanandan SOAP

Lampiran 5

: TabelHasilPemeriksaanLaboratorium

Lampiran 6

: TabelHasilObservasi

Lampiran7

: SAP Diare

Lampiran 8

: ProsedurPengukuranNadi

Lampiran 9

: ProsedurPengukuranPernapasan

Lampiran 10 : ProsedurPengukuranSuhu
Lampiran 11 : ProsedurMenyiapkanObatSuntikandari Vial
Lampiran 12 : ProsedurPemasanganInfus
Lampiran 13 : ProsedurInjeksiIntravena
Lampiran 14 : ProsedurMemandikan
Lampiran 15 : Lembar Surat IjinPengambilan Data di RSUD Surakarta
Lampiran 16 : Lembar Surat IjinPengambilan Data di DKK Surakartauntuk
Kesbangpol
Lampiran 17 : Lembar Surat IjinPengambilan Data di DKK Surakartauntuk
Bappeda
Lampiran 18 : Lembar Surat IjinPengambilan Data di DKK Surakartauntuk
DinkesSurakarta

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Lampiran 19 : LembarKonsultasi KTI PembimbingUtama
Lampiran 20 : LembarKonsultasi KTI PembimbingPendamping

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