Asuhan Keperawatan Pada Tn. R Dengan Diagnosis AF NVR DM type II SSI o/t Sternotomy Wound di Rumah Sakit Adam Malik

Ria Apriliani Waruwu, Mula Tarigan, Dina Afriani

Abstract

Background: Non-Valvular Atrial Fibrillation (NVR AF) and Type II Diabetes Mellitus (DM) are two comorbidities that often worsen postoperative outcomes in post sternotomy patients, especially in Coronary Artery Bypass Graft (CABG) cases. Poor glycemic control characterized by high HbA1C inhibits the wound healing process and increases the risk of surgical wound infection (SSI). Post sternotomy pain is the main complaint of patients, which requires a multidisciplinary approach for optimal pain management and wound care. Objective: This study aims to analyze the effectiveness of rhythmic breathing (RB) therapy as a nonpharmacological modality in reducing pain intensity in post sternotomy patients with comorbidities of AF NVR and Type II DM. Methods:This study used a case report design on a 66-year-old male patient with a diagnosis of AF NVR, Type II DM, and poor glycemic control (HbA1C 9.6%). The patient experienced postoperative sternotomy pain with an intensity of NRS 7. RB intervention was performed twice a day for three consecutive days. Data was measured through Numeric Rating Scale (NRS) to assess changes in pain intensity before and after intervention. Results: After three days of intervention, the patient's pain intensity decreased from NRS 7 to NRS 1. The surgical wound showed signs of improvement without systemic infection. These results suggest that RB is effective as an adjunctive therapy in the management of post sternotomy pain. Conclusion: Rhythmic breathing therapy is effective in reducing post sternotomy pain intensity and can be part of standard nursing interventions in postoperative patients with complex comorbidities. Patient education 

Keywords

Post sternotomy pain, rhythmic breathing, AF NVR, Type II DM, CABG, case report.

Full Text:

PDF

References

Anantasari. (2021). Efektivitas Distraksi Musik Dan Distraksi Pernapasan Ritmik Terhadap Nyeri Persalinan Pada Ibu Bersalin Kala I Di Kamar Bersalin Rs Ben Mari Pakisaji Kabupaten Malang. Hospital Majapahit, 13(2), 20–30.

Babamohamadi, H., Karkeabadi, M., & Ebrahimian, A. (2021). The Effect of Rhythmic Breathing on the Severity of Sternotomy Pain after Coronary Artery Bypass Graft Surgery : A Randomized Controlled Clinical Trial. 2021.

C, Mau1, R., Tahu, S. K., & Muskananfola, I. L. 3. (2021). CHM-K Applied Scientific Journal PENGARUH TEKNIK DISTRAKSI NAPAS RITMIK DAN MASASE TERHADAP NYERI SPASME OTOT PADA KEJADIAN LOW BACK PAIN PEKERJA BURUH BONGKAR MUAT DI PELABUHAN TENAU KUPANG.

Chen, D., Zhang, J., Wang, Y., Jiang, W., Xu, Y., Xiong, C., Feng, Z., Han, Y., & Chen, Y. (2024). Risk factors for sternal wound infection after open-heart operations: A systematic review and meta-analysis. International Wound Journal, 21(3), 1–22. https://doi.org/10.1111/iwj.14457

Iklima, N., & Maulana, D. L. (2018). Terapi Dingin Pada Nyeri Sternotomy Paien Post Coronary Arthery Bypass Graft. Jurnal Ilmu KKeperawatan, 6(2), 130–135. https://ejournal.bsi.ac.id/ejurnal/index.php/jk/article/view/4121

Jafari, H., Gholamrezaei, A., Franssen, M., Van Oudenhove, L., Aziz, Q., Van den Bergh, O., Vlaeyen, J. W. S., & Van Diest, I. (2020). Can Slow Deep Breathing Reduce Pain? An Experimental Study Exploring Mechanisms. Journal of Pain, 21(9–10), 1018–1030. https://doi.org/10.1016/j.jpain.2019.12.010

Oktaviani, A. T., Kusumajaya, H., & Agustiani, S. (2022). Faktor-faktor yang mempengaruhi penyembuhan luka post operasi. Jurnal Penelitian Perawat Profesional, 5(4), 1703–1712.

Rahmatun, V., & Heru, W. (2020). Penerapan Tehnik Distraksi Nafas Ritmik Untuk Menurunkan Nyeri Pada Pasien Post Apendiktomi. Jurnal Manajemen Asuhan Keperawatan, 4(1), 43–52. https://doi.org/10.33655/mak.v4i1.81

Riska, A., & Febri Ayu, A. (2020). Penerapan Tehnik Distraksi Nafas Ritmik Dalam Penangganan Manajemen Nyeri Pada Pasien Post Operasi Apendisitis. Jurnal.Akimba.Ac.Id, 5, 1–10. http://jurnal.akimba.ac.id/index.php/juka/article/view/40

Van Gelder, I. C., Rienstra, M., Bunting, K. V, Casado-Arroyo, R., Caso, V., Crijns, H. J. G. M., De Potter, T. J. R., Dwight, J., Guasti, L., Hanke, T., Jaarsma, T., Lettino, M., Løchen, M.-L., Lumbers, R. T., Maesen, B., Mølgaard, I., Rosano, G. M. C., Sanders, P., Schnabel, R. B., … Sarkozy, A. (2024). 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal, 3314–3414. https://doi.org/10.1093/eurheartj/ehae176

DOI: https://doi.org/10.5281/zenodo.14292264

Refbacks

  • There are currently no refbacks.